We're still waiting for that health care replacement bill.

Photographer: Andrew Harrer/Bloomberg

Paul Ryan Thinks We're Fools

Jonathan Bernstein is a Bloomberg View columnist. He taught political science at the University of Texas at San Antonio and DePauw University and wrote A Plain Blog About Politics.
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Just how stupid does Paul Ryan think we are?

The Wisconsin Republican and two other House committee chairmen claim in an op-ed today that they are just about ready to propose an Obamacare “off-ramp" if the Supreme Court decides in King v. Burwell to destroy the federal health-insurance markets in more than half the states.

No fooling around. “House Republicans have formed a working group to propose a way out for the affected states if the court rules against the administration.”

A working group!

No, I’m not impressed. Remember the pledge Ryan and four House committee chairmen made Jan. 20, 2011, in another op-ed?:

We will hold hearings in Washington and around the country. We will invite affected individuals and job creators to share their stories and solutions. We will look to the Constitution and common sense to guide legislation.

Replacing this law is a policy and a moral imperative. We reject the premise that the only way to improve access to quality coverage is to dramatically expand the federal government's reach into our lives. On the contrary, we are dedicated to solving the underlying problems in health care by prioritizing affordability, improving transparency, and creating a true, functioning marketplace for health insurance.

The committees we lead will tackle these challenges with the seriousness and steadfastness of purpose they deserve.

Those hearings never took place. The replacement bill never materialized. The “policy and moral imperative” was limited to frequent efforts to repeal or undermine the health-care system paired with occasional claims that a Republican alternative was just around the corner.

It isn't that Republicans can't generate ideas for reforming health care: Philip Klein has a whole book about them. But any plan requires trade-offs, which would entail considerable political risk. And it would require hard work on policy, something that Republicans in general and House Republicans in particular have shown zero interest in over, say, the last decade or so.

It’s much, much easier to throw around talking points (2011: “fiscally responsible, patient-centered reforms”; 2015: “toward a patient-centered system”) and to promise the moon than it is to design a policy that would really work. Or, for that matter, any policy at all -- one with details that can be studied by the Congressional Budget Office and outside independent analysts.

Instead we get a "working group" and another promise that their plan is in the mail. C’mon. 

  1. Barack Obama and the Democrats were also guilty of promising the moon – but they put together a plan that is more or less doing what it was intended to do.  

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To contact the author on this story:
Jonathan Bernstein at jbernstein62@bloomberg.net

To contact the editor on this story:
Katy Roberts at kroberts29@bloomberg.net