For years now, the Republican party has promised to “repeal and replace” Obamacare. Now that voters have delivered Republicans control of the White House and Congress and they can make good on that promise, suddenly they are singing a different, decidedly off-key, tune: “Repeal and delay.”
The plan is to effectively repeal Obamacare through the budgetary process known as “reconciliation.” But after campaigning hard against the law for six years, some Republican leaders are now hedging their bets about what to do next with health care. “We’re talking about a three-year transition now that we actually have a president who’s likely to sign the repeal into the law,” Senate majority whip John Cornyn said earlier this month. “People are being understandably cautious, to make sure nobody’s dropped through the cracks.”
Fair enough: If the Obamacare debacle has taught us anything, it’s that when you’re overhauling the laws governing one-sixth of the economy, you should do it cautiously. That said, dragging out or delaying the replacement of Obamacare would be a catastrophic mistake—and for three main reasons.
One, voter anger over Obamacare can’t be overestimated. In a January 2010 special election, voters in deep-blue Massachusetts went so far as to elect a Republican to fill the Senate seat of the late Ted Kennedy. They did so expecting his vote to be the one that would scuttle the Affordable Care Act. Democrats found a procedural ploy to force the bill through anyway. That only stoked voter anger, which found voice in the Tea Party movement that stormed congressional town halls later that year and, in the 2010 general election, would deliver Democrats the largest electoral wipeout for a major party since the end of World War II. Because implementation of the law was largely delayed until after his reelection, President Barack Obama managed in 2012 to get reelected in spite of his signature “accomplishment.” Democratic senators would not be so lucky, losing control of the Senate in 2014 in an election in which the rolling disaster of Obamacare was the driving issue.
Voters who have gone to the polls in election after election to cast ballots against Obamacare are not going to be interested in GOP excuses for not fixing the law.
Two, perhaps the biggest mistake Democrats made after Obama’s 2008 election was to believe they would control Washington for years, if not decades, to come. After ramming through both the trillion-dollar stimulus and Obamacare on party lines, voters punished them the first chance they got. In an era of political instability and populist revolt, it would be rash of the GOP to assume their control of Congress will survive the next midterm election.
Three, not fixing the law leaves an awful lot of people in the lurch. However substandard Obamacare coverage may be, it remains that some 22 million Americans have been incentivized—or forced—to get coverage through the ACA. And they aren’t the only ones to have made important decisions based on the law: Entire industries have shaped their businesses based on the demands of the ACA. Repealing Obamacare without a clear plan for what comes next will only compound with uncertainty the damage the law has done to health care and insurance markets.
The good news is that a number of Republicans in Congress—including Speaker of the House Paul Ryan and the president-elect’s pick to be secretary of health and human services, Rep. Tom Price—have put forward thoughtful, comprehensive replacement plans. Savvy wonks at conservative think tanks have offered still more.
Repealing Obamacare is an urgent priority. But the bigger leadership test will be keeping lawmakers focused on finishing the job, which means selecting one of the many replacement plans already written or combining the best ideas from several of them to create a new approach. It is a test the GOP had better not fail. North Carolina’s Mark Meadows, the new head of the conservative House Freedom Caucus, has already said any effort to push Obamacare replacement past the next election will be “the first big fight I see coming for the Freedom Caucus.”
There have been a lot of petty intra-Republican squabbles in recent years. But if GOP leaders are foolish enough to try kicking the Obamacare can down the road, it will be worth pushing back. Obamacare was foundational to the Republican resurgence; if they don’t fix the law promptly it may yet prove instrumental in Republicans’ downfall.