Repeal and Reverse

When John Boehner put the word out this week that House Republicans would indeed have some sort of agenda to “replace” ObamaCare in the event the Supreme Court strikes it down or the GOP gains the power to repeal it, there were negative reactions from two directions: from skeptical progressives like yours truly who noted how ridiculously unfeasible it would be to reenact “the popular parts” of the law, and from conservatives horrified that any Republican would be talking about taking action on health reform.

You can guess which objection got the attention of House Republicans. Almost immediately, Paul Ryan suggested GOPers would offer nothing beyond a “vision” of the “market-based” system of their dreams. Meanwhile, Boehner hastened to reassure conservatives that they would jump up and down on the corpse of ObamaCare for an extended period of time before considering what if anything they’d do to replace it.

So is the “replace” in “repeal and replace” just a shuck? Absolutely, if by “replace” you mean restoring any ObamaCare provisions. Aside from the absurdity of pretending that it makes any sense at all to reenact popular provisions like banning exclusions on pre-existing conditions (and as Jonathan Cohn notes, Mitt Romney and other Republicans are not actually on board with that in the first place) as stand-alone provisions, why on earth would you repeal a reform in order to immediately reenact it? You wouldn’t, as a matter of fact, unless you had no intention of reenacting it in the first place.

But Republicans do have plans to “replace” ObamaCare with provisions that would be far worse than the status quo ante.

Best anyone can tell, the only post-ObamaCare actions we can count on Republicans to take involve the Ryan Budget’s attacks on Medicare and Medicaid, plus that “market-based vision” which essentially means pushing the whole country into the individual health insurance market and then encouraging insurance companies to discriminate to their heart’s content by allowing them to circumvent state regulation via interstate sales. From the point of view of the uninsured, and those paying exorbitant premiums for crappy coverage because they are sick, this “vision” is a reversal, not just a “repeal,” of the progress made under ObamaCare. Between the green light they want to give insurers to discriminate, the discouragement of group coverage through elimination of the employer tax subsidy, and the vast restriction of Medicaid eligibility the Ryan budget would force, we could be looking at a significant increase in the ranks of the uninsured. I don’t expect Republicans to brag about all that, but the truth is repealing ObamaCare is the least of the damage they are promising to inflict.

Progressives should spend a little less time mocking the empty promises of Republicans to only partially get rid of ObamaCare, and a lot more time explaining their ultimate designs on the health care system.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.