WHY REPEAL AND REPLACE OF ACA FAILED
Why It Failed
Try as they might and they tried mightily, the Republicans could not repeal and replace the Affordable Care Act (ACA) in spite of controlling the Senate, House and White House. To many the failure was surprising. On the left, they fretted about the demise of Obamacare and the horror that was to follow. On the right, they dismissed the possibility of failure because of the horror that they believed was sure to come. Actually the failure to repeal and replace was easily predictable.
The most fundamental reason is that Obamacare is GOPcare. More precisely, it is Romneycare. The ACA was based directly on the successful healthcare initiative that Gov. Mitt Romney installed in Massachusetts. Once Obamacare had usurped the essential elements of the GOP’s best approach, the GOP had nowhere to go. They could posture loudly and incessantly about repeal and replace but, as well demonstrated over nearly eight years, they could not come up with any concepts better than those pirated by Obamacare. Thus, they produced an awful jumble of compromises between far rightists and moderates around which the party could not coalesce – a mess that also was rejected soundly by the large majority of the public.
Repeal and replace also failed because Trump never was behind it. Going back years before his candidacy, Trump had preached some rather liberal concepts about affordable and comprehensive healthcare for all. This bias shown through when he labeled the House’s healthcare bill as “mean.” It clearly Indicated that he had no intention of using his bully pulpit to champion a “mean” bill, and he didn’t.
He also saw the tug-of-war between moderates and arch-conservatives in the House and recognized that there was far less potential for reaching a compromise in the Senate. His sensitive nose caught the scent of stalemate and failure to repeal and replace. His narcissism would never let him take the losing side. He withdrew to the sidelines. Again no bully pulpit. Rather when it failed he jumped straight into the blame game. He blamed Mitch McConnell, the Democrats, Republican moderates, Republican right wingers, everyone but himself.
To Further ensure that not the slightest bit of blame accrued to him, he pressured McConnell into repeal and delay, a strategy he vociferously rejected immediately after the inauguration.
Other than his narcissism and his fragile ego, why would Trump withdraw so completely from the fray? Simple. He is neither a Republican nor a conservative. He has no allegiance to the GOP; only to himself.
Lastly repeal and replace failed because the GOP is not a party unified around a political philosophy. It is a fractious collection of disjoint factions.
For those who follow this blog, I take you back to my contribution about how today’s GOP got to the state in which it finds itself.
Its downward spiral began with Nixon’s Southern Strategy. Capitalizing on Southern animosity toward the Civil Rights Act and Voting Rights Act, Kevin Phillips, Nixon’s strategist and the strategy’s author, infamously summarized it: “The more Negros register as Democrats in the South, the sooner Negrophobe whites will quit the Democrats and become Republicans. That’s where the votes are.”
This was not a political philosophy or policy. It was a vote getting tactic. As a consequence, it swept into the GOP people who were not united around a common philosophy or set of policies. The various factions hoovered up are still evident in today’s GOP – racists who want voter suppression, xenophobes who would ban immigration by Muslims and Hispanics, radical evangelicals who wish biblical law, misogynists who would keep women in the kitchen, and a variety of other single issue and disaffected groups.
There is no unity in this. The GOP has devolved from a party united by conservative philosophy and policies into today’s fractious mishmash. The last gasp of the GOP as the party of conservatism was the Reagan administration but the party was not being held together by conservative doctrine. The binding force was Reagan’s personality.
What’s To Come
The schisms exposed in the inability to repeal and replace will continue to disrupt any coherent GOP policy agenda – most immediately the debit ceiling and the 2018 budget but also such as tax reform and infrastructure funding.
The GOP’s far right is furious over the failure of repeal and replace. Their wrath is directed largely at Democrats and moderate Republicans would not support the (“mean”) bill passed by the House. But they also are frustrated with themselves as having given an inch to the GOP moderates. They see this as a tactical mistake that started repeal and replace down a slippery slope.
The House Freedom Caucus is determined not to repeat this mistake. They already have voiced opposition to raising the debt ceiling and Ryan’s 2018 budget proposal. Key members are on record as being dead firm on not increasing the debt ceiling and wanting deeper cuts in the 2018 budget especially for entitlements and other social and educational programs. On debt ceiling, they claim to be willing to see the government shutdown.
This means that to increase the debt ceiling or pass a budget, the GOP will need a substantial number of Democratic votes. The Democrats are sure to extract a price and it could be steep. Things come to mind like fixing Obamacare, funding that blocks any attempt to starve it out, and budget protection for Medicare, Medicaid and Social Security.
Other GOP issues such as tax reform and rebuilding our infrastructure likely will encounter the same intraparty fractures as the debt ceiling and the 2018 budget. These issues are completely entangled with budget size and allocation along with other funding demands including defense spending with its appeal to the right and preservation of Medicaid and Medicare that appeal to GOP moderates.
In every one of these battles, the longstanding fissures in the GOP, made blatant by repeal and replace, will be magnified. This will push the GOP into uncomfortable and uncharted territory.
At first, the GOP will cast the issue as devising a political philosophy and core set of policies that will unify the GOP. Decades of trying and having to fall back on being the Party of No suggests that this is a fool’s errand. Very slowly and very reluctantly the GOP may come to realize that becoming a unified party requires them to shed many of the single-issue and far right splinter factions that they now count as their base and to rebuild among right-leaning independents. Although this would seem to be the GOP’s salvation, it would not be in the least surprising if the potential loss of political clout in the transition proved to be so distasteful that it stymied the transition or delayed it for years.
If it wasn’t for gerrymandering, the GOP’s future might indeed be dismal.