More than a year after Republicans first pledged to “repeal and replace” President Obama’s new health-care law, the GOP is still struggling to answer a basic question.
Replace it . . . with what?
The repeal-and-replace argument has been a central line of attack in the GOP’s anti-Obama assault, both on the presidential campaign trail and on Capitol Hill.
In Congress, the new Republican-led House took a symbolic vote to repeal the law in January. But since then, nothing has happened. The House hasn’t passed anything new to take its place.
On the campaign trail, both former House speaker Newt Gingrich (Ga.) and former Massachusetts governor Mitt Romney have said they want to repeal the law.
To replace it, they have reused several ideas from 2008 GOP nominee John McCain. Instead of a mandate to buy insurance, the two current front-runners would offer ways to make insurance cheaper: new tax credits, new bargains on policies from out-of-state.
But even some conservatives say these ideas might not work as advertised. And they would only be the beginning of a true “replacement” for Obama’s sweeping law.
With the 2012 elections less than a year away, Republicans’ struggle over health care could be a political liability. Democrats will blast them for breaking a promise.
It could be even more of a problem after the election. If the GOP can repeal the law, it would reopen the ugliest political fight of the past five years.
But the GOP wouldn’t have a plan to win it.
“If Republicans aren’t talking about how they would replace Obamacare,” said Michael Cannon, the libertarian Cato Institute’s director of health policy studies, “there are two good reasons for that.”
“The first one is: They’re winning the argument. Why would they change the subject?” Cannon said, meaning that Republicans have won support by focusing only on the “repeal” part of their promise. “The second one is: Their current proposals [for replacement] aren’t ready for prime time.”
Obama’s health-care law stretches over hundreds of pages, making a sweeping attempt to solve two long-standing problems. One was the millions of uninsured people. The other was the fast-rising cost of medical care.
To address the first, the law simply mandated that every American buy health insurance. If not, people could face a fine of $695 or more. To address the second, the bill drives hospitals — especially those treating Medicare patients — toward more efficient treatments.
To Republicans, the law looked like a jury-rigged mess, tainted by special favors and bloated government. They attacked the “individual mandate” as federal over-reaching, and the efficiency efforts as a first step toward the rationing of medical care.
It worked, and it is still working.
Last fall, the GOP won a whopping 63 new House seats. This year, Republicans are still campaigning to repeal the law, which a recent poll showed is viewed unfavorably by 44 percent of Americans (and favorably by only 37 percent).
But, at the same time, the GOP promised to unveil its own solutions to the same problems.
“We can do better. We can do better than their government takeover of health care,” Rep. Mike Pence (R-Ind.) said in January, when all 242 House Republicans and three Democrats voted to repeal the law. That repeal measure stalled, as expected, in the Democrat-held Senate. “It all begins with today,” Pence said.
In the House, however, not much has happened since.
Some Republican members have sketched out their own plans. One would let people take their health insurance with them from job to job. Another limits the damages handed out in malpractice suits. Another would let people get insurance through private associations, not just their employers.
But none has been passed.
“Thus far, the relevant committees have been focused on oversight to protect the American people from the effects of the law, and repeal,” Michael Steel, a spokesman for House Speaker John A. Boehner (R-Ohio), said in an e-mail. “I expect we will see more ‘replace’ efforts in the coming year.”
On the campaign trail, the two GOP front-runners are men who have both embraced the hated “individual mandate” in the past. But now, both Gingrich and Romney say they would repeal the bill if they could.
But [many Republican politicians] can see the political logic [in not proposing a specific replacement to Obamacare.] As Democrats learned, changing health care means dealing with a series of volcanic issues: fairness, malpractice, the proper role of government. And life and death.
If “repeal” is enough for the GOP primary, they said, then the details of “replace” should wait until later.
“You don’t want to be terribly detailed,” said Rep. Michael C. Burgess (R-Tex.), who advised McCain in his presidential run, and saw the details of his ideas turned into weapons by Obama. “It’s a whole lot easier to demagogue the ‘con’ than it is to defend the ‘pro.’ ”
Facebook
Twitter