The Senate’s latest attempt to repeal the Affordable Care Act, or Obamacare as it is more colloquially known, appeared to die on Tuesday. This is the third such attempt at repealing the law, which has always been opposed by Republicans. In March, the House passed the American Health Care Act, or Trumpcare 1.0. The bill was sent to the Senate, where it was declared dead on arrival. Senate Republicans, working in secret away from Democrats, the press, and even the public that their efforts would effect, began working on their own version. This first version failed before it was even brought up for a vote as it was wildly unpopular – mainly because no one really knew what was in it. The second version failed earlier this week, and the third attempt, a straight repeal without a replacement, failed Tuesday night. Why do the Republicans have such a hard time at repealing a law that they were ostensibly sent to Washington to repeal?
Well, part of the problem is that the law actually does help people. In the states that have fully implemented the law, insurance coverage has grown, and while some premiums have risen, the overall growth of cost of healthcare in those states has slowed. This was, after all, the main goal of the law, to slow the growth of spending without cutting access to or the performance of healthcare procedures. Further, since the full implementation of the law, its popularity has risen even if it is still opposed by many conservatives. One of the reasons for that is that it has actually saved lives and granted access to much needed healthcare to a plethora of people that otherwise would have never been able to afford it.
Another reason is the PR angle. In Kentucky, Mitch McConnell’s state, the law is incredibly popular and tremendously effective. But, the law is largely known by another name, KYnect. In other states and locales around the country the law remains popular among beneficiaries mostly because it isn’t known as Obamacare. For many of the conservative voters that have come to rely on the law, it is understood that this is the Affordable Care Act, or perhaps some other statewide or local moniker. Previous polls around the country have shown that when the ACA is explained to voters, they actually like it. It has provisions in it that many benefit from and many want to see improved upon. However, Obamacare is much less popular. This is despite the fact that they are the same thing. The implication is that it is all in the name.
Another reason that Republican’s efforts to repeal the law, with or without a replacement, is that the Republican Party is much like the Democratic Party, policies notwithstanding. They are a coalition of several smaller groups with different, though similar ideals and views on the role of government. Much of the opposition to the two previous Senate bills that came from Republicans was driven by their perception that the replacement was too much like the ACA. That is to say they were opposed to it because it was still too liberal.
Some of the opposition that came from Republicans was driven by the perception that the replacement was too harsh. It would unnecessarily harm their constituents for no reason other than politics. While it would be nice to assume that these Senators have compassion at the forefront, it is more likely that they are concerned with winning their next election. As Senator Joe Manchin warned in January, voters may not or may not know who gave them healthcare, but, “they will remember who took it away.” For Republican Senators in states that are not blood red, this would be political suicide.
At the end of the day, the repeal and delay plan likely wouldn’t work logistically anyway. There is too much uncertainty in such a “plan.” Are insurers going to continue to receive payment? Are individuals going to continue to be covered? Will providers be able to be paid for their work? There are a million questions that would need answered and they would need to be answered truthfully, not with evasive political doublespeak. Not to mention the biggest political question: Why do you need two more years to draft a plan, haven’t you been working on it over the last seven years that you’ve been saying that if we give you control you’ll fix it?
This cuts to the heart of the central question about Republicans. Are they even capable of governing? Their own rhetoric would suggest that they are not. A core theme among the conservative movement in America is that government is not the solution, but is the problem. I have to admit, I never understood the logic in running for office on the platform that your job should go away. Government’s central purpose is, according to the Constitution, to “provide for the common defense and promote the general welfare” of the country and its citizens. How then, does it figure that a political party whose central message is that the government shouldn’t be doing these things effectively govern?
Well, the short answer is, they don’t. A major problem that Republicans face is that they have run campaign after campaign claiming that they, and only they, can fix government. But the reality is that most of the country, and I mean nearly everyone but the top one to ten percent, relies on social programs in one form or another. Whether it is education, emergency services, or a social safety net, Americans rely on America. They want government to work efficiently and with efficacy. Is there some overspending and bloat in government? Sure. Does that mean that all these programs should be gutted and people who can’t afford to participate in an unchecked profit driven market should be left to wither? No.
The central message in the conservative rhetoric is that government is bad. That people are successful in getting elected to offices to oversee programs that they think should no longer exist is unfathomable to me, but it speaks to the larger point. Republicans are not able to govern because they do not believe that government should exist. At the same time, they have to deal with the fact that their voters rely on government in some way or another. This leaves them with the political problem of how to proceed. If they actually gut the government then their voters will suffer, and they will hold them accountable. But, if they don’t gut the government, their donors will be angry and will hold them accountable.
Perhaps the solution for Republicans is to change their message. Yes, this will mean that they are no longer in a position to accept large donations from multi-million dollar backers, but it might be easier to win elections. They can always run on the platform of efficiency and efficacy, but they are showing themselves to be more and more inept at governing – and not because this particular president or congress isn’t up to snuff, but because governing is antithetical to their ideology.
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