After Their Cheers Die Down

We’re probably about a month or so away from a Supreme Court decision on the constitutionaliity of key provisions of the Patient Protection and Affordable Care Act. We are finally beginning to get some preliminary reports about what congressional Republicans plan to do if the Court strikes down the law entirely or fundamentally–after their cheers die down. They seem to want it to be widely known they are right on top of the issue, per this report from Jake Sherman and Jennifer Haberkorn of Politico:

On Tuesday, the major options were discussed during a small closed meeting of House Republican leaders, according to several sources present.

Then on Wednesday, Speaker John Boehner (R-Ohio) gave the entire House Republican Conference a preview of where the party is heading. His message: “When the court rules, we’ll be ready.”

But Boehner warned that they’ll relegislate the issue in smaller, bite sizes, rather than putting together an unwieldy new health care bill….

Republicans would try to replace some of the consumer-friendly parts of the plan — they don’t want it to seem like they’re leaving millions of Americans out to dry. They’ll look to protect some of the law’s most popular provisions, such as allowing people to stay on their parents’ insurance until 26 and forcing insurance companies to provide coverage to those with pre-existing conditions. They also want to keep the Medicare “donut hole” closed — essentially they don’t want seniors paying sky-high costs for prescription drugs.

Gee, that sounds smart: just reimpose the “popular” parts of ObamaCare, and forget about the rest! Why didn’t Democrats think of that?

The reason, of course, is that the popular stuff doesn’t work without some unpopular stuff. Banning pre-existing condition exclusions in any effective way would send insurance premiums through the roof–unless the insurance pool is increased to include more healthy people. That’s why ObamaCare included an individual mandate.

So when Republicans talk about “piecemeal” health care reform that maintains the popular features of ObamaCare, they are probably saying they’ll propose popular provisions but nestle them in poison pills that guarantee they won’t be enacted, but succeed in spreading the blame for reinstitution of the health care status quo ante. Want “guaranteed-issue” health insurance and no pre-existing condition exclusions? Great! Glad to oblige you if you accept my Medicare “vouchers” or my Medicaid “block grants” or my interstate insurance sales or my permament extension of the Bush tax cuts!

But even the pretense of action on health reform might be too controversial for many Republicans, like Steve King:

“I don’t want any vestige of Obamacare left in law,” Rep. Steve King (R-Iowa) said. “Not one particle of DNA.”

For all the bold talk to reporters, I doubt congressional Republicans–or their partners in the Romney campaign–really know what they’re going to do if ObamaCare is struck down. The one certain thing is that whatever they do, it won’t amount to a hill of beans in the real world. Face it: most Republicans were basically happy with the health care system we had before enactment of this legislation, and thought it could be made better if poorer and sicker people sucked it up and took more responsibility for themselves. They are not going to suddenly discover a rationale for reform the morning after their friends on the Court take reform off the books.

UPDATE: Reacting to the same Politico story, Harold Pollack tweets:
“GOP health reform plan seems to resemble, in form and substance, candidate Richard Nixon’s secret plan to end the war in Vietnam.” Good one, Harold.

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.