The Democrats took their crack at major reform with the ACA, and since January the Republicans have been seeking to answer it (after their long chants of “Repeal and replace”). But the answers they have produced so far cannot and will not be the final say on the matter. They have to know that. The question is why?
The simplest answer is that they cannot come together on a reply. Their coalition is too broad and divided to give the answer that would be coherent, so they are stuck with simply saying “No” to the Democrats. Rather than admitting that the country needs universal coverage and figuring out how to spread the cost across the concerns, they are stuck simply reducing what the Democrats did.
Those concerns:
- Providers’ profits
- Taxes of the rich
- Taxes of the non-rich
- Coverage for the vulnerable (elderly, poor, disabled, etc.)
- Insurers’ profits
The Democrats spoke with the ACA, saying: “We will limit insurer profits, increase some taxes on the wealthy, and provide coverage for the vulnerable.” It was a cohesive statement.
But the Republicans are currently saying something like: “We will increase insurers profits, reduce some taxes on the wealthy, and reduce coverage for the vulnerable.” They’re just gainsaying. This is not an argument. It’s mere contradiction. Someone call up Monty Python.
The Republicans have to know that Democrats, next time, will not just repeat their previous statement when they enact healthcare reform. They will probably say, instead: “We will grandfather existing plans, but everybody else goes to a single-payer system paid for by taxes and with costs controlled by negotiating with providers.”
What will the Republicans say to that? “Socialized medicine?” When people will still pay at least part of their premiums, a la Medicare? When the CBO will say that it increases coverage and decreases costs?
This is the Republicans’ best shot at answering the Democrats, but their answer is weak. They may pass it anyway, but it will not be the last word, and they know it.