Repeal and Replace?

As the fate of Obamacare is debated in the Supreme Court, let us not forget an inconvenient truth. While polls show that the majority of Americans oppose this law, and while the Individual Mandate’s constitutionality is arguable, there is simply no good alternative.

This is the subject of a memory-jogging piece in New York Magazine by Jonathan Chait.

One of the hard facts about public opinion during the health-care debate was that, while the public quickly soured on health-care reform, it remained quite sweet on the concept of health-care reform. This is why Republican opponents took care to insist at all times they only opposed the particulars of President Obama’s plan, and wanted instead to reform the system their way, with all the popular things and none of the unpopular stuff. Republicans declared they had a “moral imperative” to reform the system, robotically insisting their plan was not merely to repeal health-care reform but “repeal and replace.” As Jonathan Bernstein notes, just last January, Republicans in Congress promised to have their all-gain, no-pain alternative ready and raring to go for the summer so they could move if the Supreme Court overturned Obamacare.

But, in a development that received almost no attention at all, Republicans quietly conceded last week that they aren’t going to replace Obamacare at all.



Huge majorities of the public support, in the abstract, the idea of universal coverage. But they turn much more negative when presented with specific measures to offset the costs, like taxes or cuts to Medicare. Republicans have been claiming to support the general goal of expanding coverage but simply opposing any specific measure to do so. But conservatives actually oppose the idea of universal health insurance on moral principle. They tend not to concede this straight out, but the belief pops up from time to time.


[Conservatives] may debate over the particulars, but the particulars don’t ultimately matter. Conservatives just don’t want to lay out the resources to provide universal coverage. They think of health insurance the way I think of flat-screen televisions — a nice thing to have, and something I’d like everybody to have, but not something to which everybody is entitled. I’d like to see conservatives defend that philosophical position openly rather than couch it in easily cast-aside particulars.

Obamacare may very well be declared unconstitutional. But before we return complacently to the prior status quo, we must not forget two things:

2) The alternative, leaving over 50 million Americans uninsured, and the soaring healthcare costs such a fate would engender, was the apocalyptic scenario spurring the passage healthcare reform in the first place.

1) Republicans opposed every other proposed measure to fix healthcare; Single Payer?–when hell freezes over! Public Option?–why, that’s socialism!

“Obamacare” is a dirty word in today’s political discourse, and the Individual Mandate has proved to be political kryptonite, but these are unfortunate reality that only our collective social amnesia has allowed to prosper.