Health care is making a comeback from the political grave. President Trump and House Republicans are talking about a renewed push for reform because they know that it needs to get done. It’s not just because it’s the right thing to do. It’s sort of a mandatory item due to conservatives making the Republican Party the dominant political force in the country. Why? The GOP said they would repeal Obamacare.
It took nearly a decade, but the Tea Party fervor and the army of conservative activists gave Republicans the House (2010), the Senate (2014), and the presidency (2016). In return, the GOP campaigned on repealing the law. It’s politically untenable for them to have a ‘we tried’ attitude. That’s not going to cut it. For Trump, he risks looking like the very politicians that he excoriated on the 2016 trail: all talk, no action. At Americans for Prosperity, which reached new levels of power at the outset Tea Party movement, they compiled a comprehensive timeline of their near decade-long campaign fighting President Obama’s health care reform. The message is clear: This is what we have done. What are you going to do?
Through the lens of a conservative, retreat is not acceptable. Surrender is not acceptable. And a half-assed attempt at repeal is not acceptable, especially when the initial replacement bill—the American Health Care Act—kept the expensive Medicaid expansion provision intact. The GOP establishment has to understand that these conservatives, whose ideas are mostly represented through the like-minded House Freedom Caucus, aren’t going away.
“In seven years, we have never wavered in our commitment to a full repeal of this disastrous law. We want to make certain that lawmakers understand the policy consequences of voting for a law that keeps Obamacare intact,” said AFP President Tim Phillips. “We have a history of following up and holding politicians accountable, but we will also be there to support and thank the champions who stand strong and keep their promise.”
And, unsurprisingly, the group is running the “You Promised” campaign to remind Republicans why they’re there and what they told voters back home.
The main points that upset AFP in the AHCA was that the refundable tax credit provision was pretty much no different that the credits offered under Obamacare. It was one program replaced with a similar one. Taxpayers would still be on the hook for it. The AHCA didn’t get rid of all the regulations and mandates with Obamacare, specifically the regulations connected to higher premiums. And last, the first unveiling of the AHCA didn’t rollback the Medicaid expansion until 2020. This point was the one that really poisoned the well for Republicans. Conservatives were mad it didn’t go far enough, while moderates were wary about how Medicaid and Medicare would be funded. A new version allowed states to apply work requirements to able-bodied Medicaid enrollees, but by that time—it was clear that the bill was on the path to legislative death, which eventually happened.
After cobbling together over three million activists for their anti-Obamacare campaign, along with another push that took aim at government spending in 2011, AFP and other like-minded conservative groups haven’t come this far for the GOP to call it quits on health care. As I’ve written before, the Tea Party has the right to be angry about what happened with this fiasco. After 3 million doors were knocked on, 20 million phone calls, and 200 million invested in television, radio, and digital ads, these folks aren’t going to rest until the GOP delivers on what they’ve been telling voters for several years.