After six long years, the Republicans finally have a chance to kick off the Trump era by abolishing ObamaCare.
Even as the outgoing president huddled with Democrats on the Hill yesterday, the incoming president voiced criticism of the program and the incoming vice president said they had a mandate to junk it.
But it’s a little more complicated than that.
Donald Trump set the tone for the day, tweeting, “Republicans must be careful in that the Dems own the failed ObamaCare disaster, with its poor coverage and massive premium increases like the 116% hike in Arizona. Also, deductibles are so high that it is practically useless. Don't let the Schumer clowns out of this web.”
At a GOP news conference, Paul Ryan and his top lieutenants attacked the program, and Mike Pence made clear that “the first order of business” is to “repeal and replace” it.
“We were told if you like your doctor you can keep your doctor. Not true. We were told if you like your health insurance you can keep your health insurance. Not true,” Pence said.
But then he got to the nub of the matter: What would happen to the millions of Americans who now get their coverage through federal and state marketplaces? The former congressman said they would begin an “orderly transition to something better” and would be careful that it “doesn’t work a hardship on American families.”
Pressed by reporters, Pence talked about such ideas as health savings accounts but stressed that “we don’t want to pull out the rug from people while we’re replacing this law.”
So here’s the rub: Trump has said he wants to keep two ObamaCare elements: allowing parents to keep kids on their policies until age 26 and barring insurance companies from refusing coverage based on preexisting conditions.
But the second provision is tied to ObamaCare’s individual mandate, which Republicans are determined to eliminate. That would allow people to wait until they get sick and then apply for insurance—and, as Rand Paul has noted, keep more healthy people out of the system.
Chuck Schumer pounced on that after what he called an “inspiring” meeting with Barack Obama, saying the Republicans would “create chaos in the health care system” and accusing them of a “full-scale assault” on Medicare and Medicaid as well as the Obama law.
“Our Republican colleagues don’t quite know what to do, they’re like the dog who caught the bus,” the Senate minority leader said at a Democratic presser.
Clearly, the Dems want to wrap Medicare into the debate, since they’ve been accusing the other party of assaulting the program for decades. What’s more, Trump has said he doesn’t want to touch Medicare.
ObamaCare is flawed, with lots of people having been kicked out of their plans and into more costly and less sweeping insurance. But it has also extended coverage to lots of Americans.
Politically, the Republicans can do whatever they want, since they have 52 senators and only need a majority vote to repeal ObamaCare through a budgetary technique called reconciliation.
And the Democrats would have trouble crying foul, since Obama pushed through his health law on a party-line vote.
But the GOP has to find a way to thread the needle. And the challenge for the media is to cut through the rhetoric and drill down on this high-stakes issue.