Is the Total Repeal of Obamacare a Pipedream for Republicans?

One way Republican politicians fire up their supporters when giving campaign speeches is to say they will scrap the Affordable Care Act (aka Obamacare). But according to ABC News some Republican Governors aren’t convinced that Obamacare is going away anytime soon and are adopting a much more pragmatic approach compared to GOP politicians in Washington.

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-Obamacare fervor of their party in Congress.

Ohio Gov. John Kasich says he doesn’t think there will be a repeal in Washington, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election.

So it seems despite all the sabre rattling about repealing Obamacare lock stock and barrel reality is starting to set in that actually dismantling the scheme isn’t actually going to be all that simple. David Nather from Politico writes that it has dawned on some in the GOP what the realities are.

Gail Wilensky, a longtime health care expert who ran the Medicare agency under the first President George Bush, concluded that even though the law is still unpopular — even after the benefits have kicked in — “I think we are at the point where people have to realize this isn’t going away.”

A big turning point, according to Senate Republican health aides, was when health insurers not only didn’t abandon the Affordable Care Act after the bumpy first enrollment season but also signed up in greater numbers for the second enrollment season, which starts in November. That’s seen as a sign that health insurance companies have accepted the law and don’t believe it’s going anywhere.

Besides, Wilensky said, “I think a lot of Republicans, in quiet conversations, understand that there is no precedent for repealing a program after the benefits have already started.”

But that hasn’t stopped GOP candidates for political purposes campaigning during the mid-term elections for total repeal. But if the law is to be repealed Republicans might like to explain to people who have already signed up what happens to them? Frankly it looks like some in the GOP are being rather disingenuous by campaigning for total repeal when they know it isn’t going to happen as long as Obama is President. And being fully aware that it will not be all that easy in 2017 if the GOP wins the presidency. The scheme may be too well entrenched by then to simply got rid of.

Republicans have various plans but cannot agree amongst themselves which one is best.

It’s not that alternatives don’t exist. A replacement plan by Sens. Orrin Hatch and Tom Coburn, a similar one by the 2017 Project and a more recent version by Avik Roy of the Manhattan Institute have all gotten serious attention in GOP circles. They all target what conservatives genuinely believe are the worst features of the health care law — higher coverage costs and fewer choices — although they differ in how much of the law they’d wipe away. Roy’s version would keep a deregulated version of Obamacare’s health insurance exchanges and use them to cover some Medicare and Medicaid beneficiaries, while the others would get rid of more of the law’s central features.

But Republicans and conservative activists haven’t gotten on board with one plan, and aren’t likely to anytime soon. They can’t even agree on whether it should be one big alternative or a bunch of smaller ones. Mitch McConnell as Senate Majority Leader will try for repeal but it has no chance of happening.

Senator John Barrasso, Republican-Wyoming., a member of the GOP leadership puts it this way.

“Obviously, we are going to try to fully repeal the law,” said Barrasso. “The reality is President Obama is going to be in office, and we know how that is going to turn out if we get a bill to his desk. If we cannot get a full repeal, we will try to bring forth a number of bills that target the worst parts of the law.”

The possible outcome is that Obamacare may never be totally repealed but may instead go through stages of evolution over the medium to long term. This isn’t uncommon with complex legislation. Until Republicans fully spell out a well thought out plan that is properly costed they’re standing on shaky ground.