Repeal and Replace: The Third Time Is Not the Charm


BY KATHLEEN MURPHY – STAFF WRITER

Another attempt at repealing and replacing the Affordable Care Act fell short last Wednesday as Senate Majority Leader Mitch McConnell withdrew the vote on the Graham-Cassidy bill after several senators refused to vote for it.

Senators Rand Paul, John McCain and Susan Collins announced they would not vote for the bill, the former believing that the bill did not do enough to repeal the ACA and the latter two citing concerns about the bill’s partisan preparation and Medicaid-cutting content.

This latest failed bill evokes the usual commentaries about Republicans having the last seven years to create an alternative policy and raises questions about their ability to maintain party coherence; friendly fire on fellow Republicans from President Trump’s Twitter account hardly helps. However, more distinctly, failure for the Graham-Cassidy bill suggests that party leadership has more interest in signed and sealed accomplishments than substantial governing. They prefer the glamour shots of celebratory press conferences to the daily, unforgiving work of solving complex problems with a stubborn and divided group of colleagues.

Graham-Cassidy’s proposal represented the most conservative of the three “repeal and replace” bills introduced in Congress during the Trump administration: its plan involved cutting Medicaid and repurposing expansion funds into block grants that will end by 2027. It also would not have covered pre-existing conditions and likely would have stripped thousands of health insurance.

Yet the previous two bills, the American Healthcare Act and the Better Care Reconciliation Act, struggled because they were too conservative to court Democrats or even moderate Republicans – Rand Paul being the exception, believing the bills were not conservative enough. Therefore, these bills should have served as a warning for the kinds of bills that would not pass in the current Congress, but the Republican leadership failed to heed these premonitions. While their determination to pass anything to replace the ACA may appear admirable as a lesson in perseverance, their emphasis on completion over quality remains problematic.

An accomplishment after years of Congresses winning the “Least Productive Congress” award would seem refreshing, particularly for a party that has not controlled two branches of government in almost a decade. But healthcare, or any policy issue for that matter, is not suited to the rapid-fire, oversimplified world of social media and twenty-four-hour news cycles.

Given their small margin in Congress and the widespread gap in conservative ideologies among their members, Congressional Republicans need to come to terms with the concept of compromise. Trying to push through bills that do not have full partisan support, let alone bipartisan support, wasted the precious window that they had to repeal the ACA with only sixty votes. With that opportunity fading away, compromise across party lines – a more difficult and demanding task- will likely become essential. With the Republican leadership’s current track record on seeking compromise, such a task does not look promising.

Most importantly, all of the party’s members should note that only appearing productive during their terms gives them little of substance to bring their home districts by the time recesses roll around. If anything, bills passed for the sake of passing bills may only add new problems to the heap their party promised to solve in 2016.


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