The Phantom Plan

It’s a menace if you have a Pre-Existing Condition

The secret Republican health-care plan, revealed
by Paul Waldman, Washington Post
October 9, 2020

It’s true, as Democrats insist, that there is no Republican “plan,” if like some kind of nerd you define it as a series of specific steps written down somewhere that lay out a health care policy that will be followed by the government and the country.

But in another sense, Republicans actually do have a plan. It’s not the kind of “plan” that involves legislation or regulations. Here’s what it is: Nothing.

This plan may be more clever than you realize. First, it’s important to understand that even if Trump wins the election and Republicans hold the Senate, they have almost no chance of taking back the House. And even when they held the House in 2017-2018, they couldn’t get their repeal plan passed. So they won’t try that again.

Indeed, in July 2017 when Sen. John McCain killed Obamacare repeal, much of the Republican Party issued a sigh of relief. Republicans had to try repeal because they’d promised it to their base for so long, but they had given little thought to a serious replacement. They knew repeal would throw the entire U.S. health-care system into chaos. The political repercussions would have been catastrophic.

So the optimal strategy was to try to repeal the ACA, but fail. And if they don’t have complete control of Congress in the near future, it’s not even worth the trying part.

Those senators run all those ads because they know that the more the ACA is an issue, the worse it is for them; they’re not trying to win the argument, just muddy the waters enough to minimize the damage they suffer.

Which is why all smart Republicans also want to lose the lawsuit against the ACA that the Supreme Court is scheduled to hear just after the election, just as they lost that 2017 vote. Which they just might, since at least some of the conservative justices — such as Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh — are smart enough to know how dangerous it is for their party.

To be clear, if Trump is reelected, his administration will continue to use its regulatory and administrative power to undermine health security, especially by trying to push people off Medicaid. But as for a plan to remake the health-care system? They’re offering nothing. And that isn’t going to change.