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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

GOP Disarray On “Repeal and Replace”

There’s a useful article by Jennifer Haberkorn up at Politico today about the sudden demise of congressional activity on the GOP’s supposed top priority of “repealing and replacing” the Affordable Care Act. And while there’s a lot of talk about the Democratic Senate representing an absolute bar to action on this topic, it’s also clear Republicans aren’t exactly united on either the “repeal” or “replace” agenda, as Michele Bachmann’s BFF Steve King makes plain:

Rep. Steve King (R-Iowa), one of the House’s most ardent supporters of repealing or defunding the law at all costs, says it has become more difficult to get the attention of House leaders.
“I can’t get any traction,” he said of his effort to repeal or defund the law. “You can’t create something in this Congress unless leadership approves it.”
He questioned whether Republican leaders are willing to repeal the whole law if it means also repealing some of its popular provisions.
“There’s a little bit of an undercurrent that I pick up among well-positioned people in this Congress who think there could be some redeeming qualities of Obamacare,” pointing to statements Republican leadership have made in support of a handful of the law’s policies, such as banning insurers from denying patients because of preexisting conditions or allowing children to remain on their parents’ insurance through age 26.

This “undercurrent” is more obvious in the reluctance of Republicans to embrace any sort of coherent plan for dealing with the health care system generally. Yes, most of them support an agenda with common features, including medical malpractice “reform,” interstate sales of insurance policies, replacement of the deduction for employer-sponsored health care with an individual tax credit, and high-risk “pools” for the uninsured, all accompanied by some strategy for privatizing Medicare and dumping Medicaid on the states. But few Republicans want to come to grips with a clear commitment on federal, or indeed public, responsibility for affordable health care. That’s probably because the ascendant forces in the conservative movement frankly think of health care as a consumer service like any other, which the government has no real business (and the federal government has no constitutional authority) to be involved in.
So it’s tough to get intra-Republican agreement on a “replacement” system, and that in turn makes “repeal” a tough sell politically, and would so even if Republicans had the votes to pull it off.
And it’s easier, of course, to be all things to all voters, posing simultaneously as the defenders of the status quo on issues like Medicare benefits and physicians’ prerogatives, even as they plan radical steps to decimate Medicare and go back to a 1950s model of health care as primarily an individual responsibility to be paid for out-of-pocket, without insurance at all.
Democrats have a continuing responsibility to smoke them out on all these contradictions.

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