HealthCare Reform

The House republicans have put out their plan to repeal and replace the Affordable Care Act.  Good for them.  It’s only taken 7 years of complaining about it to finally actually offer a replacement, not just a repeal.  But they’re quickly running into problems, and it isn’t hard to see why.

The reason it’s so hard to replace the ACA with a more conservative version is that the ACA is already the conservative version of healthcare reform.  You can’t really get more conservative than the policies of the ACA at all.  The only alternative is to do nothing whatsoever.  That puts us in the fairly bizarre world where the new plan is largely the same as the old plan, just less generous.  The most conservative members of the House of Representatives are trying to put forward a bill that just repeals, but doesn’t replace, much the same as the dozens of similar ones they put forward during the Obama years.  This is making some people believe that maybe the republicans won’t be able to pass an alternative at all.  This is silly.

Let’s be clear.  Sooner or later, enough republicans will fall into line and vote for whatever Obamacare-lite plan that comes to the floor.  Then it will go to the Senate, and things will get more interesting.  The best strategy for the republicans is to pass whatever plan they can in the House, then pass it over to the Senate, where democrats will filibuster it.  That way they can get away with saying that they tried to pass reform, but those darned old democrats just won’t do their jobs.  The worst case scenario for them is that three or four republican senators vote against as well, a possibility which may happen.  If that happens then the dominant narrative will be that not only is the White House a cesspool of chaos and incompetence, Congress is too.  Despite the fact that republicans control two out of three of the branches of government, they still can’t keep their campaign promises.  And if they do hold firm and no republican votes out of line, then one of two things will happen.  The democrats will fillibuster and give the republicans an easy enemy to blame, or a few democrats will side with the republicans and get it passed, in which case the democrats will be blamed for any bad things that happen as a result of the law, and will be further punished by their voters.  

We do need to pay attention to what the House of Representatives eventually passes.  Not only is it our civic duty, it’s important to see what the story emerges surrounding it.  Whatever story comes up, be it that the democrats are refusing to govern, the republicans are incompetent, or that Trump is finally starting to become a president and pass laws, that story is going to start to define the political world for the next two years.  Currently the first chapter of this story is that the republicans are incompetent.  It wouldn’t surprise me at all if that story continues, but stranger things have happened.


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