ACA Is "Law Of The Land" For Foreseeable Future

ACA Is "Law Of The Land" For Foreseeable Future

During the 2016 presidential election, the GOP vowed to attack the Affordable Care Act, colloquially known as “Obamacare,” like a hurricane. When the Republican Party won the triple crown of the Oval Office, House of Representatives, and Senate, most citizens assumed that Barack Obama’s namesake law would quickly be lost in the ensuing tempest. The Democratic Party, wounded and hurting, seemed embroiled in bitter infighting while trying to assign blame for the unexpected defeat of Hillary Clinton. 

That was four and a half months ago, in the dark days after November 8.

When Donald Trump took the oath of office on January 20 and became our 45th president, he vowed to replace Obamacare as soon as possible. But, within weeks, it appeared that the initiative was in trouble. Storm clouds appeared on the GOP’s horizons when Trump complained that healthcare reform was more “complicated” than anyone could have anticipated. Critics laughed at the idea that a president could be so naïve: Of course comprehensive healthcare reform is complicated!

In the House of Representatives, committees labored on the Obamacare repeal-and-replace bill.  By the beginning of March, many were miffed that such a momentous bill was being crafted in secret. In an amazing bit of political theater, libertarian Senator Rand Paul (R-KY) stormed over to the House to demand a look at the bill. Liberals and conservatives alike began complaining about the healthcare bill being created in secret, and opined that the secrecy must be because the proposal was a real stinker.

To make a long story short, they appeared to be right. When the repeal-and-replace bill was finally revealed, dubbed the American Health Care Act, it was savaged from all sides. Liberals hated all of it, moderate Republicans worried about its rolling back of Medicaid, and conservative Republicans hated that it continued a version of Obamacare’s individual mandate.  When the nonpartisan Congressional Budget Office (CBO) estimated that the law would eventually strip 24 million Americans of health insurance, the bill received an irreparable tarnish.

Though President Donald Trump, Health and Human Services (HHS) Secretary Tom Price, and Speaker of the House Paul Ryan (R-KY) all insisted that the CBO was dead wrong, the number 24 million was downright scary to most Americans… and any Republican running for re-election in 2018. After many congressional Republicans vowed not to vote for the AHCA, the GOP began trying to edit the bill to pick up more votes. Wanting a quick vote, President Donald Trump tried to rally the conservative troops by insisting that anyone who voted against it would be at risk of losing re-election. 

Many Republicans in Congress appear to have called Trump’s bluff, because the AHCA vote in the House was called off at the last moment for lack of support. And it’s not just a temporary delay: Speaker Paul Ryan has admitted that Obamacare is the “law of the land” for the foreseeable future. Right now, the GOP is licking its wounds. For a tough-talking “dealmaker” like Donald Trump, the failure of the Obamacare repeal is a humiliation…especially since his party controlled all of Congress.

So what now?

Democrats will likely play it cool for the moment, not wanting to antagonize the Republicans and risk uniting them in ire. For now, it is sufficient to take the high road and let the GOP infighting and finger-pointing attract the public’s attention. Having finally gotten some points on the board after a devastating November rout, the Democratic Party will bask quietly in victory.

But the peace won’t last: The failure of the AHCA is a clear sign that liberal healthcare is the inevitable path for America. Indeed, with single payer healthcare the policy of choice of every other industrialized nation, it should be no shock that privatized medicine is unworkable on a macro scale. Currently, the U.S. has substantially higher healthcare costs per citizen, but worse results.

Look for liberal icons like Bernie Sanders to use the AHC failure and the 2018 midterms as opportunities to renew the drive for single payer healthcare in the United States. If Sanders hopes to run for president again in 2020, he can point to the AHCA’s tabling by the GOP as evidence that privatized healthcare is doomed to fail. “We need to move Obamacare closer to single-payer, not further away. And the Republicans, deep down, knew that. If there had been any way to make healthcare more privatized and still make it workable, they would have found it during the seven years they swore to repeal Obamacare,” he could say in a fiery speech.

That’s right: The GOP has had seven years to plan a replacement for Obamacare, and that number will sting Republicans again and again during future healthcare reform debates. If you can’t do it in seven years, can it be done at all?  It will be nigh impossible for Republicans to convince voters that they can get healthcare reform accomplished if only given more time.

No, healthcare reform is now the province of the Democrats. The ball is in their court, metaphorically speaking. Although the Dems don’t have the votes in Congress to liberalize Obamacare, they have plenty of ammo to start picking up contested House and Senate seats in 2018. The public now sees the GOP as ineffectual, failing to accomplish their most key proposal despite enjoying unprecedented power in Washington.

Looking ahead to 2020, President Trump has suffered a grievous wounding. Having failed to cajole recalcitrant congressional Republicans to back the AHCA, he risks losing control of Congress in 2018. Republicans up for re-election in less than two years will have to choose between criticizing the failed AHCA, which hurts Trump, or supporting it and risking a loss.  Many will repudiate the AHCA and make the president look weak.

Trump had the best playing field any president could hope for, and he flubbed the play. Unless he can pick up a major success between now and 2020, which seems rather unlikely, it’s almost guaranteed that voters will demand a new quarterback.