The Obamacare repeal effort was already in unstable condition. Now its status must be downgraded to critical – and completely unserious.
After years of Republican yammering about the urgent need to repeal the Affordable Care Act and months of fruitless pursuit of an alternative, President Trump now says he may not unveil a replacement this year at all. And from Capitol Hill comes new word that Republicans aren’t even talking about a plan.
“To be honest, there’s not any real discussion taking place right now,” Sen. Bob Corker (R-Tenn.) told reporters Tuesday at the Capitol. Corker, according to the Huffington Post, said he has “no idea” when Republicans might start drafting an alternative to Obamacare, adding, “I don’t see any congealing around ideas yet.”
For seven years, opponents of the Affordable Care Act vowed to make its repeal their top concern, warning that the law would turn America overnight into a socialist dystopia. Now these opponents have unfettered control of the government and they aren’t even talking about repealing.
On Nov. 1, a week before the election, Trump gave a speech pledging “to immediately repeal and replace Obamacare.”
But in his weekend interview with Fox News’s Bill O'Reilly, Trump said that “maybe it'll take till sometime into next year” for his administration to unveil a new health-care plan. It is, the president said, “very complicated.”
So complicated, in fact, that he apparently wants nothing to do with it. At Trump’s meeting with congressional leadership, Trump told the lawmakers Obamacare would be replaced with something better, and then he turned to House Speaker Paul Ryan, R-Wis. “And Paul’s going to fill in the details. Right, Paul?”
A secret recording of Republican lawmakers’ Obama-repeal talks late last month revealed angst and uncertainty about how to proceed and a great deal of worry that they would be blamed for whatever went wrong in the health-care market. Corker, in his talk with reporters this week, said that “you would have heard more of the same” in other meetings that weren’t recorded.
What Republicans don’t seem to have come to terms with is that, as a political matter, they already will be held responsible for whatever happens to health-care markets, even if they don’t introduce a replacement soon. An executive order Trump signed relaxing enforcement of Obamacare, and the constant talk of repeal, have injected a debilitating uncertainty into the health-care market – essentially beginning the unraveling of Obamacare with nothing to replace it.
The executive order Trump signed directed federal agencies to do what they could to “minimize” the burdens of the act by exercising their authority “to waive, defer, grant exemptions from or delay” parts of the law. Insurers have warned that the uncertainty is deterring them from participating in Obamacare. The head of Anthem told Wall Street analysts that he would be deciding about “extracting” his company from health-care exchanges if it doesn’t see stability.
This means that Republicans, while waiting for their alternative to “congeal,” have already set in motion the disintegration of the current health-insurance market. “It’s worse than the dog who caught the car,” said Jesse Ferguson, a strategist advising Democrats on health care. “It’s the dog who somehow is now driving the car.”
That would explain the series of erratic maneuvers we’ve seen from GOP lawmakers lately.
Take Sen. Ron Johnson, R-Wis., who in 2011 called Obamacare “the single greatest assault on our freedom in my lifetime. It will destroy our health-care system. … It must be repealed.”
Now Johnson has shed the hysteria. “Let’s start working with Democrats,” he said on CNBC. “Let’s transition to a system that will actually work, that, you know, Democrats are talking about. … It’s way more complex than simply repeal and replace.”
Then there’s Rep. Tom McClintock, R-Calif. In 2014, he proclaimed that Obamacare’s “damage cannot now be undone by delaying it or tinkering with it – it must be repealed and replaced with the patient-centered plan proposed by House Republicans.”
These days he’s not so bold. “We’d better be sure that we’re prepared to live with the market we’ve created,” McClintock said in the recorded session with Republicans. “That’s going to be called Trumpcare. Republicans will own that lock, stock and barrel, and we'll be judged in the election less than two years away.”
Or sooner. Arguably, Republicans already own the instability in the health-care system that their inaction has caused. Now that Trump is talking about delaying a health-care rollout for another year and Republican legislators aren’t even talking about an Obamacare alternative, it’s becoming clear what “Trumpcare” will look like: chaos.
Follow Dana Milbank on Twitter, @Milbank.