The Zeal to Repeal

“Gridlock, deadlock, stalemate, budgetary brinksmanship, paralyzing partisanship.”

Those are some of the various terms frequently used to excoriate the dilatoriness of Capitol Hill. Much of the time, the battle-axe of rebuke against a Congress stuck in a chronic quagmire of bluster and blunder — while the country goes to pieces — is right on target.

However, there are times when taking it slowly is actually the preferable approach.

Republican Susan Collins, the senior senator from Maine, has introduced an amendment to extend the deadline for budget reconciliation instructions from Jan. 27 to March 3, in order to give Congress time to consider the best way to repeal the Affordable Care Act (ACA), otherwise known as Obamacare. Several fellow Republicans have joined her in the call, and it does appear to be a wise idea to go slow on this one.

It may not be so easy, for senators and congressmen who are for once ready to go fast. President-elect Donald Trump has been exhorting his majorities to get going on it, he has a still-fresh election mandate to do it, and the zeal to repeal will not be easily stalled.

“We have to get to business,” Trump said on Tuesday. He envisions a repeal vote “probably some time next week” and a replacement “very quickly or simultaneously, very shortly thereafter.”

Probably not since Prohibition has there been such eagerness to get rid of an unpopular law. But re-legalizing the sale of alcoholic beverages was a simple matter compared to unraveling the tangled web of Obamacare. The fact is, much of the population at the time never stopped drinking, they just carried on illegally. So it was hardly a wrenching change either economically or socially.

Obamacare is a very different matter. Even if the Republican leadership regards it as a horrible disaster, closing their eyes and ripping it away would be painful to 11 million newly insured Americans and throw the insurance industry into chaos.

“In an ideal situation, we would repeal and replace Obamacare simultaneously, but we need to make sure that we have at least a detailed framework that tells the American people what direction we’re headed,” Collins says.

In other words, before we repeal, we have to know what we’re going to replace it with, at least in some vague sense. Right now, nobody knows what replacement means. Even the notion of a “detailed framework” is probably a touch pollyanaish. Any framework at all would be an accomplishment at this point.

These Republicans no doubt realize that the zeal to undo Obamacare should not lead them to unnecessarily undo the real benefits that so many Americans now receive from it. Even the biggest enthusiasts for “repeal and replace” are wary about how their party’s chances in the 2018 elections will be affected if certain elements of ACA are eliminated.

One example is forbidding insurers from denying coverage for pre-existing conditions. Approximately one in four Americans has a pre-existing medical condition that could make it difficult to find insurance, and about three million of them are now currently covered by Obamacare.

But as strong as popular support for keeping it will be, insurers will be exuberantly in favor of repeal. Some compromise may have to be crafted, one which recognizes different degrees of risk from pre-existing conditions, and adjusts coverage accordingly. If it can be done at all, it will take time to square this circle.

On the other hand, the individual mandate to have health insurance — forcing citizens to buy into a plan, and one that fits the parameters of Obamacare — is a leading candidate for full repeal. Republicans fought it from the start as an unconstitutional imposition, tantamount to creating a new taxing power. Nor will it take much time or negotiating skill to work out a viable replacement, at least for those who don’t see the need for one.

The liberal media are saying Republicans are too divided, and the complications are too daunting, and that neither repeal nor replacement is a realistic prospect. However, that is likely wishful thinking on their part. The president-elect and Congress have a mandate for change in the Obamacare system. How far-reaching that change will be, and how soon it will be accomplished, remains to be seen. But change there will be; we can only hope it will be done in a responsible way.