The Republican dilemma on health care is that the party may have the ability to destroy the status quo, but it doesn’t have the ability to put something in its place. One reason is mechanical: They can defund Obamacare with just 50 Senate votes, but they need 60 to rewrite its insurance regulations. The other reason is ideological: Giving people the better coverage they promised, or even minimally acceptable coverage, requires providing resources, and there’s no way that’s ideologically acceptable to their party to conjure those resources, which is why the unified Republican plan has been stuck in the almost-there stage since 2009.
The Republican strategy to solve this dilemma is to coerce Democrats into solving their dilemma for them by repealing Obamacare and blaming Democrats for the disaster caused by the repeal unless they agree to support some kind of Republican proposal — and, by supporting it, neuter their chance to blame Republicans for the outcome. And yet some doubt is already creeping in as to whether this massive hostage-taking scheme can actually work. Their answer to this dilemma is … take even more hostages. Specifically, some very small ones. “According to multiple GOP sources, Republicans are looking at whether to use reauthorizations of existing programs, such as the Children’s Health Insurance Program, as vehicles for replacement measures,” reports Mike DeBonis in the Washington Post. “That could give them leverage to secure cooperation from Democrats.”
A bit of explanation is required. The Children’s Health Insurance Program, or CHIP, was created in 1998 as part of a deal in which Democrats got health coverage for children and Republicans got a capital-gains tax cut. It has since grown quite popular, and insures 8 million children from low-income families. In 2015, it was reauthorized by a vote of 392–37 in the House and 92–8 in the Senate. It needs to be reauthorized again at the end of this year or it will expire.
The “leverage” for Republicans to “secure cooperation” from Democrats for their plan to give people cheaper, skimpier insurance than Obamacare offers is to threaten to end the Children’s Health Insurance Program. Apparently the idea is that it’s not enough to threaten to throw millions of adults off their insurance. You also need to have some sick children to threaten as well.
Now, the notion that this will actually compel Democrats to support a painful Republican plan, as opposed to simply making the Republican Party even more unpopular, seems quite fanciful. But it’s the kind of idea you settle on if you truly have no better options.