Repeal & Replace GOP Senators Who Oppose Healthcare Reform

Brian and Garrett Fahy,

Senate Republicans this week skipped town without voting on the Republican alternative to the Affordable Care Act (ACA) because many GOP senators (Portman, Collins, Murkowski, Heller, etc.) appear to lack the political courage to repeal Obamacare.  

Predictably, the blame game has started: it’s Mitch McConnell’s fault; it’s Trump’s fault; it’s the House’s fault; it’s the fault of those senate “moderates” (Susan Collins, Lisa Murkowski) or “conservatives” (Mike Lee, Ted Cruz).  Or: reform is too complicated; it cuts Medicaid too much; it will leave too many without coverage-as if guaranteeing coverage is the federal government’s job.   

Beyond the personal finger pointing and the substantive excuses, the real reason for the Senate GOP’s failure to deliver is much more pedestrian: some senators want re-election more than repeal. Exhibit A: Nevada senator Dean Heller. According to the Washington Post, Sen. Heller, whose opposition to the overdue Medicaid reforms proved decisive, refused to back the reform bill because he was instead, “doing what’s best for his state and Heller.”   

gopsenators_small Repeal & Replace GOP Senators Who Oppose Healthcare Reform GOP

Bold leadership this is not, but it is instructive. Those members doing what they (falsely) think will best help them get re-elected, keeping 80 percent of the ACA and its bloated Medicaid expansion, are inviting their own demise. 

As the Senate GOP should know by now, nothing’s more offensive to a voter and therefore politically suicidal than failing to deliver.  GOP congressional candidates made all kinds of promises during Obama’s administration (repealing the ACA, reigning in the EPA, stopping Obama’s rewrite of immigration laws) only to fail time and again.   

Frustrated by national Republicans’ failures to deliver, Republican voters in 2016 kicked to the curb all the establishment candidates (the Hellers, Portmans, Murkowskis and Collinses), and went with Mr. Drain-the-Swamp.  He won, and after the House passed the American Healthcare Act (AHA), Republicans are halfway to making good on a long term promise.  And while the AHA isn’t perfect (what legislation is?), it’s a good and necessary first step.  

And taking this first step and delivering on a central campaign pledge would give Senate Republicans a stronger hand in the 2018 midterms, when Republicans defend eight seats and Democrats defend 25, than passing a watered-down bill that keeps much of Obamacare in place. No one campaigned on repealing and replacing 30 percent of Obamacare.  

Not only is passing the AHA (or some version of it) good politics, it’s good policy: it’s unquestionably better for patients, doctors, and the federal balance sheet, and it’s vital to re-calibrating the proper relationship between citizens and the federal government, which was distorted by the ACA’s mandates, taxes, and Medicaid expansion.   

In view of this, only two options are possible: Either senators like Dean Heller never believed in the merits of ACA repeal in the first place, in which case they misled the voters all along; or they do believe in the merits of repeal but simply lack the courage or conviction to finish the job.  Either position is reason enough to repeal and replace senators like Dean Heller in 2018. 

  • DrArtaud

    Sticky wicket:


    (cricket) a pitch that has become wet because of rain and therefore on which the ball bounces unpredictably

    [British] A difficult or unpredictable situation

    The sticky wicket problem with Republican Healthcare Reform of obamacare, overlooked by so many gainfully employed Republicans, is several fold:

    Trump promised again and again that the obamacare replacement would offer more for less, but the Republican plan, for many on obamacare now, offers less for more. This will not sit well with crossover voters; formerly dedicated democrats that voted for Trump; in the 2018 elections.

    In the following, ACA=Obamacare AHCA=Republican House Plan.

    • Group 1 - 27 yo Income $30,000:
    Premium $2730 - ACA Tax Credit $250
    Premium with Credit Applied $2480/w - 8% of Income

    Premium $2520 - ACHA Tax Credit $2000
    Premium with Credit Applied $520/w - 2% of Income

    • Group 2 - 40 yo Income $30,000:
    Premium $3330 - Tax Credit $850
    Premium with Credit Applied $2480/w - 8% of Income

    Premium $3300 - ACHA Tax Credit $3000
    Premium with Credit Applied $330/w Credit Applied - 1% of Income

    • Group 3 - 60 yo Income $30,000:
    Premium $7080 - Tax Credit $4600
    Premium with Credit Applied $2480/w - 8% of Income

    Premium $9510 - ACHA Tax Credit $4000
    Premium with Credit Applied $5510/w Credit Applied - 18% of Income

    In fact, by some estimates, under the Republican plan, I’ll have to pay $13,500/yr for healthcare.

    obama said you can keep your doctor, you can keep your plan, and you’ll save $2500/yr on obamacare. Trump justifiably ridiculed this for his entire campaign. But what did Trump say about his own plan?

    Throughout the 2016 campaign, candidate Trump talked about his desire to let people buy health insurance across state lines.

    Even Sarah Huckabee, when pressed on this point, said “overall, they’ll be savings” but they’re funding the savings by charging people more that are less able to pay. Older people can be charged 3x the rate of younger people under obamacare, and 5x the rate under the House plan, and, drum roll please, states can apply for waivers and charge even higher rates than 5x for senior citizens.

    It’s not merely a matter of costing more for some under the Republican plan, it’s a matter of costing way more!

    And, from what I’ve read, early on, people with preexisting conditions can be charged much more still, or denied coverage, under the Republican plan, at least the House plan.