Oped: Repeal-and-delay won't work for GOP on Obamacare
In the congressional Republicans' rush to put some meat on the bones of the president-elect's pledge to bury Obamacare, they've already found themselves out of the starting gate without another horse to ride.
After trying about 60 times to repeal the retiring president's health-insurance law, the Affordable Care Act, it is astonishing they have no specific and detailed plan with which to replace it. Even Donald Trump has spotted their weakness and vulnerability. He has warned them using his much-favored medium, Twitter, "to be careful the Dems own the failed Obamacare." In other words, in their bid to replace Obama's signature legislation, Republicans risk being blamed by the electorate for making an imperfect health insurance system worse.
Senate Minority Leader Chuck Schumer of New York has indeed recognized this hazard. He has declared that the Republicans are "going to own it and all the problems in the health-care system."
Schumer, demeaned by Trump for openers as a "clown," observed that any GOP-authored replacement "will be on their backs, and I believe a year from now they will regret they came so fast out of the box." He taunted, "If you are repealing, show us what you'll replace it with first, and then we'll look at what you have and see what we can do."
Republican Sen. Rand Paul of Kentucky told CBS News' "60 Minutes" that his party should have a replacement plan on the table when Obamacare is repealed, to avoid the political hazard of scrapping it and leaving uncovered the 20 million Americans now enrolled in an Obama plan. Paul has asserted that Trump "fully supports my plan to replace Obmacare the same day we repeal it."
It's already apparent the objective will be more easily said than done. In the early going, it seems very likely that any replacement would have to include important features of the existing plan. Trump himself has specified it should retain two of its most popular provisions, coverage for pre-existing medical conditions and for parents' offspring up to the age of 26.
For all the vocal support among congressional Republicans for repeal of Obamacare and simultaneous replacement, the scope of the challenge seems only now to be dawning on many of them. Dealing with the complex challenges of revising or eliminating state health-care purchasing exchanges, and assuring broad enough public engagement to cope with already-rising premiums, can't be accomplished overnight, even with willing insurance companies and public cooperation.
Thus, what seems most likely achievable would be repeal and delay, with the looming problem of continuing to provide some coverage as the challenge is addressed. Stories are being written locally around the country of families hard hit by illness and poverty. They testify to the real-life crises entailed, competing for sympathy with the old conservative arguments against government intruding into the lives of average Americans.
The nation's aging population and the growing struggles of the middle class — a focus of the recent presidential campaign to which the Democratic Party and Hillary Clinton failed sufficiently to rally — requires that politicians on both sides address more intently now the second step in the repeal-and-replace formula.
It was a prominent part of President-elect Trump's winning campaign, and the congressional Democrats, led by Schumer and House Minority Leader Nancy Pelosi, will be fighting tenaciously to salvage what they can of Obamacare as the core achievement of the departing Democratic president.
The long struggle of liberals on Capitol Hill to make health care a key element of the New Deal package of social safety net programs that began with Social Security under Franklin Roosevelt and expanded to Medicare under Lyndon Johnson will certainly be on the front burner as the Trump presidency begins, well stocked with conservative naysayers in key social-welfare agencies.
Yet the fight is also an opportunity for the new president to demonstrate his ability and willingness to embrace a vital middle-class concern and calm the millions of Americans who anticipate his political ascendance with trepidation and even fear and loathing.
Jules Witcover's latest book is "The American Vice Presidency: From Irrelevance to Power," published by Smithsonian Books. You can respond to this column at firstname.lastname@example.org.