The Dallas Morning News
Just about everyone in Washington wants to move on from last week’s big standoff over Republicans’ failed attempt to repeal and replace the Affordable Care Act.
That’s understandable, maybe, but it’s also deeply cynical. The health care plan has always needed improvement, and for six years Republicans refused to tweak it, preferring to use its shortcomings as a political rallying cry.
Take President Donald Trump’s tweet from Monday night: “The Democrats will make a deal with me on healthcare as soon as ObamaCare folds — not long. Do not worry, we are in very good shape!”
No, Obamacare is not going to fold. And the president’s tweet shows he misunderstands entirely the lessons from last week.
One lesson was that his party’s success in November merely papered over, rather than healed, the GOP’s deep divisions. And we learned that Americans actually want health insurance; they now expect that it can’t be taken away by pre-existing conditions, a loss of a job, or other unforeseen developments.
But that doesn’t mean every American loves the Affordable Care Act. Or that the way health insurance works today is the way it has to always work. But whatever eventually replaces Obamacare is going to have to build off the guarantees already in place.
That’s why House Speaker Paul Ryan said that the law will be with us “for the foreseeable future.”
Still, if everyone agrees that the Affordable Care Act needs fixing, why can’t we fix it? All that is standing in the way is the kind of Washington cynicism that puts party and politics ahead of people and policy.
To change that, House Republicans should accept that the Affordable Care Act is here to stay for now, but develop a list of small-scale changes aimed at fixing its best-known problems.
For instance, maybe Trump’s insistence that health insurance be sold across state lines could be tried, on a pilot basis, in one region where it looks most promising. Maybe one or two states could be allowed to replace the individual mandate with the GOP’s proposal for heavy penalties for letting insurance lapse.
These are starting points. The idea is for Republicans to put forth fixes, but to do so within the framework of the system already in place.
Democrats could be honest about where Obamacare doesn’t work as well as it should, and either sign on to the GOP fixes or develop their own with the an eye toward winning moderate GOP support.
And Trump? He should tell Republican leaders he’ll sign the first Obamacare bill that reaches his desk with at least, say, 20 Democratic votes in the House and five or 10 in the Senate. He’s said he wants to work with Democrats; time to show it.
That way, everyone wins. The health care system gets better. And if its critics still want to try to repeal it altogether sometime in the future, nothing is stopping them from trying.
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