Are Republicans Going Soft on Obamacare?

Peter Sudman from Reason amasses the evidence:

In March of last year, Senate Minority Leader Mitch McConnell (R-Ky.) stood on stage at the Conservative Political Action Conference  and declared that "Obamacare should be repealed root and branch." But in May, when he was asked about whether Kentucky’s health insurance exchange, Kynect—the local face of Obamacare—should be dismantled, he insisted that the two weren’t related. "I think that’s unconnected to my comments about the overall questions here," he said. More recently, when McConnell was questioned by The New York Times about what to do with people in his home state who now receive coverage through the law’s Medicaid expansion, he responded, "I don’t know that it will be taken away from them." Root and branch repeal is starting to look more like twig and leaf.

McConnell is, of course, still broadly opposed to Obamacare, as are most residents of Kentucky. His opponent, Democrat Alison Grimes, has been delicate in her support of the law, and clearly believes that, overall, Obamacare is a political liability. But there is a shift happening. It’s not that Republicans are abandoning opposition to the law. But they appear increasingly uncertain about how to deal with it now that it has arrived.

McConnell is only the most prominent example. Rep. Tom Cotton, who is challenging Democratic Senator Mark Pryor in Arkansas, continues to state his opposition to Obamacare. But he has also avoided directly answering questions about the state’s participation in the Medicaid expansion, even in the state’s modified Medicaid "private option." Asked last month about people who are already covered through the health law, Cotton said, "We’ll see what we can do about reforming it, and potentially protecting people who have already received some of the benefits." Is that support for repeal? Or reform?

There are more examples. Pennsylvania GOP Gov. Tom Corbett recently agreed to a modified Medicaid expansion. And as TPM’s Dylan Scott recently noted, Republicans legislators in Indiana, Wyoming, and Tennessee are looking at ways to participate too.


But the bigger issue is that Republicans never really had a post-Obamacare battle plan. Late last summer, at a small private event, I asked a senior Hill Republican what would happen after January 1, 2014, when the health law’s coverage expansion went live. The response I got was that something would have to change, and that Republicans would finally, after years of promising to propose and promote a replacement health law, have to figure out how to describe what they wanted to do next. There would be a reckoning. There would have to be.

Then October arrived, the exchanges crashed out of the gate, insurers started canceling plans that people liked, and the GOP decided they didn’t need to figure out what to do next. Obamacare’s crash saved them from having to decide.

At the end of the month, with the exchange still in disarray, and hopes for a quick fix fading, I asked a House GOP aide what the party would do next when, inevitably, the mess cleared up. Here's what I was told:

"There's just no appetite to lay out an entirely new agenda of ideas," a House GOP staffer told me in October. Instead, the focus is on "expanding existing criticism" and "continuing to bludgeon the administration" over problems with the current law. "If Republicans were interested in fixing health care, they would have been talking about it much earlier," the staffer said. "They weren't."


Republicans have repeatedly promised, in public, to move beyond repeal to replace, and privately many will even say that reform is more likely, but so far, work on plans that would do so has occurred largely at the margins. At least for now, we’re likely to see the holding pattern continue; the GOP is almost openly running a no-agenda strategy in the mid-terms this fall. Much will depend on how the second and third open-enrollment seasons go, the results of the 2014 election, the messaging and policy choices made by the party’s next presidential nominee, and the outcome of the race for the White House in 2016.

But it’s at least possible to imagine that the current convergence continues, and eventually results in a melding of the two party’s stances, leaving much of Obamacare’s basic infrastructure, including the exchanges, in place but altering them substantially and using them, in a kind of ju-jitsu move, as a vehicle to reform the rest of the entitlement system, which is ultimately a much bigger fiscal problem. That’s essentially what the Manhattan Institute’s Avik Roy has proposed in his recent health entitlement overhaul plan, which would deregulate the exchanges, end the individual mandate, transition Medicaid and Medicare to the exchanges, and, according to one estimate, could expand coverage even more than Obamacare.

The danger with that sort of plan is that no one will like it—that Republicans will see it as a concession to Obamacare, and Democrats as a fundamental attack on entitlements. Certainly it’s not something that the base on either side is willing to accept right now. But it’s also the sort of clever compromise that could eventually find backers on both sides of the aisle, especially as Obamacare settles in further.

It wouldn’t be root and branch repeal, and Republicans and their allies would need to accept that. But, to extend the metaphor a bit, it might be something more ambitious and arguably more important—a plan that, yes, leaves Obamacare’s roots in place, but instead replants the rest of the garden around it.

The most significant sentence in this article may be the quote from the unnamed GOP staffer that the party has no "appetite for new ideas." Hence they will either learn to live with (if not love Obamacare) or settle for some minor reforms that amount to "Obamacare lite."

Of course, "Obamacare lite" will suffer from the same fundamental problems as Obamacare. The difference is that the Republicans will not be able to escape blame for the failures of "Obamacare lite." The failures of "Obamacare lite" could be used to the advantage of the advocates of a single-payer system, who could point to the failures of the corporatist health care system as justifying a "pure"  socialist system.

Many Republicans enable the single-payer advocates, not just by arguing for “Obamacare lite,” but by pretending that America had a free-market health care system before Obamacare.  Thus, those of us who understand the only efficient health care system is a one free of any government intervention must not only challenge Obamacare but those who defend the pre-Obamacare system.

We must explain how the problems with pre-Obamacare health care system where caused by government interventions in the health care system and that further government interventions will only create more problems with American health care.

Click here to read Campaign for Liberty Chairman Ron Paul's column "Middle of the Rod leads to Health Care Socialism."

Click here to support Campaign for Liberty's efforts to repeal Obamacare.



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