Obamacare Replacement: Lotta Smoke, Not Enough Mirrors

One definite bit of fallout from the DHS/immigration dumpster fire is to make it clear how ludicrous it is to expect Republicans to get their act together on anything truly complicated or controvesial. I mean, if you can’t find your butt with both hands, you probably aren’t going to pull off a perfect performance on the parallel bars the next minute, are you?

So the timing is pretty bad for the effort made today in a WaPo op-ed by three Senate Republicans to convince the world–and more especially, the U.S. Supreme Court–that they’ve come up with a workable replacement plan for Obamacare if SCOTUS accepts the plaintiff’s arguments in King v. Burwell.

Nobody’s buying it. Not Ezra Klein, who looks at the op-ed and concludes: “This isn’t a plan. It’s the barest possible sketch of some nascent ideas that could, one day, be used as the basis for a plan.” More importantly, neither does conservative health policy wonk Avik Roy, who bluntly dismisses the “plan:”

Hatch, Alexander, and Barrasso outlined their contingency plan in a March 1 op-ed for the Washington Post. They describe it as a “bridge away from Obamacare.” It would “provide financial assistance to help Americans keep the coverage they picked for a transitional period.” Then, it would “give states the freedom and flexibility to create better, more competitive health insurance markets offering more options and different choices.”

That’s pretty much it, so far. Many reformers hope that Republicans will come up with a plan that could serve as the backbone of a full-fledged proposal to replace Obamacare. But Republicans have not yet come to agreement on the specifics. Though more details may emerge over time, the op-ed reflects the limited consensus within the GOP as to how to proceed.

Roy goes on to explain that aside from a thousand nettlesome details, Republicans are deeply divided over the extent to which it is ideologically permissible and/or politically necessary to build on the structure of Obamacare–especially its endangered subsidies–or tear it all down and plow and salt the earth. So it’s not just a matter of giving congressional staff and allied wonks the time to finish up work on a “replacement.”

For Klein and for Roy, moreover, the display of ineptitude over DHS/immigration makes the idea of Congress being ready to smoothly respond to disruption of Obamacare by SCOTUS kinda laughable. Greg Sargent sums up the general impression:

[A]nyone who watched last week’s chaos in the House knows Congressional Republicans are unlikely to coalesce around any “transitional” relief for those who lose subsidies (that would require spending federal money to cover people) or any permanent long-term alternative. This chatter appears transparently designed to make it easier for conservative Justices to side with the challengers.

Greg also notes the states who might theoretically solve the problem by setting up their own exchanges aren’t exactly racing to a pre-ordained conclusion, either–in part, of course, because most conservatives don’t want to see Obamacare “fixed” if it’s damaged by the courts.

So what this really comes down to is a question of how much cover John Roberts needs to wreak havoc with a ruling on King v. Burwell. He hasn’t been given much at all.

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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.