Contrary to the usual cliché, the failure of Obamacare repeal and replace had many parents. House Speaker Paul Ryan failed by not forging a consensus for a bill before drafting it but instead feverishly trying to amend the legislation as various factions within his caucus, particularly the House Freedom Caucus, objected. President Donald Trump failed by not intervening early and for not realizing that the Art of the Deal has to be modified when parties are motivated by ideology. The House Freedom Caucus failed by not bending an inch and by getting hysterical about “Ryancare” or “Trumpcare” or even “Rinocare” on social media.
Proponents of Repeal and Replace failed by not getting the millions of people who have been harmed by the law to make their voices known, leaving the field to people who think that Obamacare saved their lives.
The question now arises, what now.
Trump is undoubtedly right when he suggests that the need to address Obamacare is not going away, but will only get more urgent as the law continues in its death spiral. Premiums will continue to explode, and choices continue to vanish. He should be careful about making deals with Democrats. They want Canadian style single payer health care and down that path resides misery and death, not to mention another political firestorm.
To be sure, pivoting to tax reform is likely an excellent idea, though Republicans had better make sure that effort does not end in a train wreck as well.
Two significant losses in a row will not do. But also the various factions in the Republican Party should start quietly meeting to devise a repeal and replace bill that will pass at least the House and will force Senate Democrats to choose either to cling to the horror they made seven years ago or to swallow reform. The bill should not be in stages or be overly complicated.
It should truly repeal the old law and replace it with something market driven.
In the meantime, thanks to the way the affordable care act is written, Secretary of Health and Human Services Tom Price can go a long way toward dismantling it. Because the original law was written to give the HHS Secretary broad powers to implement it, a way of bypassing Congress, Price can use those powers to help destroy it and hasten the day when Congress has to put the zombie law out of our misery.
