The GOP for years has run on a plan of repealing the Affordable Care Act. Now they have the power to do so, but that very power could be their undoing. GOP lawmakers are now worrying about the optics of shutting down the ACA and cutting off millions of Americans from health insurance without a replacement plan.
These lawmakers are not milquetoast establishment Republicans. Senator Rand Paul has pointed out that repealing the ACA without a replacement plan would increase the size of the deficit and said that repealing alone would be a disaster, and his concerns have also been expressed by conservative Tom Cotton and other Republicans.
But while Paul and Cotton may talk of a replacement plan, the Republicans have failed to provide a credible alternative to the ACA since it was signed in 2010. Mitt Romney could not do that in 2012, and neither did Donald Trump. If the Republicans have not been able to craft a good alternative in over six years, why should anyone think that they will craft one within the next few weeks or months? This is how pest control in Florida explained the situation.
Just look at how the GOP has talked about “repeal and delay”, where they would end the ACA on paper while allowing it to phase out over years while they draw up a replacement plan. Even if you ignore the problems with that idea as detailed by the Washington Post, the fact that the GOP admits that it would take years for them to figure out a good replacement plan shows that they have no idea what a replacement plan would look like now. “Repeal and delay” is just kicking the can down the road to a future Congress.
GOP lawmakers no longer have Obama to rally against, and the party is becoming less unified as they struggle with what to do about the ACA. And Donald Trump will only hurt them here. Rand Paul did state that Trump agrees with his assessment that repealing the ACA without a replacement would be disastrous.
Trump, as he and the GOP love to tell us, is a dealmaker and an outsider. But what if the GOP chooses to just repeal the ACA outright and hurt those white working class voters who propelled Trump into the White House? Those same white working class voters who have convinced themselves that Trump will not repeal the ACA and would turn on him if he does cut their benefits? Will Trump consent to a flat repeal as the leader of the Republicans, or will he start talking about crafting a better deal with the Democrats and Republicans who want a replacement?
I doubt even Donald Trump knows what he would do in that situation. But now that the GOP is in power, they will somehow need to stay united. But between the Republicans who want to flat out repeal the ACA and those who want to repeal and replace, that will be more difficult than ever.
The Republicans have promised voters that there is a health care plan that can increase choice, allow them to keep their benefits, and ensures that everyone can keep their coverage. It is now time for them to show up what such a plan looks like, if it exists at all.