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Tuesday, December 6, 2016

With the Supreme Court considering a case that could unravel the Affordable Care Act, leaving some 8.2 million Americans suddenly uninsured and sending premiums skyrocketing, the Republican Party has a comforting message for voters: We have a solution.

“As Supreme Court Weighs Health Law, GOP Plans to Replace It,” blares the headline in Friday’s New York Times. In the article, reporter Jonathan Weisman asserts that “the search for a replacement by Republican lawmakers is finally gaining momentum.”

A legislative scramble is underway. On Monday, Representatives Paul D. Ryan of Wisconsin, Fred Upton of Michigan and John Kline of Minnesota, the chairmen of the powerful committees that control health policy, proposed what they called an “off ramp” from the Obama health act that would let states opt out of the law’s central requirements.

On the other side of the Capitol, Senators John Barrasso of Wyoming, Lamar Alexander of Tennessee and Orrin G. Hatch of Utah, all Republicans, offered their own plan this week to provide temporary assistance to those who would lose their subsidies and new freedom to all states to redesign their health care marketplaces without the strictures and mandates of the health care law.

So are Republicans really ready to finally advance a health care reform bill of their own?

Probably not.

While the House and Senate groups both laid out broad visions for new health care laws, neither offered any sort of details on how their plans would actually work. Saying that “we would provide financial assistance to help Americans keep the coverage they picked for a transitional period,” as the Senate Republicans promise, sounds great. But until they explain how much financial assistance they would provide, or how long the transitional period would last, it is a hollow bromide. Similarly, the House Republicans’ plan to form “a working group to propose a way out for the affected states if the court rules against the administration” sounds great — but Americans still have no idea what, exactly, the way out would be.

Of course, it’s possible that Congress will fill in the details in the coming weeks. But it’s incredibly unlikely. After all, Republicans have literally been promising a detailed alternative to the Affordable Care Act for six years, and so far it’s not much closer to reality than it was in 2009. Why should this time be any different?

Even if Republicans did coalesce around a health care plan of their own, it’s almost impossible to imagine a significant reform passing both the House and Senate. The GOP already has deep divisions on health care policy, and they are likely to intensify as the 2016 elections draw nearer. Republicans who face tough re-election fights will be loath to vote on a controversial measure with such high political stakes (a side effect of the GOP’s all-out war against President Obama’s health care policy).

Put simply: If the Republican Congress could barely come together to avoid a self-inflicted shutdown of the Department of Homeland Security, there is no reason to believe that they could pass a massive reform bill on the most radioactive issue in politics.

Republicans have plenty of good reasons to pretend that they have a solution to the disaster that would ensue if the Supreme Court guts the Affordable Care Act. But until they prove otherwise, the latest batch of Republican Obamacare replacements should be viewed as no more likely to become law than their countless predecessors. And if the Supreme Court does rule against the Obama administration in King v. Burwell, no help will be on the way for the Americans who would lose their insurance.

Photo: Senator Orrin Hatch (R-UT) in the Capitol Rotunda on the way to the State of the Union Address, Jan. 20, 2015. (Talk Radio News Service via Flickr)

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