Republicans on What Would Replace Obamacare: Hey, Look Over There!

Reporting on Politics and Policy.
May 27 2014 10:15 AM

Republicans on What Would Replace Obamacare: Hey, Look Over There!

I wrote a little bit about this on Friday, but it took a while for the full comments from Mitch McConnell's post-victory press conference to get printed. LEO Weekly's Joe Sonka now has a full story up about the ways McConnell approached a question about the repeal of the ACA, and whether achieving it meant kicking people off health insurance.

The first question asked how he would respond to those who say repeal would take away the healthcare of 413,000 Kentucky, to which McConnell launched into his standard answer that Obamacare was raising premiums, raising deductibles, and killing jobs, concluding, “It was a big mistake, we ought to pull it out root and branch and start over.”
WHAS’ Joe Arnold followed up that answer by asking, “But if you repeal it, won’t all of the state exchanges be dismantled? How does that work?” McConnell then launched into his standard “solution” of sorts, calling for an “international market” of insurance companies that aren’t limited by state lines, in addition to “malpractice reform.”
... Arnold followed up, asking “Should Kynect be dismantled?” McConnell gave this jaw-dropping one-sentence reply: “I think that’s unconnected to my comments about the overall question here.”

As Greg Sargent has been documenting, no Republican candidate in a tough race has come up with a workable response to this question. What would replace the Affordable Care Act? What would do so without kicking more people off their existing plans? It's just impossible to answer, given that Republicans want the focus to be on the people whose private plans were ended or altered by the ACA. When I was in Georgia, I asked (since narrowly defeated) GOP Senate candidate Karen Handel what she thought Republicans could achieve come January 2015, given that Democrats will retain the presidency through 2017 at least. Her answer:

You have a majority in the House and the Senate, because the administration has delayed so many key components, there's a window of opportunity to do a repeal/replace. Then we need to seize on that immediately. It is important for us, as Republicans, to come behind it with a bill that has reforms that most Americans want, like portability plans, high-risk pools for people with pre-existing conditions, more malpractice reforms, more opportunities for health savings accounts. 

So what about the people who have insurance now and didn't before the ACA?

We don't even know how many people, quote, got it. We have a figure of eight million. Well, some of the estimates are that about 5 million of those are people who got notices from their insurance companies that said their plans went away. They'll be happy in the private market. So what we're talking about is maybe 1.5 to 2 million, and for those folks, we can look at some kind of premium assistance, or we have a network of health networks across this country -- and that's never been part of the debate.

This sounded like the demo version of an answer other candidates could use. It assumed that the official estimates of who got/didn't get coverage are bogus, and that "premium support" can be turned into a positive. And all of it reflected a sad reckoning that a lot of Republicans had gone through in Georgia. Having been told in 2012 that the election was their last chance to repeal Obamacare; having been told the same of the 2013 continuing resolution fight; having learned all that, they demanded their candidates talk about repeal but were cognizant that the law had taken root.

David Weigel is a reporter for Bloomberg Politics



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