There Is No Grand Strategy to Repeal Obamacare

Late yesterday afternoon the Congressional Budget Office (CBO) released their report on the projected effects of the Republican plan to repeal and replace Obamacare. The top line news was startling: 24 million people would lose their health insurance by 2026. Most notably, the people who would be disproportionately impacted would be those who are older and/or poorer.

I’d like to highlight what we’ve seen from conservatives/Republicans/the White House since then. If anyone can see a grand strategy here, I’d like to hear about it.

  1. HHS Sec. Tom Price and OMB Director Mulvaney said you can’t believe what the CBO says.
  2. Speaker Paul Ryan praised the CBO report.
  3. The White House produced a report that was even worse than CBO’s – suggesting that 26 million people would lose coverage.
  4. Someone leaked the WH report to Politico.
  5. Breitbart validated the CBO report by broadcasting the news that Paul Ryan’s plan would result in 24 million people losing their health insurance.
  6. Almost simultaneously, Breibart released a tape from last October in which Ryan said he was abandoning Trump forever and wouldn’t support him.
  7. Trump is telling conservative Republicans that he’ll work with them to make the bill even worse by speeding up the changes to Medicaid and basically saying, “who cares if that makes it less likely to pass the Senate, we’ll deal with that later.”

Let’s note one thing right away. The plan to rally right-wing media around the idea that the CBO report cannot be trusted has completely gone off the rails. When everyone from Ryan to Breitbart to the released White House report are validating it, that simply isn’t going to fly.

In commenting on #’s 4 and 6, Kevin Drum shared his theory that perhaps Steve Bannon is working behind the scenes to discredit Speaker Ryan. In support of that theory, I’d simply note that Breitbart has consistently referred to this bill as “Ryan’s plan,” even though the president embraced it as “our wonderful new health care bill” the day it was released. It’s also true that, at the last minute, Trump cancelled his plans to go to Kentucky last weekend to rally for this bill and sent VP Pence instead. Finally, that theory would fit in with recent reporting that Bannon is getting cold feet on Obamacare repeal. I’ve also suggested that, as controversy grows over this bill, Trump will pull back on being the public face out there defending it.

But then why is Trump working with conservative Republicans behind the scenes to get the bill passed, apparently with an assist from Bannon in dealing with the head of the Freedom Caucus, Rep. Mark Meadows (per Politico)? Their overtures would certainly make the bill worse, but they seem determined to find a way to get it through the House, which could possibly save Speaker Ryan.

For now I’m going to assume that the error in my thinking is assuming that there is either some grand strategy for passing Obamacare repeal or fighting the factional war between establishment and insurgent Republicans. The easier position to defend is that this is a party that doesn’t know how to govern and it’s being exposed for its inadequacies. The silver lining is that it could be good news for the 24 million people who want to keep their health insurance.

Nancy LeTourneau

Nancy LeTourneau is a contributing writer for the Washington Monthly.