Republicans’ New Bridge to Nowhere

It’s been nearly 5 and 1/4 years (63 months for those counting) since President Obama signed the Affordable Care Act into law.  Since then, Republican Congressional leaders have continually declared their intentions to advance their own plan to repeal the law and replace it with something else.  This took on new urgency this year because of the U.S. Supreme Court’s (SCOTUS) decision to hear the King v. Burwell lawsuit that would eliminate all insurance subsidies to ACA private coverage enrollees in the 34 states with federal — as opposed to state — run exchanges/marketplaces.

New federal data show that 6.4 million would lose their insurance subsidies if the Court rules for the plaintiffs (King) and against the government (Burwell).

All this year, Republican lawmakers in the Senate and House have been insisting they would have a replacement plan out and even scored by the Congressional Budget Office before a SCOTUS decision in late June (an assurance made by House Ways and Means Chairman Paul Ryan (R-WI).

1 McCarthy Rep

US House Majority Leader Rep. Kevin McCarthy (R-CA).

Now, House Majority Leader Kevin McCarthy (R-CA) has announced the Republicans will have no replacement plan to unveil until after a Supreme Court decision is released, expected late this month, and Senate Republicans are stating the same.  As Jon Cohn notes in the Huffington Post, not only is there no plan, Republicans have not even held a hearing on the matter — though they repeatedly berated Obama Administration officials, notably Health & Human Services Secretary Sylvia Burwell, for having no contingency plan in the event of an adverse ruling in the King case.

What about Congress? [asked Supreme Court Justice Antonin Scalia]  You really think Congress is just going to sit there while – while all of these disastrous consequences ensue?”  The Solicitor General responded “well, this Congress, I ….,” a response which generated laughter.

Some may quibble and point to a number of ACA replacement bills filed by various members.  None of them have even received a committee hearing, much less a committee markup, or a vote in either chamber.  The most prominent replacement proposal, the Patient CARE Act, from Sen. Richard Burr (R-NC) and Orrin Hatch (R-UT) and Rep. Fred Upton (R-MI), which has had two public unveilings since 2013, has yet to be translated into legislative language and sits as a well-trumpeted narrative description of a non-existent bill.

I believe it’s pretty plain what is happening here.  Republicans are quite capable of uniting around what they all oppose and quite incapable of uniting behind what they would propose as an alternative.  With firm control of the House and Senate, the GOP has a golden opportunity to advance a comprehensive and clear alternative to the ACA.  They just can’t do it — short, medium, or long term — it’s a bridge way too far for them.  A bridge to nowhere.

About John McDonough

I offer insights and opinions on how to improve health care systems for everyone
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