Repealing Obamacare

Republicans—leadership, rank and file—and Conservatives want to repeal Obamacare, and they’re right to do so. Obamacare has been an unvarnished disaster for our nation.

To this end, Republicans need to pass repeal legislation and put it on President Barack Obama’s desk, where he surely will veto it. That veto will work to Republicans’ benefit as it helps shape the 2016 elections, but things must not stop there.

The leadership also is playing small ball, working a piecemeal approach. This includes

  • a bill that would define a full-time worker under the health law as working 40 hours per week
  • repeal [of] the…2.3% tax on medical devices such as X-ray equipment and artificial joints
  • a bill that would allow Americans to opt out of the law’s individual requirement to buy insurance

Other pieces that need to be addressed, say I, include

  • repeal of the employer mandate to provide insurance
  • repeal of the contraceptive mandate

All of this will require the Republicans on the right side of the party—the Cruzes, Gohmerts, and so on—to exercise far more patience than has been their wont. Repeal’s veto won’t be overridden, we need a Republican President to sign a re-passed repeal. Most of the piecemeal approaches also will be vetoed, and most of those will be sustained by the Democrat minority in each House. But all of these votes, initial passage and veto override alike, should be by roll call. With all the Democrats—every single one of them—explicitly on the record as favoring the Obamacare disaster, those votes will very favorably shape the ’16 elections.

But that’s not enough. Even when successful, the result will be a return to the status quo ante-Obamacare. The then-existing health insurance and health provision industries badly need restructuring. Republicans need to have in place a plan to achieve that and a timetable for the plan’s execution.

House Ways and Means Committee Chairman Paul Ryan (R, WI) has been cited as saying

that Obamacare would be replaced with something that gives Americans more choices and lowers costs, improves their access to care and is “truly patient centered….”

But he says he does not have a “timeline.”

House Speaker John Boehner (R, OH) has said

Our challenge, our opportunity is to pass common-sense solutions…that repeal Obamacare and replace it with patient-centered reforms that will help our constituents have better access to high-quality health care in America….

That’s not enough: it’s time to get specific. It’s time to lay out exactly what legislation will be proposed to restructure those two industries.

There’s this critical caveat, too. Accepting arguendo Obamacare as a general solution for the restructuring, it was doomed to fail because it tried to do too much all at once. The restructuring of those two industries, even in accordance with Conservative imperatives, will see a similar doom if it attempts the restructuring all at once. These industries need to be restructured piecemeal. Pass legislation to correct (some of) the worst ills in one session, and use the year to observe how those corrections worked and where they failed. In the next year of the session, correct the corrections where necessary and pass legislation correcting the next worst ills. And so on, year by year. The industries can be favorably and successfully restructured over the course of 4-6 years (much faster than the 80 years it took to get to the point of Obamacare, but not overnight, and especially not in one fell swoop).

But that takes patience. All or nothing right damn now will only achieve nothing. With Obamacare left in place.

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