“This is the closest we will ever get to repealing and replacing
Obamacare. This is the moment. It really comes down to a binary choice.”
– Paul Ryan this week, speaking on the American Health Care Act (AHCA),
his proposal to replace Obamacare.
“RINO” – Republican In Name Only.
is the RINO blueprint: Campaign in a conservative district spouting all
the normal rhetoric. In 2016, repealing Obamacare topped the charts of
conservative rallying cries. Once election is secured, move to the
middle to avoid becoming a focal point for the press and the screaming
protestors in the streets. Shift the target while in Washington to the
real conservatives who are foolish enough to keep their campaign
promises – let them take the heat until the next election cycle when,
since nothing was accomplished in the meantime anyway, you can claim
that you’ve been fighting the good fight all along. If it wasn’t for
those darn Democrats, by golly, we’d get there. Hell, we’d be there
Careers were made on this. John Boehner. John McCain.
“Establishment Bob” Latta. Now Ryan is making them all look like rank
amateurs. This little deal, the exclusion of conservatives with a behind
closed doors drafting of the AHCA and the presentation of it to the
public as the only possible solution, this takes some kind of cake. But
if you didn’t see this coming the day after Donald Trump’s surprise
election last November, well, you just don’t know RINOs.
of weeks ago I wrote a column arguing that the Republicans would be wise
to repeal Obamacare without even trying to replace it yet. A few days
after the column, Ryan presented the AHCA and conservatives from Rand
Paul to Jim Jordan started saying that we should flat out repeal
Obamacare without replacing it yet. I’m well read in Washington, I hear.
wasn’t all that prescient. I was only proposing what Republicans had
guaranteed they would do once elected. House Republicans had previously
passed legislation six times repealing Obamacare. Jordan re-introduced
one such bill last week and the RINOs fled from it, conjuring the image
of Cool Hand Luke laying beaten on the ground reaching his hand in the
air for help saying, “Where are you now?”
Ryan says that outright
repeal is not possible. He is lying. Obamacare itself was passed through
the budget reconciliation process that only requires a majority vote in
the Senate instead of the 60 votes to avoid a filibuster. It is alleged
that four of the 52 Republican Senators will defect, however, if the
repeal is passed without a gradual phase out for the Medicaid expansion.
These alleged defectors include our very own Rob Portman, he who
abandoned the Republican presidential candidate last fall and, prior to
that, decided that the meaning of the Constitution had changed when he
found out his son was gay.
Instead of pressuring the defectors to
come on board for repeal, a true RINO would coddle the defectors, who
are only trending toward the middle after all, and pressure the
conservatives to abandon their principles. True to form, Ryan turned on
Jordan and the gang, refusing to challenge the Vichy Senators.
alert: In the end, Medicaid expansion is going to be phased out anyway
if it is touched at all. Without losing anything, one could appease the
Senate Four by agreeing to a phase out with an otherwise absolute
repeal. Nope, says Ryan, the choice is binary.
And it isn’t that
Ryan’s AHCA won’t dramatically improve the health care system. It will.
But it will also fail. More slowly than Obamacare, but it will fail for
two reasons. First, it doesn’t address tort reform or any other measures
that would get costs under control. The problem with the health care
system isn’t that insurance is unaffordable, it is that the healthcare
which it covers is unaffordable.
The second reason the ACHA will
fail is that it forces insurers to cover pre-existing conditions without
a mandate to buy insurance. You can’t have one without the other. Such a
system encourages people to not have insurance until after discovering a
condition that necessitates expensive care. Of those who choose to go
without insurance, only those that incur such a condition would ever
enter the insurance pools, driving the costs sky-high for everyone else.
This was one of the many problems of Obamacare, which had a mandate but
did not enforce it.
Further, if the first draft of the ACHA is
passed, there will be no substantive amendments in a second and third
phase as Ryan promises. Conservatives understand this. It will take all
the political capital available just to get the first phase done and the
media bombardment will begin the next day.
Worst of all is that
if the ACHA goes into effect, Republicans will own the health care mess.
And still a colossal mess it will be. Through transitive association,
conservative policies will own the mess, even though conservative
policies had little to do with it.
In a clean repeal, or even in a
repeal that includes a phase out for Medicaid, Democrats would be
forced to negotiate and co-own the legislation. The RINOs cry that there
would never be a Democrat vote for a Republican health care plan.
yeah? What happens if 24 million people were going to lose Medicaid
coverage but a conservative offered a proposal that would save this
coverage but with a catch – we’re going to need tort reform in exchange.
Suddenly, you have a bi-partisan bill in which everyone is vested.
is how legislation used to work before the advent of the RINO, who
occupies the middle of every argument before a real debate or
negotiation can happen. Democrats are going to skate on what they did to
the health care system. By next fall, they are going to be campaigning
on a return to the halcyon days of Obamacare. And the RINOs will be
following their blueprint all over again.