With the nation at their mercy Republicans are about to blow the mission they staked their reputation to the instant Democrats passed the Affordable Care Act. We’ve heard the buzzwords: repeal, replace, dismantle. We might as well add destroy. The press isn’t great, but how could it be? Republicans will be lucky to make this sale to themselves not because their ideas are bad, but because their campaign to make this overhaul palatable is all wrong.
The party is not good at selling its conservative ideas to America and this is a really tough sale. There is one overwhelming problem with the GOP sales pitch:
It is built on reforms conservatives have been pursuing for decades.1
Replacing a health care system popular with many that was championed by a president they adored can’t be about Republican health care and conservative values. That’s the kind of promotional campaign that creates fear and anger. It sounds like Republicans are preparing to repeal, replace, and destroy something people depend on with values they don’t agree with. That’s not going to make this go down easy, especially when many are already infuriated by the Trump administration.
Repeal, replace this terrible law: the horrible problem
The problem with this terrible law is that it’s not terrible for everyone. It was very good for people with pre-existing conditions. Guaranteed issue was a badly-needed reform that past Republican majorities never delivered. Now they are threatening to repeal, replace, dismantle, and destroy what gave people insurers won’t touch a chance to avoid ruin from uninsured medical bills or pricey state high-risk pools.
Ryan can’t sell his bill like this*
Speaker Paul Ryan’s sales pitch for how the new plan deals with this big pre-existing condition problem doesn’t sound encouraging to anyone who dealt with high-risk pools before the ACA:
Our plan will introduce the Patient and State Stability Fund to help finance solutions designed by state leaders to meet the specific needs of their populations. Ultimately, our plan will give states the flexibility they need to protect their most vulnerable citizens.2
It doesn’t match the House GOP’s pitch on the same topic:
Prohibit health insurers from denying coverage or charging more money to patients based on pre-existing conditions.3
What does the bill say? The purpose of the Fund is:
Helping, through the provision of financial assistance, high-risk individuals who do not have access to health insurance coverage offered through an employer enroll in health insurance coverage in the individual market in the State, as such market is defined by the State (whether through the establishment of a new mechanism or maintenance of an existing mechanism for such purpose).4
The bad thing about state high-risk pools wasn’t access. It was paying the premiums. If this plan lowers costs, why do we need a special financial assistance fund for people who by definition were not high-risk with ACA guaranteed issue?
It may be unclear how the American Health Care Act protects all Americans, but the bill’s moral slant and fulfillment of a promise to cut the legs off of Planned Parenthood starts on page 3 with the definition of “Prohibited Entity.”
Religious restrictions and going after women’s health care?
Do Republicans really think they can impose conservative religious restrictions while the country is up in arms over what liberal America calls a Muslim Ban?
The Speaker gave conservatives a long list of reasons why they should back the American Health Care Act including defunding Planned Parenthood.5 I can imagine the left mounting pretty good arguments for discrimination, violating the separation of church and state, and worse over abortion restrictions that will be condemned as an attack on women’s health care.
Obamacare repeal, replace was never the right message
The House GOP vows that their health bill:
Keeps our promise to repeal and replace Obamacare.6
It will do that and may be the best health care bill America could hope for. If Republicans can’t sell their plan it doesn’t matter. Repealing and replacing a system to impose conservative spending and values will not make the American Health Care Act more appealing without a believable campaign to go with it. That’s a vital part of this bill we haven’t seen or heard yet.
*UPDATE March 25, 2017: Ryan can’t and he didn’t. Yesterday’s defeat of Republican health care by refusing to even bring it to a vote was an appalling display of GOP failure. The party proved again that it is much better at taking away than offering the people something that helps. That’s where Democrats come in. President Warren and Speaker Pelosi, anyone?
UPDATE July 18, 2017: It’s official. In less than seven months the GOP killed its long-promised fix for Obamacare. All that remains is the arguing over whether Republicans will suffer more for refusing to pass a wildly unpopular replacement or by refusing to honor a promise they staked a claim to many years ago.
We are way past embarrassment on this one. This is disgraceful.