Much has been made of recent comments from two prominent Republicans, both of whom appear to suggest that the GOP may need to shift its approach in opposing the president's unpopular healthcare overhaul. Has 'full repeal and replace' be a relic of the past? Let's review the quotes. The first comes from Rep. Cathy McMorris Rodgers, a member of House Republican leadership:
With the news this week that more than 600,000 Washington residents have acquired new health care plans through the state exchange, U.S. Rep. Cathy McMorris Rodgers said it’s unlikely the Affordable Care Act will be repealed. “We need to look at reforming the exchanges,” the Eastern Washington Republican said Thursday. McMorris Rodgers has been part of the Republican leadership in the House that has voted multiple times to repeal parts or all of President Barack Obama’s signature health care law. GOP members have said the law is unworkable, will increase costs for some and force others into inadequate coverage or plans they don’t want. McMorris Rodgers continued those criticisms Thursday, but said the framework established by the law likely will persist and reforms should take place within its structure. “It is a top-down, one-size-fits-all approach to health care,” she said. Consumers should have more choice for their coverage, and Democrats should abandon the idea that everyone will enroll because of the mandate, McMorris Rodgers added. The congresswoman also said that the 85 percent of enrollees who received Medicaid coverage is a sign the program is not sustainable and many will receive subpar care.
Up next is Sen. Rand Paul of Kentucky, a Tea Party favorite, who's raised eyebrows with a number of recent political analyses. Et tu, Senator?
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Sen. Rand Paul (R-Ky.) admitted Friday it’s “difficult to turn the clock back” on ObamaCare, but proposed making the law voluntary as a possible fix for consumers. “I think it’s going to be difficult to turn the clock back. People get assumed and accustomed to receiving things, particularly things that they get for free,” he told a crowd of students at Harvard’s Institute of Politics on Friday. Paul’s comments echo those of other Republicans who have admitted it will be difficult to fully repeal the law after some of its more popular provisions took effect...“I think one of the practical things you might be able to do, and I think the public at large might accept this, is to make ObamaCare voluntary. You make it voluntary, basically you get rid of the coercion,” he said, presumably by eliminating the penalty those without insurance are required to pay, known as the individual mandate. He said he may keep some parts of the law, like the subsidies to help poor Americans afford insurance, or the Medicaid expansion -- two of ObamaCare's more popular provisions but potentially its more expensive. “Does that get rid of the subsidies? Not necessarily, or the Medicaid. But I think also we’re going to find out we can’t afford to have everybody on Medicaid, we can’t afford to have everybody on subsidized insurance,” Paul said. The Kentucky senator also railed against President Obama for the idea of the law in the first place, telling students gathered at Harvard’s Institute of Politics on Friday that Obama “says that you are not smart enough…to choose your own insurance.”
One retort to Paul's "people like free stuff" argument is that even though some people are certainly benefiting from Obamacare, at least as many have been pummeled with cancellation letters and higher costs -- thus, there will be a natural constituency for massively overhauling or scrapping the law. Regardless, do these comments signal a strategic GOP retreat, or are they merely nods to prevailing political realities? Put another way, are McMorris Rodgers and Paul being descriptive or prescriptive? From an objective standpoint, it is simply a fact that Obamacare -- or whatever current permutation of the law may count as "Obamacare" on any given day -- will remain the law of the land until at least 2017. Even then, repealing the law will require a Republican president and a Republican Congress, with members willing to use hardball legislative tactics such as reconciliation to peel it back. I don't need to tell you that winning the next presidential contest won't be easy for the GOP, and on top of that, the 2016 Senate map looks to be unusually challenging. Merely taking note of these factors and planning accordingly isn't "selling out." It's grappling with reality as it exists, not as one wishes it would be, so spare my the "they lied!" histrionics. Repeating the repeal mantra over and over won't make the task of unraveling this harmful law any easier. Indeed, burying one's head in the ideological sand isn't generally a winning political strategy. (Look no further than the righteous but doomed "defund Obamacare" gambit that led to last fall's unpopular government shutdown). McMorris Rodgers and Paul have each made clear that they remain committed to the goal of repeal, but they're also discussing various methods of dismantling aspects of a law that will remain on the books for at least the next few years -- during which time, to Sen. Paul's point, more Americans will become dependent on it.
One obvious play is to push to eradicate as many mandates as possible, including the twice-delayed, job-killing employer mandate. Robert Gibbs predicted this would happen sooner rather than later, so it's not some right-wing pipe dream. Another is to eliminate Obamacare's IPAB rationing board, which has been criticized by the likes of Howard Dean. Still another would be focusing on stamping out the hated individual mandate, the coercive enforcement of which is to be carried out by the IRS. This step might be attempted in tandem with a series of reforms to the exchanges, including changes to the battery of cost-increasing coverage mandates. Granted, any of these changes would present significant problems to the law's sustainability, but each one polls well and has strong populist appeal. If the goal is to replace this already-broken law with something better, undermining and chipping away at it is the only hand the GOP has to play at the moment. Beyond that, it will be incumbent on Republicans to propose a unified, viable alternative to Obamacare without overselling its attributes, or lying about its repercussions. That's a heavy lift politically. Americans are resistant to healthcare changes, which explains why Democrats resorted to telling huge lies both to pass their 2010 experiment, and to demagogue needed reforms to Medicare. All of which is to say that in spite of sustained public opposition to Obamacare (which should and will impact the coming election cycle), getting rid of it is going to be impossible in the near term, and rather difficult in the medium term. Pretending otherwise accomplishes nothing. All that being said, however, midterm elections disproportionately hinge on turnout and enthusiasm. I'm not sure it's wise for Republicans to be publicly discussing "plan B" on Obamacare at this juncture, especially since so much of their fired-up base is vehemently opposed to the law. In the same vein, I'm fairly certain that igniting an immigration conflagration this summer is deeply unwise for any number of reasons.
Parting thought: I've seen some high-fiving on the Left about conservatives finally "throwing in the towel," or whatever, on Obamacare. One of the tropes they love to repeat is that Republicans have idiotically attempted to repeal Obamacare more than 50 times. What they never mention is that several of those attempts were successful, nor do they seem to understand that others were savvy messaging votes. In other words, like most liberal Obamacare celebrations, this round of self-congratulation is also completely misplaced. But kudos on the big "winning streak," guys.
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