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Will We Always Have Been At War With Obamacare?

I’m going to be boarding a plane shortly, and I’ll likely be in the air when the AHCA vote happens. So it’s possible that this post will look pointless in a couple of hours.

But assuming the vote fails, as it currently looks likely to do, we’re about to learn just how Orwellian the GOP electorate is.

A failure of the AHCA isn’t necessarily the end of the road for GOP attempts to reform President Obama’s healthcare reform. They could start again pretty quickly in the Senate, which was unlikely ever to pass the House’s bill in the first place. They could also move on to other business, hope to expand their majority in 2018, and then try again. They could even campaign on a particular vision of reform in 2018, and then claim a mandate if they did expand their majority.

But of course, to do that they’d need to have an intra-party debate about what that policy agenda should be. Which would require somebody — and that somebody is probably President Trump — to stand up and say: the House Freedom Caucus’s vision is wrong, and here’s my alternative, whether that’s Medicaid for all [1] or some as-yet undescribed alternative to both Obamacare and the status-quo ante circa 2008.

It’s possible that’s a fight Trump doesn’t want, because he doesn’t care much about healthcare except as a way of bashing Obama and the Democratic Party. Indeed, it’s possible that much of the Republican party sees the matter in precisely the same way: that there wasn’t anything in particular they objected to about Obamacare (other than the tax hikes to pay for it); they just hated that it was a Democratic initiative. It may be that Paul Ryan and the House Freedom Caucus folks are the only ones who actually want to have this fight on the merits. If that’s the case, then if the bill fails that will be the end of any action on health care, and Obamacare will remain the law of the land.

The question then is: how will the party membership react?

If the reaction is fury and renewed attempts to unseat Republicans deemed insufficiently determined to repeal the ACA, and to expand the ranks of the ultras whose demands made any plausible compromise impossible, then we’ll know that what we’re dealing with is a real ideological conflict. Our political system might have a particularly hard time negotiating it, but a substantial irredentist faction would pose a real challenge to any political system.

If the reaction is a mix of soul-searching and teeth-gnashing, and a concerted attempt to find whatever formula delivers a more durable majority, then we’ll know that at the end of the day the GOP is a normal party after all, one that, when it loses, tries to figure out how to win. It wouldn’t be as encouraging as an open fight about policy and principles, but it would be far more encouraging than continued irredentism.

But I wouldn’t be completely shocked if the whole debate just dropped down the memory hole, and the party leadership acted like repealing Obamacare was never that big a deal — and the rank-and-file mostly went along as the party moved on to whatever they are told was always really the priority. Which would be the most depressing — indeed, alarming — possibility.

The vote’s in half an hour. We’ll find out pretty soon whether my whole premise is fallacious.

26 Comments (Open | Close)

26 Comments To "Will We Always Have Been At War With Obamacare?"

#1 Comment By victory over eurasia On March 24, 2017 @ 3:02 pm

I hear from the ministry of Truth that under our glorious new health care plan the number of uninsured will drop to only 52 million by 2026 (no doubt accompanied by an increase in the chocolate ration to 20 grams….)

#2 Comment By Nick Stuart On March 24, 2017 @ 3:08 pm

Absolutely no excuse why House GOP didn’t have a bill ready for vote on 1/20/17. They had SIX years to get it ready. If there’s a major fail they ALL own it.

#3 Comment By The Other Sands On March 24, 2017 @ 4:35 pm

GOP voters will be fine with ACA now because what they didn’t like was Obama. They never understood the ACA in the first place, and just listened to GOP politicians tell them it was a catastrophe (without providing any details to that effect.)

As opposed to GOP voters, the GOP establishment wants to cut taxes for upper income people. Full. Stop.

(They used to also want to start wars, but GW Bush ruined that for them.)

To “pay for” tax cuts they want to degrade all government programs outside the military. They may wave their arms about social issues and the like, but they don’t care about them and don’t intend to do anything about them. Some realize that they can get away with deficit spending and so don’t even want to cut government programs all that badly.

Cutting taxes on rich people while degrading popular programs and services is not a popular platform. If laid out plainly in those terms, there is not a 51% constituency of voters behind that program.

And so the GOP lies to low information people. Exactly as they have done for over 30 years. Lie, lie, lie about what you are about, and what you intend to do if elected. Lie for seven years about repealing the Obamacare “catastrophe.” Whatever riles them up. Whatever gets them pissed enough to vote and send money.

Getting into power is the important thing. Pass the tax cut. Then figure out what the new unifying lie is going to be. Muslims and Mexicans most likely….

#4 Comment By sean mcauliffe On March 24, 2017 @ 5:21 pm

“Will We Always Have Been At War With Obamacare?”

Huh? Is this a sentence?

#5 Comment By DRK On March 24, 2017 @ 5:40 pm

It will go down the memory hole.

Remember how in 2006, Bush told the Weekly Standard that catching Osama bin Laden was not a priority? That was 4 years after we invaded Afghanistan with precisely that in mind. And the Republican party was just fine with that, it would seem, so much so that when bin Laden was caught during the Obama administration, the Republican reaction was a massive shrug.

These are people with very short attention spans, who’ve elected a guy with no attention span at all. It turns out that healthcare reform is actually very complicated, according to Trump. Gee, who’d have thought it?

#6 Comment By WAB On March 24, 2017 @ 5:50 pm

Bill was pulled and looks from here as if the same Freedom Caucus/Tea Party ideologues who can’t ever get to “yes”, even with their own party, on anything other than demanding 100% capitulation are responsible. They never wanted the “replace” part of “repeal and replace” to begin with.

Some moderate Republicans and more obliquely Trump are inviting Democrats to come in and help them fix it. Whether the Democrats can stop playing 2018 politics and take advantage of that openness is a question. We’ll know soon enough whether the Democrats can get to “yes” with Republicans on anything or will they follow the McConnell strategy? I’m afraid it will be the latter.

As usual, the American people will suffer through this dysfunction. The more things change the more they stay the same.

#7 Comment By Fred Bowman On March 24, 2017 @ 6:01 pm

Looks like AHCA didn’t have enought votes. Truth be told it was not a well thought out plan. If America is to get a decent Healthcare system then somehow the politicans have to realize what going to work is to start thinking what’s best for most American without screwing the most needy. Unfortunately most politicans are whores for the special interest crowd and wants and needs of the most American are quickly forgotten. Sad that Congress doesn’t have to live under the laws they pass.

#8 Comment By Geoffrey On March 24, 2017 @ 6:17 pm

Turns out this was a very relevant post!

“But I wouldn’t be completely shocked if the whole debate just dropped down the memory hole, and the party leadership acted like repealing Obamacare was never that big a deal…”

I guess the question is how many Republicans are principally motivated by some form of cultural rancor and how many by conservative ideas or principles.

#9 Comment By Alter Kacker On March 24, 2017 @ 7:07 pm

Memory hole it is!

[2]

#10 Comment By Allen On March 24, 2017 @ 8:01 pm

re: sean mcauliffe question.
I paused over it to, but parsed it as a very elegantly constructed sentence the likes of which we don’t often see in these times. The meaning: if the debate drops down a memory hole, the republicans will erase the historical memory that there was ever awar.

#11 Comment By EngineerScotty On March 24, 2017 @ 8:59 pm

I’d have no problem with the Democrats and moderate Republicans working on something better than Obamacare. But it would have to be, you know, better than Obamacare to win my support–and I strongly suspect that as long as Paul Ryan wields the gavel, nothing that would meet this criteria would ever get a floor vote in the House.

There’s no incentive for Democrats to participate in legislation that moves the football in the wrong direction. But it will be interesting to see how GOP moderates, of the sort who have to pay attention to voters rather than just donors, respond to this debacle. There are things wrong with Obamacare, much of it due to GOP sabotage–but the bill that is now being ridden out of DC on a rail is no improvement.

#12 Comment By CascadeJoe On March 24, 2017 @ 10:33 pm

from sean “Will We Always Have Been At War With Obamacare?”

Huh? Is this a sentence?

I know what it means. If you diagram it, turns out you make it into a statement as “We Always Will Have Been At War With Obamacare.” Not the same, but my ex-English teacher wife says that’s the way it is done (Google agrees).

#13 Comment By Nelson On March 25, 2017 @ 12:13 am

Cutting taxes on rich people while degrading popular programs and services is not a popular platform.

Granted, I don’t favor that platform but it is the platform the GOP ran on. I can’t look at the evidence my fellow voters have presented – GOP control of all branches of the Federal government along with most state governments – without coming to the conclusion that it is in fact, popular.

#14 Comment By balconesfault On March 25, 2017 @ 5:34 am

WAB “Some moderate Republicans and more obliquely Trump are inviting Democrats to come in and help them fix it. Whether the Democrats can stop playing 2018 politics and take advantage of that openness is a question.”

What EngineerScotty said. Most Dems are aware that there are some real flaws with the ACA.

Some of these were due to the GOP refusing to provide any votes in 2009 no matter what compromises were made, empowering the Bayh/Lieberman/Nelson triumverate whose interests lie in protecting big Pharma/big Insurance to extract compromises in order to defeat the GOP filibuster.

Some of these were been more deliberate, like the Rubio-led gutting of Risk Corridors in 2015. Risk Corridors were what allowed insurers to gamble to compete in a lot of smaller insurance marketplaces and not fear losing a lot of money if they gambled wrong … without them the industry fell into the behaviors that we saw last year, pulling out of many small markets while jacking up prices in others in order to minimize their exposure.

And finally, there’s insurance industry greed itself. The industry might be making excellent profits as a whole, but that doesn’t mean that they’re going to take competitive risks in markets that they view as having higher loss potential. Better to just pull out of those markets altogether, even if the potential losses in those small markets would be a trivial impact on their overall balance sheet.

After all – there’s no point in using “loss leaders” to encourage participation in plans in certain markets when the exchange itself (and the now prohibition on denying coverage for pre-existing conditions) makes it much easier for consumers to switch from plan to plan on an annual basis after comparing rates and benefits (something that pre-ACA was very difficult for the average consumer).

So if instead of the massive bellyflop into the healthcare regulatory pool that RyanCare represented, Trump invites Dems in to sit down and work on compromise legislation that addresses a lot of these issues without gutting much of what the ACA has done to expand the insurance net – I’m betting that the Dems would take that seriously.

OTOH, I’m not sure how many Republicans could take the political risk of actually sitting down at the table with Dems to hammer out legislation that isn’t at its core a cut in benefits for the poor and taxes for the wealthy. Seems to me a pretty good way to end up being primaried in 2018.

#15 Comment By Weldon On March 25, 2017 @ 9:21 am

>“Will We Always Have Been At War With Obamacare?”
>
> Huh? Is this a sentence?

Indeed. If you revert its finite-verb-first interrogative order, it parses as

“We will always have been at war with Obamacare”

Stripping the adverbial “always” as well as the modifying prepositional phrase, the skeleton of the sentence is then

“We will have been at war’

Which is the standard English construction for future perfect (i.e., the sentence refers to a time in the future from the perspective of which the thing in question will be in the past).

#16 Comment By Rugeirn Drienborough On March 25, 2017 @ 9:57 am

Re Sean McAuliffe’s question and Allen’s response: Neither of you show any sign of knowing where this phrase comes from. The point, from George Orwell’s 1984, isn’t that we will forget there was ever a war. It’s that we will all obediently “know” the the war that replaces the current war will, as soon as it begins, be the only war ever to exist. We will all obediently “know” there was never any other. Immigration EO’s? Never happened. Trumpcare? Never happened. Flynn? Never happened. Inaugural attendance? Never happened. Voter fraud? Never happened. And so on, in an orgy of post-truth. That, anyway, would be the Orwellian outcome. The antidote is memory, testimony, and accountability.

#17 Comment By William Burns On March 25, 2017 @ 10:15 am

Time to unite the Republican party, so sell any real estate you own in downtown Tehran ASAP.

#18 Comment By WorkingClass On March 25, 2017 @ 10:54 am

The American health care racket is an abomination. It will remain so until we institute single payer. The Democrats could not do it when they had the chance because corruption. The Republicans will miss their opportunity because Communism. But for the people the issue will not be forgotten. Actual people need medical attention when they are sick or injured.

#19 Comment By Unmesh Agarwala On March 25, 2017 @ 1:24 pm

@seanmcauliffe,

The allusion is to 1984 by George Orwell where history is rewritten to make it appear that the policy of the day was always the policy of the land.

#20 Comment By ChrisM On March 25, 2017 @ 2:57 pm

I fail to see why there cannot be a compromise capitalist socialist system. People need cheap catastrophic medical insurance so why not have the existing govt programs address that (medicare/Medicaid).
The allow the private sector to offer plans for all other care with a law that says no plan may be offered without seemless coverage between both types of plans.

People want private healthcare at the local level. I like the idea of devolving it from the federal to the states and allowing states with little competition to band together and form a regional cooperative.

However people are afraid of catastrophic healthcare and that should be the role of the govt just as it is for the elderly for nursing homes, etc.

#21 Comment By Karen Harris On March 26, 2017 @ 12:25 am

@OtherSands: No, GOP voters will not be “fine” with Obamacare now that Obama’s gone, because they know the impact it’s had and continues to have on their own lives in the way of higher costs and less healthcare choice, and the lies they were told about being able to keep their plan and their doctor. “They never understood ACA in the first place but just listened to what the GOP told them”, how incredibly condescending and obnoxious. I suppose only liberals and Obamacare supporters like you “understand” it. Your self-superiority and “we know what’s best for you” liberalism is one of the reasons Trump won.

Obamacare is a disaster. I’ve experienced that in my own life in various ways, I don’t need anyone to spoon-feed me that; I can think for myself.

You’re reading a conservative publication why? Oh right, to insert your liberal smugness and pompousness and to show how “smarter” you are.

#22 Comment By mohammad On March 26, 2017 @ 3:22 am

William Burns says:
“Time to unite the Republican party, so sell any real estate you own in downtown Tehran ASAP.”

I hope you are wrong, Sir, as I live in Tehran, though I have no property there. But the ugly thing is that there is good probability you will be proved right. Republicans usually have nothing constructive to sell, only war and war and war and war…… Democrats are only marginally better!

#23 Comment By Matt On March 26, 2017 @ 1:39 pm

I’m surprised it failed. I mean, it was always hopeless to get rid of the mandate while keeping the pre-existing conditions guarantee. Americans don’t actually want “insurance”, they want to just get healthcare for free, or at worst some nominal fee that in no way actually covers the cost. Let others make up the difference, or just write it off–it’s all just numbers anyway right?

But I’m surprised they didn’t go to a vote just to save face. It wouldn’t have been good to fail the vote, but at least there is some nonzero chance it would have passed. Pulling it is just embarrassing all around.

#24 Comment By philadelphialawyer On March 26, 2017 @ 6:39 pm

balconesfault:

“So if instead of the massive bellyflop into the healthcare regulatory pool that RyanCare represented, Trump invites Dems in to sit down and work on compromise legislation that addresses a lot of these issues without gutting much of what the ACA has done to expand the insurance net – I’m betting that the Dems would take that seriously.”

Of course they would. Democrats actually want to improve Obamacare. Republicans, at least many of them at Congressional level, and perhaps in many States too, are no longer interesting in governing. Rather they are all about the preening and posturing, ranting and raving, and bomb throwing. They don’t have a plan. And they lack the ability to formulate one, and the diligence, discipline and know-how to get a plan through Congress (or even the House, which they completely control).

Philip Klein, Washington Examiner

[3]

“What’s so utterly disgraceful, is not just that Republicans failed so miserably, but that they barely tried, raising questions about whether they ever actually wanted to repeal Obamacare in the first place.

“Republicans for years have criticized the process that produced Obamacare, and things certainly got ugly. But after having just witnessed this debacle, I think Paul Ryan owes Nancy Pelosi an apology.

“One has to admire the commitment that Democrats and Obama had to delivering something they campaigned on and truly believed in. They spent 13 months getting the bill from an initial concept to final passage, and pressed on during many points when everybody was predicting doom. They had public hearings, multiple drafts of different bills, they kept negotiating, even worked into Christmas. They made significant changes at times, but also never lost sight of their key goals. They didn’t back down in the face of angry town halls and after losing their filibuster-proof majority, and many members cast votes that they knew risked their political careers. Obama himself was a leader, who consistently made it clear that he was not going to walk away. He did countless rallies, meetings, speeches — even a ‘summit’ at the Blair House — to try to sell the bill, talking about details, responding to criticisms of the bill to the point that he was mocked by conservatives for talking so much about healthcare. [Klein leaves out that Obama desperately tried to get Republicans on board as well. Indeed, Obama tried to get all stakeholders involved in the process.]

“The contrast between Obama and Democrats on healthcare and what just happened is stunning. House Republicans slapped together a bill in a few weeks (months if we’re being generous) behind closed doors with barely any debate. They moved the bill through committees at blazing speed, conducted closed-door negotiations that resulted in relatively minor tweaks to the bill, and within 17 days, Trump decided that he’d had enough, and was ready to walk away if members didn’t accept the bill as is…

“Here’s the bottom line: Republicans didn’t want to repeal Obamacare that badly. Obamacare was a useful tool for them. For years, they could use it to score short-term messaging victories. People are steamed about high premiums? We’ll message on that today. People are angry about losing insurance coverage? We’ll put out a devastating YouTube video about that. Seniors are angry about the Medicare cuts? Let’s tweet about it. High deductibles are unpopular? We’ll issue an email fact sheet. Or maybe a gif. At no point were they willing to do the hard work of hashing out their intraparty policy differences and developing a coherent health agenda or of challenging the central liberal case for universal coverage. Sure, if the U.S. Supreme Court did the job for them, they were okay with Obamacare going away. But when push came to shove, they weren’t willing to put in the elbow grease.

“There was a big debate over the course of the election about how out of step Trump was with the Republican Party on many issues. But if anything, this episode shows that Trump and the GOP are perfect together — limited in attention span, all about big talk and identity politics, but uninterested in substance…failing and then walking away on seven years of promises is a pathetic abdication of duty. The Republican Party is a party without a purpose.”

Perhaps Trump can learn something. Now that he understands that repealing Obamacare and replacing it with “something great” is not “so easy” after all, and cannot be done “immediately,” and that it is, in fact, actually quite complicated (nobody knew!), maybe he will deal with the Dems and the remaining sane Republicans in Congress.

All along, Trump campaigned on leaving nobody uncovered. On making the premiums and co pays and deductibles lower. OK, has found out it ain’t so simple to make that happen. Still, there are people who would be willing to work with him to implement those changes. But they ain’t Paul Ryan and they ain’t the “Freedom” Caucus either.

#25 Comment By The Other Sands On March 27, 2017 @ 2:27 pm

Karen Harris, I don’t retract anything I said. After talking about repeal for seven years, they tried (not very hard) for two weeks and just gave up.

If people are having trouble with Obamacare, do you know what the GOP alternative is? For an additional 24 million people to have no insurance at all. That is what the bill did. So that they could cut taxes for rich people. If Obamacare has flaws, they could be talking right now about how to fix them, how to make incremental changes. They still have the majority don’t they? If they are really concerned about helping people on Obamacare, they could start addressing the flaws one by one. A bill doesn’t have to completely replace the current system and start over. So if they really care about people like you, where is the interest in fixes? Incremental changes for the older and working class people who voted for them? They say that “Obamacare will explode”. Well, if only the people in charge of the Federal Government, the Republican Party, cared enough about the American people to keep working on it instead of quitting.

So what will they do now? Forget health care and move on to tax cuts for rich people. Because its the only thing they actually care about. They lie to you to get your votes. But they love you, because you keep believing them. You vote for them again and again, so that they can go to DC and get paid six figures by the taxpayers (with government-provided health insurance which seems to suit them just fine). And they do favors for rich people and global corporations, until they retire and become lobbyists for them.

The GOP has been a con for at least 30 years, and you are the mark. You are the sucker. They never intend to help you with anything.

#26 Comment By EliteCommInc. On April 1, 2017 @ 12:12 am

As someone who largely thinks this is nonsense from 2007 to this day, i still have enough faith to defend Republicans.

“The GOP has been a con for at least 30 years, and you are the mark. You are the sucker. They never intend to help you with anything.”

The idea of removing such a huge program that has been ground into the fabric of health services and the economy, it takes a lot of chutzpah to remove it – regardless of what you replace with.
It ,means new regulations, new plans, new hospital procedures all of which are probably under strain and yet to make sense or be routine.

But repeal is the answer. I don’t think there’s much evidence that Republicans don’t care. The evidence merely indicates that the task will require some effort. I agree that they should have been able to design some repair or other program in seven years, in fact it appears they have, it was just rejected.

Am I a sucker because I vote Republican. I don’t think so. And I am not above being suckered.

“Truth, justice and the “american way” was actually something I believe in. Home, hearth, an apple pie . . .

I don’ believe that I expected the Republicans to deliver more than what is expected of the Constitution. Your suggestion implies personal help. To the extent that personal help is in keeping truth, justice, etc and the Constitutional guarantees and protections, I doubt I expected them to do anything for me personally.

Perhaps, it’s the ideological difference between the conservative mind and the liberal expectation of what the government is designed to do. And generally, it’s not personal.

But your comment suggests something else, perplexing as it is sinister. That something about the country has turned against Republicans that is personal in some manner and it implies they need help. I find that an intriguing thought.
______________________

“Of course they would. Democrats actually want to improve Obamacare.”

Hmmmmm . . . your defense while eloquent lacks something, any indication that the democrats have ever made a single solitary effort at improving the existing program. They haven’t improved a single solitary measure on the issue of healthcare. Not SSC, not medicare and not medicaid.