Republicans should slow down, write a better bill, and build the political support they need.
It feels like 2009 all over again.
Eight years ago, a new president was in the White House, flanked by friendly congressional majorities and eyeing an overhaul of the American health-care system. That president and Congress intended to provide universal health-insurance coverage, by hook or by crook. Closed-door negotiations, procedural machinations, and veritable bribes (such as the infamous “Cornhusker Kickback,” “the Louisiana Purchase,” and the “Omaha Stakes”) ultimately put the Affordable Care Act on Barack Obama’s desk. He signed it on March 23, 2010, and ushered in seven years of mayhem: soaring premiums, the withdrawal of major insurers, the de facto collapse of the individual insurance market, and more.
Now, Republicans are rushing to repeat Democrats’ mistakes.
The Freaky Friday remake that Washington, D.C., is currently performing is not difficult to spot. Start with the sudden declarations of urgency. Speaker Paul Ryan insists that Republicans have no choice but to embrace the House GOP’s Obamacare-reform bill, the American Health Care Act. “This is the closest we will ever get to repealing and replacing Obamacare,” Ryan said earlier this month. “The time is here. The time is now. This is the moment.”
In his 2009 address to a joint session of Congress, a newly inaugurated President Obama was similarly definitive: “Let there be no doubt: Health-care reform cannot wait, it must not wait, and it will not wait another year.”
Obama’s urgency was misplaced, and Ryan’s is, too. There was time for the GOP to craft a strong alternative, to roll it out methodically, and to build support. But a mad rush is now on to push the American Health Care Act through Congress. Republicans unveiled the bill just over two weeks ago, and aim to vote it out of the House on Thursday. Senate leadership, despite firm opposition from several Republican senators, aims to force the legislation through its chamber next week, according to a recent report from Politico. The GOP hopes that the whole process will be wrapped up by Easter.
Democrats famously pushed Obamacare legislation to the president’s desk, thanks to maneuvering by then-Senate majority leader Harry Reid and to the budget-reconciliation process. Reid gave his chamber six days to debate the final version of the Senate bill, and most senators admitted that they didn’t even attempt to read all 2,700 pages. (Max Baucus suggested that doing so would be a “waste of time,” because the details were too complex for anyone but experts.)
But, as the Washington Examiner’s Philip Klein quipped on Twitter: “Obamacare was passed at the pace of Zootopia DMV sloths compared to this AHCA attempt.”
There is something to be said for political momentum — except that it’s not clear how much momentum Republicans have any more. For several years, there has been party-wide agreement that Obamacare needs to be gutted, but this ill-conceived effort has sapped much of that energy. A Politico/Morning Consult poll released on Wednesday morning showed that 41 percent of respondents approve of the AHCA, compared with 38 percent who disapprove. Approval has dropped slightly, and disapproval has risen since last week. These findings should not be over-interpreted — one in five respondents had no opinion of the bill — but even Republican support is tepid. Only 62 percent of Republicans are behind the bill. The AHCA probably does not threaten to galvanize a left-wing “Tea Party,” but Republicans seem oblivious to the dangers that can accrue to a party that pushes through large-scale legislation with only lackluster political support.
Republicans seem oblivious to the dangers that can accrue to a party that pushes through large-scale legislation with only lackluster political support.
Finally, Republicans, despite promises of a “three-phase” legislative strategy, seem to be under the impression that they are about to wrap up our interminable health-care tussle. “There is no Plan B,” White House spokesman Sean Spicer said on Wednesday, asked about reports that the AHCA lacks the requisite votes in the House and Senate. “There is Plan A, and there’s Plan A. We’re going to get this done.” Perhaps. But even if the AHCA is signed, health-care reform — according to the White House’s own plan — will not be “done.” Yet increasingly Republicans seem to think they are about to put a bow on the entire health-care debate.
And in that, too, they are sounding like Democrats: Just before the Obamacare exchanges opened for enrollment, in the fall of 2013, President Obama told a Maryland crowd: “We’re now only five days away from finishing the job.” Of course, Obamacare didn’t “finish the job” of reforming the nation’s health-care system (or even of providing universal coverage), and neither will Republicans’ plan. Nor will it free them from the political tangles of health-care policy. The remedy of at least one Republican senator, speaking anonymously to Politico this week, is to abandon the issue altogether: “Maybe the best outcome is for this to fail in the House so we can move on to tax reform. Which is what we should have done anyway.”
Memories are short, especially in politics. For seven years, Republicans have been railing — rightly — against Democrats’ health-care boondoggle. But now, finally in a position to clean up some of that mess, they are repeating many of Democrats’ mistakes.
When the means are so dispiriting, can the ends be much better?