The mainstream press corps and (at least privately) many Republicans officeholders have adopted two seemingly irreconcilable positions. They claim Obamacare is politically toxic for Democrats yet is somehow immune to repeal by Republicans (even after President Obama leaves office). A recent piece by National Journal’s Josh Kraushaar perfectly illustrates this confusion. Kraushaar observes that “the politics” of Obamacare have “never been complicated” — it was unpopular when passed, “became the driving force behind the GOP’s takeover of the House in 2010,” and was “again was the leading issue Republicans campaigned on to retake the Senate in 2014.” But rather than proceeding to the logical next step — if Republicans win the presidency in 2016, they’ll likely owe their victory to Obamacare, and repealing it will be among their first priorities — Kraushaar instead asserts that repeal is “politically untenable,” even if a Republican wins the presidency.
This claim that Obamacare is politically toxic yet politically bulletproof would seem to be rather contradictory on its face. According to this account, the American people despise Obamacare enough to deliver a big defeat to Democrats in not one, not two, but (in this scenario) three different federal elections, granting power to the party that promises to repeal it — yet they won’t tolerate repeal. In truth, if Obamacare leads to GOP control of the House (in 2010), the Senate (in 2014), and the presidency (in 2016), the GOP will either repeal Obamacare or will fairly quickly lose all the ground it gained — and deservedly so. A party that runs and wins on repeal, and then fails to repeal, is not a party with a legitimate claim to power.
A much truer picture of Obamacare’s future was recently outlined by Nebraska senator Ben Sasse. Republicans have split into three camps: the “Fix-It Caucus,” the “Replacement Caucus,” and the “Repeal-Only Caucus.” The first camp has given up on repeal. The second and third are both committed to repeal — with the second thinking, as Sasse does, that a winning alternative is a necessary condition for full repeal, while the third apparently thinks that repeal can be achieved even in the absence of an alternative.
Most polls suggest that this third view — that repeal is achievable without an alternative — is fanciful. For 70 years, the federal tax code has been biased against people who buy health insurance with their own money (rather than getting it through their employer), and it is hard to see how repeal can be achieved in the absence of providing that core aspect of real health-care reform (which Obamacare didn’t do). At the same time, most polls on repeal don’t even ask about the second camp’s view, as they fail to ask about an alternative.
However, a poll taken last fall by McLaughlin & Associates (and commissioned by the 2017 Project) asked a question that almost exactly parallels Sasse’s three camps, and it found overwhelming support for repeal. It asked (see question #8) 1,000 likely voters (including 38 percent Democrats to just 32 percent Republicans),
“Which comes closest to your view of the Patient Protection and Affordable Care Act, commonly known as Obamacare?
“1. It should remain the law of the land, either in its current form or in amended form.
“2. It should be repealed and replaced with a conservative alternative that aims to lower health costs and help people get insurance.
“3. It should be repealed but not replaced with an alternative.”
Only 32 percent of respondents said Obamacare should be kept as-is or fixed. A clear plurality of 44 percent said it should be repealed and replaced with a conservative alternative that deals with both costs and coverage. Another 16 percent said it should be repealed but not replaced.
In other words, with a conservative alternative in play, 60 percent of respondents expressed support for repeal.
Kraushaar — who to his credit at least seems to recognize the price that Democrats have paid, and will continue to pay, for Obamacare — not only seems unaware of such polling but also doesn’t seem to understand the three Republican camps. Sasse writes that the “Replacement Caucus” (in which he places himself) is “committed to full repeal” but also “believes that actually getting rid of Obamacare — rather than just romantically fighting lost causes — requires admitting that you cannot beat something with nothing.”
Here’s how Sasse’s position is characterized by Kraushaar: “[The] Replacement Caucus…would make significant changes to the law after campaigning on a reform-oriented health care agenda in the presidential election. That’s the most tenable approach [to dealing with Obamacare] — and the fact that Sasse, a hard-line Senate conservative, is calling for something other than outright repeal is telling.”
Kraushaar’s characterization contains three big errors: One, the “Replacement Caucus” wouldn’t “make significant changes” to Obamacare (that’s what the “Fix-It Caucus” would do); rather, it would fully repeal and replace it. Two, making “significant changes” is not “the most tenable approach”; rather, it is a sure political and policy loser (as Republicans weren’t put there to fix Obamacare, and Obamacare can’t be fixed). Three, Sasse isn’t “calling for something other than outright repeal”; rather, he is calling for a winning alternative that will make outright repeal a reality.
(In a subsequent addition to his piece, Kraushaar adds, parenthetically, “(Sasse still supports repealing the law but only with a replacement plan in hand.)” This provides something of a correction while adding yet another error. For Sasse supports repealing Obamacare, period. But he rightly thinks the way we get to repeal is by advancing an alternative.)
Thus, the key over the next year or so is to pick a presidential nominee who will run on a politically winning plan. As Sasse puts it, “We have an opportunity here, but let there be no more talk of waiting until some future date to produce the Republican health-care alternative. Now is the time.” He adds, “Your move, 2016’ers.”
Alas, the Republican presidential field runs the gamut from those (at one end of the spectrum) who have been AWOL on Obamacare for six years, or who claim that being a good Christian means expanding Obamacare, to those (at the other end of the spectrum) who rightly frame the 2016 election as a referendum on Obama’s centerpiece legislation. The presence of those in this second camp, combined with Obamacare’s continuing unpopularity, means that the repeal of Obamacare is anything but “untenable.” In fact, if such a candidate were to win the election, Obamacare’s repeal would be nearly inevitable.
Jeffrey H. Anderson is executive director of the 2017 Project, which is working to advance a conservative reform agenda, including a winning alternative to Obamacare.