How the GOP Can Still Repeal Obamacare, and Why it Hasn’t Happened Yet

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Despite the GOP’s failure to repeal Obamacare, there is still hope for market-based healthcare reform.

My number one pet peeve with politicians is the constant and blatant hypocrisy that is often exposed during the passing (or not passing) of key legislation. The Tax Reform Act of 1986 is ample proof that many politicians will do whatever it takes to get elected – or in many cases, prevent themselves from losing. What if I told you that in the 1986 Congress, Senators Al Gore, Joe Biden, Harry Reid as well as Congressman Chuck Schumer, voted for the Reagan-championed Tax Reform Act that lowered the top marginal income tax rate to 28%? Ironically, now-Senate Minority Leader Schumer recently denounced capitalism as a whole, claiming that it has “broken down” and that the “old Adam Smith idea of competition” is “gone.”

It’s somewhat amusing to see that when the economy was booming with immense GDP and job growth, Mr. Schumer thought it was valid, along with 96 other senators at the time, to vote in favor of capitalism. With the Democratic Party on an interminable march to the left, I assume that Mr. Schumer has now realized that he will keep his seat only if he moves left with the party, regardless of whether he truly embraces destroying the free market.

In defense of the Democrats, they are not the only ones at fault here. For years, GOP leadership railed against the Affordable Care Act (also known as Obamacare). Repeal and replace will not happen until it is politically convenient for Republicans.

Knowing that President Obama would veto their legislation, House and Senate Republicans sent a strong message to the President’s desk in 2015 by passing a bill that repealed most of the ACA. This was a smart political tactic that helped energize their base and get many of them re-elected in 2016.

However, the truth is that Obamacare expanded benefits to many people who did not have such benefits under the old system, meaning that repealing the bill could be quite damaging politically. Republicans are finding it difficult to come through on their campaign promises, for the time being, even when they have a president who is willing to sign any marginally more conservative health bill that gets to his desk. Some GOP leaders are realizing that the potential backlash from yanking benefits from their constituents could end up being political suicide if the health care market doesn’t improve rapidly enough before a major election cycle.

The Wall Street Journal Editorial Board summarized the situation on July 18th of this year: “narrow political and ideological preferences” were put “ahead of practical legislative progress.” These “Obamacare Republicans” are just as hypocritical as the Democrats of the 1980s who praised tax cuts then and demonize them now. Republicans ran vigorously on platforms of repeal and replace, but choked during crunch time.

Often running as conservatives who embrace entitlement reform, Republicans in opposition of the Senate bill knowingly rejected $772 billion in cuts to Medicaid by 2026, while also reducing the federal deficit by $321 billion over the next ten years. Free-market champions such as Mike Lee and Rand Paul consistently thwarted progress toward a freer market. Some GOP Senators were even opposed to the tax cuts within the bill. If tax reform, immigration, and infrastructure fall onto the same path, the GOP might as well personally hand over power to the Democrats in 2020.

Eventually, Obamacare’s strict mandates, price fixes, and regulations will cause the health care market to implode, causing rising premiums, higher deductibles, and fewer coverage options. In addition, the law’s Medicaid expansion accelerates the bursting of the bubble that is the national debt.

President Trump is correct when he says that leaving Obamacare alone will abruptly force cooperation in the future due to a substantially destabilized marketplace. However, he is also correct to want to take initiative now to prevent further damage from happening. With intense ideological diversity and a dangerous lack of conviction within the party, that effort appears dead … for now.

Though Congressional attempts at “repeal and replace” appear to have failed for now, Obamacare adversaries should not be too optimistic. President Trump can continue to weaken the law through executive measures. Actions that can be taken through executive orders include halting the individual mandate, limiting cost-sharing subsidies, and eliminating funding for programs that embed people into the Obamacare exchanges. Although it wouldn’t be the best solution, bipartisan legislation would likely be better than leaving the health care law as it is.

If the American people want an actual overhaul of the ACA, multiple factors need to coalesce. First, citizens need to hold their elected officials accountable and pressure them in both town halls and at the ballot box. Second, ideological divisions and inflated personal egos within the party need to deteriorate. And lastly, the economic environment must call for “repeal and replace” just like it called for Chuck Schumer, Harry Reid, and the rest to play ball with Reaganomics in the 1980s.

If health care reforms fails completely, the only thing being repealed and replaced in Congress will be the GOP.

Mitchell Siegel studies public policy at Duke University. He is a healthcare policy intern at the Heritage Foundation.

Editor’s Note: The opinions expressed in this article do not represent the views of The Heritage Foundation or its associated bodies.

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