If Republicans are going to try to repeal Obamacare, they should go all the way. Otherwise, don’t even start.
Poet and novelist Charles Bukowski once said, “If you’re going to try, go all the way. Otherwise, don’t even start.”
Speaker of the House Paul Ryan, R-Wis., and House Republican leaders could have learned from this pearl of wisdom. Unfortunately, they are trying to ram through the House a bill — the so-called American Health Care Act — that falls far short of their frequent and many campaign promises to repeal Obamacare and create free-market reforms that would lead to greater competition and choice, with lower costs. Those were campaign promises that, by the way, helped Republicans win the House in 2010, the Senate in 2014, and the White House in 2016.
In January 2016, after President Obama vetoed an Obamacare repeal bill that had overwhelming Republican support, Ryan made it clear that the baseline for repeal had been drawn. “We have shown now that there is a clear path to repealing Obamacare without 60 votes in the Senate,” he declared. “So, next year, if we’re sending this bill to a Republican president, it will get signed into law.”
Conservative activists — who have been fighting for years to repeal Obamacare and supporting conservative candidates who got elected on pledges to scrap the 2010 law — will accept nothing less than a bill that follows through on these promises. Just as important are Americans who have seen their premiums skyrocket because of Obamacare. They are looking for relief.
House Republicans now have that opportunity to produce a strong repeal of Obamacare and its onerous regulations, and institute free-market reforms. They shouldn’t let themselves be bound by narrow interpretations of Senate rules.
Unfortunately, the American Health Care Act fails to follow through on Republican promises. The bill effectively preserves Obamacare, leaving the cost-driving provisions in place. As one conservative member of the House put it, the American Health Care Act “is an amendment — and not a clean repeal — to Obamacare.”
While the American Health Care Act includes various reforms, including the per capita funding of Medicaid funds, the repeal of Obamacare taxes, and the expansion of Health Savings Accounts, the bill replaces Obamacare’s market-distorting subsidies with a Republican version, all while leaving the law’s costly, market-destroying regulatory architecture in place. The bill also creates a “doc fix”-style scenario in which repeal of Obamacare’s Medicaid expansion will never actually happen.
Conservatives inside and outside of Congress are told that Obamacare’s regulations and the establishment of free-market healthcare policies will be addressed in a second and third “phase,” but history tells us otherwise.
Obamacare may have given the Department of Health and Human Services tremendous regulatory power, but HHS Secretary Tom Price, who now serves in this crucial role and is tasked with carrying out the elimination of Obamacare’s regulations, will almost certainly face legal challenges. That means any break in the burden of skyrocketing health insurance costs will be delayed even further. Another obvious concern is that any administrative actions can be undone by the next administration, making the relief only temporary if Congress doesn’t eliminate the federal government’s power over these aspects of our healthcare system.
The supposed third phase of this effort — the free-market reforms that President Trump campaigned on — relies on the mythical notion that Republicans will get 60 votes in the Senate. Good policies, like the buying and selling of health insurance across state lines, won’t stand a chance because Senate Democrats will want to leave Republicans with healthcare reform fully in their laps. Sadly, the rhetoric from House Republican leaders about this particular phase just doesn’t match reality.
When the latest Obamacare repeal effort began in January, conservatives were repeatedly told that the 2015-2016 repeal bill, the Restoring Americans’ Healthcare Freedom Reconciliation Act, would be the baseline. Based on their own promises, we all hoped that Republican leaders would finally stop negotiating with themselves and go further this time around, knowing that we could send to a Republican president’s desk an even better bill that would actually drive down premiums.
Instead, Ryan is playing Lucy to the conservatives’ Charlie Brown. House Republican leaders are resorting to arm-twisting tactics and backroom deals to get the votes they need to pass the American Health Care Act.
Republican leaders have lost sight of their campaign promises to make health insurance coverage more affordable for the American people, but conservative activists and voters will judge Republicans on whether they fulfilled their campaign promises.
The American people, including Independents and Democrats that voted for Trump, will judge Republicans on whether they stopped Obamacare’s death spiral of premium hikes and reduced choices for average Americans.
The American Health Care Act fails that test.
Contrary to what we hear from Republican leaders, the bill is bad policy that will lead to bad politics for Republicans at the ballot box in November 2018, and it will be well deserved.
Adam Brandon (@adam_brandon) is a contributor to the Washington Examiner’s Beltway Confidential blog and the president of FreedomWorks. Ken Cuccinelli (@KenCuccinelli) is the president of the Senate Conservatives Fund. Mike Needham (@MikeNeedham) is the CEO of Heritage Action for America. David McIntosh is the president of the Club for Growth.