This weekend’s coverage of the health-care debacle was interesting. The newspapers have been full of articles about who is to blame for the failure of the Republican bill in the House: President Trump, Speaker Ryan, the Freedom Caucus (or the son-in-law, Gary Cohn, or Reince Priebus). Ignoring that its members voted for an Obamacare repeal bill many times in the past, the Freedom Caucus is getting the brunt of the blame. As Washington Examiner’s Philip Klein writes:
They are being blamed for making the naive mistake of assuming that Republicans wanted to do what they were promising to do for seven years.
In this case, the hardliners were playing a productive role by pointing out the real policy consequences of the piecemeal approach being pursued by the House leadership. Though we’ll never know for sure how the numbers might have looked if a vote had taken place, it’s clear that many centrist members of the Republican caucus were also prepared to vote this bill down. House conservatives, if they could be blamed for anything, it’s for having the audacity to urge leadership to actually honor seven years of pledges to voters to repeal Obamacare. If anybody was moving the goal posts, it wasn’t Freedom Caucusers, it was those who were trying to sell a bill that kept much of Obamacare’s regulatory architecture in place as a free market repeal and replace plan.
That being said, the debate largely ignores two key points.
First, by focusing on the politics of who is to blame, the policy dimension of the bill’s failure is mostly ignored. Maybe that’s not all that surprising since Speaker Ryan, who has a reputation of being a policy guy, delivered a bill that was driven by politics and got a lot of the policy wrong. But let’s face it, as Klein mentioned in his article, the bill just wasn’t a good bill. It wasn’t a conservative or a free-market bill, either. Sure it had some merits — which isn’t saying much considering that Republicans had been supposedly working on this for seven years — but overall it had serious and lethal problems. As such, the blame should fall on those who put out a bad bill not on those who prevented it from going through the House. Again, I like how Klein puts it:
Sure, I know, Republicans had a narrow majority, and they could only pass something through the Senate by reconciliation, which imposes limitations. But the thing is, Republicans don’t hide behind the vagaries of Senate procedure during campaign season. Trump did not win the Republican nomination telling rallies of thousands of people, “We’re going to repeal and replace Obamacare — as long as it satisfies the Byrd rule in the judgment of the Senate parliamentarian!”
What’s so utterly disgraceful, is not just that Republicans failed so miserably, but that they barely tried, raising questions about whether they ever actually wanted to repeal Obamacare in the first place.
That’s correct. It also seems that the bullying tactics used to try to force the bill through were counter-productive. And leaving aside the fact that Republicans had seven years to be ready, one can also ask why this shouldn’t be viewed as a great opportunity to go back to the drawing board and get it right. There is no doubt that Obamacare needs to go, and doing nothing seems like the worst possible option.
Second, absent from the conversation is the fact that it was less than likely that this bill would have survived in the Senate. As such, talk about how it is a disaster that the bill was pulled in the House ignores its potential failure in the upper chamber and overstates the opportunity cost of its failure in the House.
I hope Republicans will learn a lesson or two from this experience: If your end goal is to improve health-care policy, start with health-care policies that will actually improve health care. If you promised to repeal Obamacare for seven years, repeal Obamacare.