I’ve been pondering last week’s GOP health care train wreck for a few days. Here are a few thoughts I have on the matter, in no particular order:

I’ll start with a question: What were President Donald Trump and Speaker Paul Ryan thinking when they attempted to replace Obamacare quickly? It’s one thing to just repeal Obamacare, but it was quite another to replace it with something. That might take a little time to hammer out wouldn’t you think? Sure, the Republicans have had a lot of years to consider it and there were several plans already drawn up, but to get a majority of Republicans on board with a single plan (as they found out) was not a quick and easy enterprise. Artificially scheduling a vote on the anniversary of Obamacare being passed into law was a really bad idea. These guys needed to take their time and get it right. They needed to forget the optics for a moment and think about what we, the American people, needed, and that was something other than something half-baked.

I understand the political realities that may necessitate getting new legislation passed through reconciliation. It just strikes me as ludicrous that we would be repealing, reworking, or replacing arguably the most important piece of legislation in my lifetime within the restrictions of the reconciliation process.

I was surprised (shocked, really) when the House bill did not include a provision making it legal for insurance companies to sell across state lines, something the GOP has been talking about for decades. Senator Lindsay Graham said in mid-March that getting 60 votes for that in the Senate was a “fantasy”. Perhaps he’s right, but if that’s so the American people need to know why it’s a fantasy and who to hold accountable.

One has to ask if the Freedom Caucus was surprised when, among other things, the coverage for pre-existing conditions was left in the House bill. They shouldn’t have been. All I heard over the last several years is how popular that coverage was, even among Republicans. I remember Sam Clovis saying he was in favor of it in spite of its expense, and that was when he was campaigning for a Senate nomination back in 2014. It may be an economic black hole, but people want it anyway. As my friend Erik Charter observed when the House health care vote was cancelled, “Republicans confirmed yesterday that once an entitlement is in place it is politically impossible to take it away.”

A number of Republicans, Senator Graham included, are suggesting that the best course of action will be to simply let Obamacare collapse. I don’t think that’s such a good idea. The Democrats (and a sympathetic media) will find a way to blame the Republicans for the demise of Obamacare. Everything would have been fine, they’ll say, if the Republicans simply would have worked together with the Democrats to fix Obamacare. Instead, they’ll allege confidently, the Republicans were bent on destroying Obama’s signature legislation. You can bet the old accusation of race-motivated hate for Obama will be brought up by somebody.

I hope I am wrong, but I’m not particularly optimistic that this whole business will end well.

  1. “Sure, the Republicans have had a lot of years to consider it and there were several plans already drawn up, but…”

    Plans which have not be widely shared and none of which would provide the necessary replacement. Working out the issues of healthcare requires a level of maturity and common purpose most of the GOP lacks. There is a clinging to dogma and historical ideology that needs to be set aside. In the current environment, there has to be work across the aisle. The Freedom Caucus needs to be ignored because they’ll never contribute substantially to progress.

  2. The Republicans had 7 years to come up with a plan to replace the ACA. I guess they were too busy to plan but not to complain. And don’t cancel coverage for those who have it now. Letting the ACA collapse is a crazy idea as it would simply leave a huge mess they would have to clean up in a hurry. Hurry is not good in this case.

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