Paul Ryan
Credit: Gage Skidmore/Flickr

Because people in politics tend to like labels, over the past few years I’ve come to adopt “pragmatic progressive” as a way to define my own position. The word pragmatic indicates a focus on what works. While articulating ideological goals can win a public relations contest in the short term, unless they are grounded in pragmatic solutions, they can come back to haunt you over the long term. We are now witnessing a perfect example of that as Republicans are faced with the challenge of following through on their promise to repeal and replace Obamacare.

Republican opposition to Obamacare has always been, in part, ideological. They tend to be against almost any form of government regulation. But it was also a result of their strategy of total obstruction. Given that health care reform was the centerpiece of Obama’s agenda (along with recovery from the Great Recession), it was imperative that they stake out a claim of fierce opposition.

Neither of those reasons were grounded in a pragmatic argument. Given that simply defending the pre-Obamacare status quo was not an option, they chose to exaggerate their arguments against the reforms as long as there was nothing they could actually accomplish when it comes to health care.

With the results of the 2016 election, those chickens have now come home to roost. Some Republicans have altered their total opposition and tried to pick and chose which portions of the law they want to keep. A pragmatic look would tell them that, when it comes to something as complicated as health insurance, that is going to be difficult (if not impossible) to implement. Sen. Lindsay Graham at least recognizes the problem.

“Once you say that everybody should be covered, can’t be denied coverage because they are sick – which most Americans would agree with that – you put yourself in a box. Insurance is about young people who are healthy buying insurance like you all to pay for me and him,” Sen. Lindsey Graham (R-SC) said, pointing to the oldest reporter in the scrum. “If you don’t have to buy insurance until you get sick, most people won’t. That’s where the mandate becomes important.”

Graham added: “Somebody’s got to work through this problem. If we’re going to accept the proposition that you can never be denied coverage because you’ve been sick, then somebody’s got to create a system where people participate.”

Hmmm…”somebody’s got to work through this problem.” I think somebody already did. It’s contained in what we call “Obamacare.” Too bad you guys staked your claim on getting rid of it.

But from a political perspective, the big problem Republicans now face is how to repeal a law that is benefiting so many Americans when you have no plan in place as an alternative. Some GOP leaders have decided that the way to handle that is to mollify their base by passing a bill immediately to repeal the law, but delay it’s implementation for 2-3 years while they work on a replacement. Just as they began to rally their troops around that plan, it looks like they’ve figured out there might be a problem with it.

Republicans are planning to pass repeal legislation as soon as January, but plan to delay it from taking effect for a few years to avoid immediate disruption in people’s coverage. The delay would also buy them time to come up with a replacement.

But industry officials and healthcare experts are warning that insurers might bail out of the system altogether once a repeal bill passes, particularly since many of them have been losing millions of dollars on ObamaCare plans.

An exodus of insurers could dramatically limit the coverage options for the roughly 10 million people enrolled in the system, potentially creating a backlash.

Oops. Now what? How about the old tried-and-true method of buying people off while we figure it all out?

Recognizing the problem, Republican congressional staffers are in talks with insurers about policies they could implement to help improve their financial situation in that interim period and prevent a breakdown in the market, according to three Republican lobbyists…

Any policies favorable to insurers could be politically treacherous for Republicans, given that they have railed for years against ObamaCare “bailouts” of insurance companies.

What they are contemplating is doing something similar to what Republicans like Sen. Marco Rubio railed about when criticizing Obamacare.

If the Republicans actually had a plan that would work instead of relying simply on ideology and obstruction, they wouldn’t have to be shuffling around covering their backsides by trying to figure out how to pay off insurance companies while they figured things out. Meanwhile, the healthcare of tens of millions of Americans hangs in the balance.

Nancy LeTourneau

Follow Nancy on Twitter @Smartypants60.