Why Is the US Republican Party So Confused About Health Care?
2019-02-07 from nytimes.com
Judging by exit polls, the single most effective midterm issue for Democrats was health care — in particular, the argument, made by Democratic candidates across the country, that Republicans were out to eliminate the Affordable Care Act’s regulations governing pre-existing conditions.
So when a Texas judge ruled in December that the entirety of the health law was unconstitutional, he ensured that this issue, and this argument, would remain front and center heading into the 2020 election.
Legally speaking, the ruling is weak, and the case may be tossed in the appeals process. But if it travels all the way to the Supreme Court, it would effectively guarantee that health care remains politically potent throughout the presidential campaign. You can expect the Democrats’ cast-of-thousands presidential field to all swear to protect Obamacare’s pre-existing conditions rules — and President Trump to demonstrate his usual command of the finer points of health care policy in response.
The ruling thus represents a challenge for Republicans — but also an opportunity. At least in theory, it could force the party to finally figure out, or at least start figuring out, exactly what it stands for when it comes to health care policy.
The empty mantra of “repeal and replace” — which was all but buried by the midterms — was never a stand-in for an actual shared vision for the governance of health care in the United States. At the moment, the party seems confused about what, exactly, American health care policy should look like.
That confusion extends beyond Obamacare to Medicare (which President Trump has ruled off limits) and Medicaid (which the repeal bills tried and failed to restructure), as well as to the tax deduction for employer-sponsored insurance around which health care policy has contorted for so many decades.
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