Mitch McConnell
Credit: Gage Skidmore/Flickr

I can imagine John Boehner chuckling to himself that this time it’s Paul Ryan’s problem. On many occasions the former House Speaker faced the same kind of chaos within his party’s caucus that Ryan is experiencing now with their attempts to repeal Obamacare. Actually, it doesn’t take much imagination. Here’s what Boehner said recently:

Earlier in the panel discussion, Boehner said he “started laughing” when Republicans started talking about moving lightning fast on repeal and then coming up with an alternative.

“In the 25 years that I served in the United States Congress, Republicans never, ever, one time agreed on what a health care proposal should look like. Not once,” Boehner said.

It’s helpful to go back a few years and remember how we got here. One of Barack Obama’s major promises when he ran for president in 2008 was that he would champion health care reform. After passing a stimulus package to deal with the Great Recession, he and the Democrats immediately got to work on fulfilling that promise.

Because Republicans had already committed to total obstruction of anything the opposition party attempted to do, they vowed from the beginning that health care reform wouldn’t receive a single vote from them. They were successful in that endeavor.

Both during the negotiations over the ACA and after it had been passed, the country was subjected to a whole series of lies about the legislation. It was described as a government take-over of health care, there were so-called “death panels,” it would bankrupt the country and eliminate jobs. Of course, none of this was true. But an awful lot of Americans bought it all. As a result, repealing and replacing Obamacare became a battle cry in the Republican power games against the administration.

Now that the GOP controls Congress and has a president who is willing to sign a bill to repeal/replace the law, the reality Boehner described is on display: “Republicans never, ever, one time agreed on what a health care proposal should look like.”

At this point, Ryan has the outlines of a plan that is taking heat on one side from his colleagues in the House Freedom Caucus and the Republican Study Committee for spending ANY federal dollars on health care. On the other side, he’s hearing from Republican Governors (especially in states that expanded Medicaid) that they don’t want to face the possibility of people losing coverage provided by Obamacare. It is a perfect example of the proverbial rock and a hard place.

Apparently Ryan recognizes that there is no possibility for compromise and his plan at this point is to engage in a game of chicken with fellow Republicans.

Congressional leaders are signaling a “now or never” strategy that will dare the Republicans to stand in their way, regardless of their disagreements over the details of repealing the Affordable Care Act, according to a Wall Street Journal report.

“You’re a Republican, you’ve been running to repeal Obamacare, they put a repeal bill in front of you,” Doug Badger, a longtime Republican leadership health policy adviser, told the Journal. “Are you going to be the Republican senator who prevents Obamacare repeal from being sent to a Republican president who is willing to sign it?”

David Leonhardt spells out the irony.

Republicans have spent so long promising repeal that failure would leave them vulnerable to primary challenges and make them look weak. They have many incentives to pass a bill.

But aficionados of irony will appreciate the fundamental source of their struggles. In drafting his health care plan, Barack Obama chose a moderate, market-based approach. It was to the right of Bill Clinton’s and Richard Nixon’s plans and way to the right of Harry Truman’s — and yet Republicans still wouldn’t support it.

Many liberals regret that decision. Obama, for his part, believes that a more left-wing version would not have passed. Either way, the version that did pass doesn’t leave Republicans much room to maneuver.

I was reminded of the fact that I often described Obama’s strategy to deal with Republican obstruction as being one where his pragmatism allowed him to encompass a large portion of the identified political spectrum and relegate Republicans to backing themselves into an ever-more extremist corner in opposition. That is exactly what Leonhardt described with respect to health care reform. Republican lies about Obamacare combined with their promises to repeal the law have left them with no pragmatic options for replacement. They backed themselves into such an extremist corner that they now have no room to maneuver.

The one conservative who saw this coming was David Frum.

A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994…

This time, when we went for all the marbles, we ended with none…

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

This is not to say that Republicans won’t find a way to make a mess of Obamacare. While that is looking less likely every day, Ryan is right. Many of them won’t have the guts to vote against a repeal plan that actually comes up for a vote. But their position between a rock and a hard place is clear. Either they renege on their promise to repeal Obamacare, or they pass something that harms large swaths of their constituencies. Part of what got them to that place is that the reforms passed by Democrats left them no room to maneuver. That just might be what saves Obamacare in the long run.

Nancy LeTourneau

Follow Nancy on Twitter @Smartypants60.