The GOP is just now realizing that they’ve become the dog that caught the car: they don’t know what to do with it. Horrifying how much of contemporary American politics resembles a Dark Knight movie, isn’t it?
Mike DeBonis – The Washington Post:
“We’d better be sure that we’re prepared to live with the market we’ve created” with repeal, said Rep. Tom McClintock (R-Calif.). “That’s going to be called Trumpcare. Republicans will own that lock, stock and barrel, and we’ll be judged in the election less than two years away.”
A dirty little secret about the GOP notion to do away with the Affordable Care Act is that they’ve never had an actual plan to do so. The House of Representatives has voted to repeal it dozens of times over the last six years, with a Republican majority carrying the vote each time. Not once has such a bill passed the Senate. And not once did the House GOP include a plan to replace the insurance that would be pulled out from under Americans who’ve just recently been able to secure it.
Whatever they end up doing this year, as the above surreptitiously gathered conversation among GOP members in Philadelphia this past week indicates, they know they’ll own the result. Recall the backlash against the enactment of the ACA? Then-President Obama’s party lost its majority in the House in the following mid-term election in what’s considered a direct repudiation of it.
Any ACA replacement will look a lot like the ACA. Why? The major aspects of the ACA are the parts that make it work, without which the exchanges collapse.
Consider the individual mandate, requiring everyone to secure a health insurance policy. Remove that key element and mainly the ill, elderly and those with or about to have children will apply. The markets tip toward the most costly insured, making it unprofitable for insurance companies to do business. Companies will pull out of unprofitable markets.
We’re already seeing this happen due to the low penalty for not complying with the mandate.
Consider the requirement that young people be able to remain on their parents’ health insurance policy until they turn age 26. That’s a hugely popular aspect of the ACA. It also adds generally healthy young people to the pool of insured, and charges their parents for the pleasure. Those additional premiums prevent the pool of insured from tipping toward those claiming benefits. Remove this aspect and the market tips unprofitable, and insurers exit.
Consider the ban on refusing insurance to those with pre-existing conditions. Another hugely popular provision, one that tips the pool of insured toward more claims, and a reason in itself to strengthen the individual mandate. This aspect simply cannot be dropped from any national health insurance law.
Point by point, much of what would constitute an as-of-yet unwritten replacement for the ACA will by necessity resemble nothing so much as the ACA itself.
My prediction: the GOP has trapped itself in a gunfight without any ammunition, has awoken to the problem, and will not repeal the ACA at all. Instead they’ll work to remove or improve the parts most onerous to their constituency. Funny thing about that constituency, though. So many of them only have health insurance by way of the ACA. Rock, meet hard place.
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