A Chance for a New Beginning on Health Care
They may have avoided the ditch, but Republicans have driven themselves into a cul-de-sac. After the failure in the Senate of their disastrous plan to replace Obamacare, Majority Leader Mitch McConnell now promises to make his colleagues vote instead on just a repeal of the Affordable Care Act.
In other words, the process is still being driven by politics instead of policy. Until that changes, Republicans can expect their efforts to address the U.S. health-care system to end badly.
This is not to say that it would be easy or simple to fix what is wrong with Obamacare, whose shortcomings have long been obvious. It is only to say that, if they're interested, Republicans now have room to work with Democrats -- what a radical idea! -- on a better bill. This will require them to give up their obsession with cutting Medicaid and giving tax cuts to the wealthy and instead focus on "a bill that finally provides Americans with access to quality and affordable health care," as Senator John McCain of Arizona has said.
Republicans need to accept that expanded insurance coverage, whether through Medicaid or subsidized policies, is the new American normal. The effort to roll back health-care access for millions appears increasingly futile, as well as cruel. The spectacular unpopularity of the Republican replacement bill should make that clear.
This new normal may not sit well with the party's most conservative members. But the inability of Republicans to agree on a rollback -- despite all the political pressure and promises -- suggests that it may no longer be an achievable goal.
Once Republicans accept that the landscape has shifted, their options immediately improve. For one, they can leave behind the backroom antics that have tarnished the repeal effort and follow the recommendation of Republican Senator Jerry Moran of Kansas for an "open legislative process."
With a fresh outlook, Republicans might look anew at proposals to shore up the private insurance market and facilitate necessary cost-sharing and reinsurance payments to insurance companies. Maybe Republicans can even find a way to bolster the individual mandate. It was a conservative idea once. With a change in perspective, it can be again.
--Editors: Francis Wilkinson, Michael Newman.
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