Why Can’t Republicans Repeal and Replace Obamacare?

Lately our President’s team and our Congressional leaders have been throwing verbal jabs back and forth, each blaming the other for the failure to repeal and replace the Affordable Care Act, which those of you not paying attention, is the official name of what we have taken to calling “Obamacare”.

In the latest, Senate Majority Leader Mitch McConnell has indicated the repeal failed because of artificial timelines and unreasonable expectations on the part of the President, for whom “it may not have been understood” just how these things work.  Dan Scovino, Trump’s director of social media fired back basically saying “more excuses”, you’ve had seven years, how much time do you need?

Now I’m going to do something that might surprise you.  In this blame-apalooza between Trump and Congress, I’m siding with Trump.  Yes, you heard me.  Trump said on day one he was going to ask Congress for a bill to repeal and replace Obamacare, and as far as I know, he did essentially that.  He did his part.  The only other thing he had to do was sign the bill when it came out the other end.  A bill that never came.

It was up to Congress, and particularly the Republicans in Congress, who by the way, have literally FULL control – they can do anything they want, it was up to them to actually come up with the replacement.

Now Trump was no help on that front, but honestly, did anyone think he had an actual plan?  Come on, of course not.  We all know he’s not a “details” guy, he just blusters around and throws out tasty sound bites, and expects others to come up with the details for him.  This is not new, he has literally always worked this way.  No one should be surprised by this.

So, Republicans, with a solid majority in both houses of Congress, were unable to pass a bill to repeal and replace.  Why?  It’s simple.  Their bills were, in a word, shit.

Trump promised to repeal Obamacare and replace it with something better.  Remember?  Better.  That’s the key point here.  The replacement was meant to be an improvement.  It was going to be “a beautiful picture”, remember – his words.  And you know what?  I’m on board with that.  I can get behind that.  You want to repeal the ACA and replace it with something better, you have my full support.  Have at it.  Seriously.  Do that.

The problem is, not one single bill from the Republicans, not the House bill, not the first Senate bill, not the revised second Senate bill, not the repeal-now-replace-later bill, not even the “skinny repeal” bill, whatever the fuck that was, not one of those bills was even remotely better than the existing ACA.

Not.  One.  Of.  Them.

Not even close.  They were all, demonstrably and quantifiably, worse.  And by a lot.

How do we know they were worse?  I’m glad you asked.  Did you know, we have a department of the government, the Congressional Budget Office, whose sole job it is, I mean really, this is the only thing they do all day long, is to look at every single piece of proposed legislation that comes out of Congress, and determine its financial impact.

These are not politicians or bureaucrats.  These are accountants and actuarials and statisticians and economists, you know, the mathy, sciencey guys.  In short, they’re professional bean counters, non-partisan bean counters, and they count up exactly how many non-partisan beans it’s going to cost us, for literally every piece of legislation.

And they counted the beans for each of those repeal and replace bills, the ones that survived long enough to be counted anyway, and they all came up short.  Way, way short.  And yes, I know:  projections, estimates, error, all of that.  Sure, but… even if their estimates are off by a factor of ten.  Even if the exaggerated the impact to ten times worse than reality, those bills are STILL significantly worse than the ACA they meant to replace. More uninsured, higher premiums, less coverage.  By any measure, each and every one of the proposed bills was far worse than Obamacare.  Like I said.  Shit.

The real shame for Republicans here is not that they failed to repeal Obamacare.  The real shame is that, in the end, there were only three Republican Senators, only three, unwilling to sell out their constituents and replace Obamacare with something they knew would be worse.  That, is shameful.

So, why could they come up with nothing better?  Well, first off, what nobody ever realized, according to our President, is that:  healthcare is hard.  I mean really hard.  It’s complicated, with like lots of math and probabilities and charts and stuff.  Us ordinary guys have no chance of understanding it.  Who knew?

Beyond that, to come up with something better almost certainly means moving closer to universal coverage, that’s just the way insurance pools work.  And it probably means moving closer to single payer, or otherwise removing the profit motive from the business of deciding who lives and who dies.  And because modern-day Republicans have decided they will always side with businesses interests over the best interests of individuals, they can’t move in either of those directions.

To be fair, Democrats often side with businesses over individuals too, but at least they’re coy about it.  They at least pretend to support and value the individual, and on rare occasion even put forth legislation to reflect that, you know, just to keep up appearances.  Things like, for example, oh, I don’t know, the Affordable Care Act.

And by the way, the ACA is devolving into the problem it is today precisely because of the business interests at work with the Democrats during its creation.

So where does that leave us?  Well, Obamacare is starting to stink like day old fish.  All this flailing about in Congress for the last six months has done nothing to solve the problems with the ACA.  It still needs to be fixed.  Or replaced.  Either way, I don’t care, but the result HAS TO BE something better than what we have now.

I cannot explain why no one in Congress understands that.  Even Trump figured out that part of it.  Sad.

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