President-elect Trump should have taken out Speaker Paul Ryan the morning after the election when he had the chance. Ryan earned a no-confidence vote by his attempted sabotage of Trump’s election, and 23 members were all it would’ve taken to deny Ryan a majority. The American Health Care Act’s demise was not the result of conservative intransigence, but rather of Ryan’s horrendously incompetent legislative skills, and of his kiss-up-to-liberals, kick-down-at-conservatives reflex, a disease particular to establishment Republicans.
Voices excoriating conservatives for promising to vote ‘no’ on the AHCA ignore what an awful piece of legislation it was. Among the more egregious Philippics was a Wall Street Journal editorial blaming the Heritage Foundation for wanting to fundraise via a “perpetual outrage machine” and encouraging Trump to “get even” with House Freedom Caucus members. This level of immaturity and rage is conduct unbecoming, especially when the legislation in question enjoyed a 17% approval rating.
To comprehend why conservatives could not swallow the AHCA, one must understand the basic reason why ObamaCare destroyed the insurance market, and despite what some might say, it is not complicated. Preventing companies from discriminating against applicants with pre-existing conditions (so-called guaranteed issue) means that people won’t sign up for insurance until they’re sick. This is the infamous death spiral, whereby the pool of people being insured gets more and more sick, as healthier people drop out because insurance becomes increasingly expensive. The AHCA did nothing to address this; in fact, it made it worse.
ObamaCare attempted to avoid the death spiral by penalizing (or taxing if you believe Justice Roberts) people for not signing up under the individual mandate. The AHCA repealed this mandate and replaced it with a 30% increase of insurance costs for one year. So while ObamaCare penalized people without insurance (in theory up to the cost of buying the minimum qualifying plan), the AHCA penalized people for re-entering the insurance market, but 110 days’ worth of extra premiums is inconsequential when compared to the years they might have avoided paying anything at all. That the majority of elected Republicans actually thought this would work is a testament to just how poorly our country is governed.
The Republican Party ran on repairing the Titanic, not re-arranging the deck chairs. Had Trump and the GOP passed this madness, they would’ve looked like blithering idiots – not now, but six or twelve months down the road. As it is, the GOP will get a second chance to get it right; hopefully they will do what they should’ve done before and start by asking themselves as a party, ‘what do we believe?’
Does the GOP believe in guaranteed issue? If so, they do not believe in insurance. You don’t get to buy fire insurance after your house burns down. Do they believe in making everyone’s health insurance cost the same, i.e. community rating? If so, they believe in transferring money from the young and healthy to the old and sick. Once upon a time, the Republican Party believed in freedom. Do they still?
The Party leadership retorts that of course they would’ve loved to repeal all the worst parts of ObamaCare, but those pesky moderates would never have gone along with it. Perhaps, but those moderates voted sixty times to repeal ObamaCare, and now, when it actually matters, they get a free pass by not even having to vote? Once upon a time such cowardice would be regarded as shameful, but to listen to party elders, such pusillanimous fakery is now wise and virtuous. It is rather those disgusting conservatives, who actually believe in their campaign promises, who are the problem.
Remember Bart Stupak? He was the “moderate” Democrat congressman from Michigan who waged a public Hamlet-like struggle with ObamaCare’s abortion funding. He was finally persuaded by some worthless verbal assurance, and promptly wiped out along with 62 of his colleagues in the 2010 elections. That’s what Democrats do to their moderates, when they’re not screwing them over on worthless committee assignments, and keeping them as far from the centers of power as possible.
The 2010 election was the one where Republicans were going to get the majority and deliver the country from ObamaCare. The GOP got the House, and funded ObamaCare. They said give us the Senate, and we’ll really be able to get rid of ObamaCare. The GOP got the Senate, and funded ObamaCare. They said in the words of Paul Ryan, “if we’re sending this [ObamaCare repeal] bill to a Republican president, it will get signed into law.” The GOP got the White House – no thanks to Paul Ryan – and what did Ryan do? Instead of voting on a filibuster-proof repeal and pressuring a handful of moderates to honor their previous votes and pledges, he introduced a thoroughly dishonest non-repeal bill and blamed the few conservatives that wouldn’t sell their soul.
Speaker Ryan is a hero of our time.
Had Ryan’s AHCA gone into law and blown up in the GOP’s face, Democrats would be screaming from hilltops that the “conservative” solution had failed, and that the only alternative was single-payer. Game. Set. Match.
President Trump should not avoid his share of the blame. He could have pulled the plug on what he knew was a bad bill at any time, but chose not to. He can pretend to “move on” from healthcare all he wants, but those premiums aren’t moving anywhere but up. If Trump does not find a way to substantially repeal ObamaCare, he will have a hard time preventing its dead hand from holding down the economy.
There are ways of providing coverage to those with pre-existing conditions, but they have to be means-tested, and they have to be paid for honestly, i.e. with tax dollars, not by sending the check to another table and claiming a 100% service charge is included. With $20 trillion in debt, America can ill afford another middle class entitlement, yet that is exactly what RyanCare would have enshrined on a bipartisan basis. If this is the best the Republican Party has got, they won’t be in power very long.
The author is a former Republican campaign operative. His work has appeared in USA Today, Real Clear Politics, The Federalist, and the Daily Caller. He has also appeared on Dan Caplis show on KNUS710. He currently resides in the Washington, D.C. area. Follow him on Twitter @PHGuthrie.