Paul Ryan
Credit: Tony Alter/Flickr

Since his inauguration, Donald Trump has been busy defending his legitimacy, making unfounded accusations about voter fraud, signing executive orders, approving botched terrorist raids, threatening federal workers and bullying foreign allies. Meanwhile, when it comes to Congress, not much is happening.

Republican leaders made it clear that their first legislative priority was to repeal Obamacare. That got bogged down because they have no idea about how to replace it and are experiencing a backlash from constituents who fear losing their coverage. Lately the divisions in Republican ranks have been fueled by a controversy over whether to repeal or repair the law.

Some Republicans in Congress are starting to talk more about trying to “repair” Obamacare, rather than simply calling for “repeal and replace.”

There’s good reason for that.

The repair language was discussed by Republicans during their closed-door policy retreat in Philadelphia last week as a better way to brand their strategy. Some of that discussion flowed from views that Republicans may not be headed toward a total replacement, said one conservative House lawmaker who didn’t want to be identified…

Republicans are grappling with their party’s desire — and President Donald Trump’s promise — to dismantle Obamacare, as well as the political disaster that could ensue if millions of Americans lose coverage as a result of legislation.

That kind of talk isn’t sitting well with some lawmakers.

Conservatives have voiced frustrations about the slow pace of repeal, aiming to get rid of the law as soon as possible and figure out a replacement later, if at all.

“I’m out there saying repeal and no replace — that’s as pretty strong as it gets,” Representative Roger Williams, a Texas Republican, said in an interview. He said he believes things should “just go back the way they were” before Obamacare.

A former Republican governor obviously sees an opening to exploit.

The current Speaker of the House it simply trying to cover all of his bases.

“We’ve been working with the administration on a daily basis to map out and plan a very bold and aggressive agenda to make good on our campaign promises and to fix these problems — to repeal and replace and repair our broken health care system,” Ryan said at a news conference during the Philadelphia retreat.

In other words, they have NO IDEA (much less consensus) about what to do.

Meanwhile, the one thing all Congressional Republicans have agreed on – to block grant Medicaid – isn’t going as planned either. Here’s what Rep. Phil Roe (R-TN) told Sarah Kliff:

What I thought was going to be easy was I thought Medicaid, we’d just block-grant it to the states. That one actually is going to be a little harder than I thought. The reason is there are states like New York, states that expanded [Medicaid]. How do you cover that 10 or so million people on Medicaid?

Block granting Medicaid means dividing the federal dollars between states and letting them decide how to spend it. But that raises the question of “who gets how much?” Going with how it is distributed right now means that states who refused Medicaid expansion under Obamacare (i.e., red states) get the short end of the stick. As he does so often, Kevin Drum provides us with a helpful visual to explain how that would affect the blue state of California and the red state of Texas.

What we can learn from all this confusion is that this is what happens when you make ideological promises without a pragmatic plan for how to implement them. That has been the essence of Republican failure in their post-policy rejection of governance. The good news is that it just might save the essence of Obamacare.

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