Republican congressional leaders thought they had come up with a great idea: Pass a bill through the House getting rid of an Obamacare “slush fund” that is slated to be used to advertise the benefits of the program. To make the bill more painful for the Democrats to oppose, redirect the funds to Obamacare’s ailing fund for “high-risk pools” for sick people — a better version of which is part of every conservative plan to replace Obamacare.
Now those congressional leaders are furious with conservative House members and organizations who have scuttled the bill for the time being; the bill’s opponents see it as a surrender in the battle to repeal Obamacare completely. While we side with the leadership on this specific bill, the uproar reflects the justified suspicion of grassroots conservatives that Republicans are just mouthing their support for repeal and replacement of Obamacare and have no real plan for bringing it about.
The failure to devise and articulate an anti-Obamacare strategy is, however, not that of the party leaders alone. Their conservative critics, when they have advanced their own strategies, have made proposals that are likely to set back the cause — such as using the threat of a government shutdown to force the Democrats to acquiesce in repeal.
The basic outline of a workable strategy is easy to draw up. First, Republicans should explain why Obamacare is unlikely to work. Second, they should finally unite behind an alternative that would let at least as many people get coverage as Obamacare but without the law’s side-effects. Third, they should say that they plan to repeal and replace Obamacare as soon as they can do so — whether in one fell swoop, which could occur only under a new president in 2017, or one step at a time. Fourth, they should advance bills that both replace parts of Obamacare and highlight its flaws.
If Republicans adopt and explain this strategy, they will provide hope for grassroots conservatives that this cause is winnable — and that they themselves are committed to it. In the context of this strategy, proposals such as the funding of high-risk pools make sense. (It nicely focuses attention on Obamacare’s prioritization of an ideology-driven remaking of the health-care system over actually helping the people for whom that remaking was supposedly accomplished.) Some piecemeal reforms of the program, on the other hand, would not further the strategy: For example, legislation to exempt congressional employees from the onerous requirements of Obamacare would communicate that Republicans are indifferent to the burden those requirements place on the private sector. Speaker John Boehner was right to dismiss the idea yesterday.
Some conservatives worry about any attempts to amend Obamacare that fall short of total repeal. They fear that Democrats will accept these bills, provide cover for themselves, and reduce public opposition to the program. That scenario is highly unlikely. “Fixing” Obamacare so that it does not jeopardize current coverage arrangements, raise premiums, and depress job growth would require replacing it, which Democrats will not accept. Nor will they get any cover if Republicans keep clear on the point that full repeal is the only real solution. Let Republicans unite around the need to replace Obamacare while Democrats divide on whether to cling to its flaws.