health care

Republicans Have Lost Interest in Fixing, or Killing, Obamacare

Those who rallied on Capitol Hill in May 2017 to protect the ACA got their wish — sort of. Photo: Alex Wong/Getty Images

As you may recall, health care was kind of an important issue in the 2018 midterms. Annie Lowrey documented that clearly right before the election:

In 2016, the Affordable Care Act came up in just 10 percent of pro-Democrat campaign advertisements and 16 percent of pro-Republican ones. This year, it came up in more than half of Democratic ads and nearly a third of those for Republicans.

The two parties obviously had different messages on health-care policy, but they overlapped in terms of the public concerns addressed:

For Democrats, the pitch to … voters is straightforward: We are the party that will shore up the Affordable Care Act, maintain protections for preexisting conditions, and work to make coverage universal and affordable. For the first time in years, the party is defending a popular law rather than an unpopular one — and is doing so vocally, playing on voters’ very real fears that Republicans will take away their coverage …

For Republicans, the law’s sudden popularity — and their continual efforts to reduce coverage and increase costs — have made their campaign pitch a little harder. With no real health plan to run on, many have alighted on the bizarre argument that they would protect individuals with preexisting conditions.  

Obviously some Democrats went further to advocate Medicare for All, and some Republicans focused on opposition to the same idea. But there was certainly enough talk about addressing problems with the Affordable Care Act to create an expectation that it would be a lively topic of debate in the 115th Congress.

There’s been talk from Democrats all right, as Paige Winfield Cunningham reports:

[House] Democrats have spent the bulk of their time lambasting Republicans over various ways they’ve undermined protections for patients with preexisting conditions or pushed what Democrats term “junk” insurance plans — topics that helped Democrats win the House majority last year. Over the past two months, Democrats have held a half-dozen hearings framed along these lines.

Moderate House Democrats who want to dramatize their interest in health-care policies that aren’t Medicare for All have introduced multiple bills aimed at “fixing” Obamacare. But the Senate Republicans who, in theory, might cooperate with them, as some tried to do in 2017, just aren’t into it, notes Cunningham:

As for congressional Republicans, they’re publicly admitting they’ve pretty much moved on from Obamacare and any effort to improve, weaken or otherwise change it.

“I think there’s a little bit of once burned, why are we going at it again?” Sen. Bill Cassidy (R-La.) told reporters Thursday.

Obviously enough, Republicans understand that having failed to repeal and replace Obamacare when they controlled both Houses of Congress, there’s no point in even trying to go back to that poisoned well with a Democratic House. But there seems to be a more pervasive GOP desire to ignore Obamacare, most notably from the one Republican member of Congress who was most interested in redressing some of the damage Trump inflicted on Obamacare participants, Lamar Alexander:

 ”[A]s a Republican legislator, I look for where can I get a result …”

“We’ve proved over eight years that’s hard to do on Obamacare so I’d rather work on this other set of issues for the next couple of years,” Alexander continued, pointing to broader efforts underway to rein in drug prices and increase transparency.

It’s a striking admission from the senator, who poured energy into advancing a bipartisan measure he co-wrote in late 2017 with Sen. Patty Murray (D-Wash.) to infuse more funding into the Obamacare marketplaces.

Part of the problem is that just about any bipartisan legislation involving Obamacare funding is likely to succumb, as did the Alexander–Murray bill, to conservative demands to attach anti-abortion language. But simple fatigue, and wariness over ever getting the president to commit to a constructive course of action on health care, have clearly taken their toll.

So despite serious issues involving high premiums for certain Obamacare participants (especially older middle-income people in the Midwest), congressional action is unlikely. Health care should again be an important campaign issue in 2020 at both the presidential and congressional levels, whether the debate revolves around Obamacare or Medicare for All.

Republicans Losing Interest in Fixing, or Killing, Obamacare