Opinion | The secret Republican health-care plan, revealed


Democrats counter that this “plan” is a phantom, a fantasy, something President Trump and other Republicans keep promising but never deliver. It’s as though the GOP says, “We have a plan to make car theft illegal!” while its members go around smashing people’s car windows.

On a purely factual basis, the Democrats are absolutely correct. But it’s also the case that Republicans do have a plan of a sort, to be explained below.

First, let’s note just how desperate Republicans are to deny that they’ve been trying to destroy the ACA from the moment it was passed in 2010. Here, for instance, is a new soft-focus ad from Texas Sen. John Cornyn:

If you’re wondering whether the Republican Party is confident in the appeal of its agenda, here’s one of the most senior Republicans in the Senate essentially claiming to be a protector of Obamacare, the repeal of which has been one of his party’s central policy goals for a decade.

To be fair, Cornyn has sponsored one of the GOP’s perfunctory bills to “protect” preexisting conditions. But these bills offer far less protection than the existing ACA.

Regardless, almost every endangered GOP senator is getting in on this same act. Here’s an ad in which Cory Gardner of Colorado gets his mom to tell you he’ll protect people with preexisting conditions. Here’s another ad in which Joni Ernst of Iowa enlists her sister to attest to the same. Here’s an ad from David Perdue of Georgia, and another one from Martha McSally of Arizona, and still another one from Steve Daines of Montana, all making the same promise.

So inspiring! Were it not for the fact that every one of them has voted to take away coverage for preexisting conditions.

As for the Trump administration, they’re sounding the same tune; when pressed, they will say: Well yes, we want to repeal Obamacare. But it will be replaced with our awesome new health-care plan! No, you can’t see it.

That has been the subject of much mockery, as it was recently when Trump said in an ABC News town hall, “I have it all ready, and it’s a much better plan for you.” Or as Vice President Pence said at this week’s debate, “President Trump and I have plans to improve health care and to protect preexisting conditions for every American.”

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 barely bothered to give any thought to a 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 hope that just as they lost that 2017 vote, they lose the lawsuit against the law that the Supreme Court will hear just after the election. 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.

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