The Patient Protection and Affordable Care Act—or PPACA, or ACA, or Obamacare, or the death of freedom as we know it—is in a bad state. Not through any fault of its own; it's not dying a natural death. Rather, it's being murdered with furious violence.
From John Boehner's furious "NO WE CAN'T" to the GOP House's million repeal votes, the ACA was always teetering on a knife's edge. Only Barack Obama's veto pen saved it after disappointed or disinterested voters stayed home in 2010 and 2014.
Now Republicans hold all the cards. They're the house, and the house always wins.
Yesterday, The Hill published a report. It detailed a Monday announcement by GOP Senator Susan Collins for a replacement for Obamacare. Needless to say, it was rather interesting.
"We recognize how different the needs of our states are, but our citizens should have access to affordable health care and to choose the path that works best for them," Collins said.
She added that they would be releasing more details, but that it would allow states to keep the Affordable Care Act if they like it or go an "alternative route" with funding previously earmarked for the ACA.
Well. That's interesting. A party whose mission it is to erase the Affordable Care Act has a senator proposing that states be allowed to keep the ACA if they so choose, or go another route using money earmarked for the ACA. Senator Rand Paul will also debut a replacement plan next week, according to this report.
And then, of course, you have the magilla, President-elect Donald Trump, vowing in an interview to the Washington Post over the weekend that his position is to provide universal coverage.
That's certainly not what Speaker Paul Ryan and Majority Leader Mitch McConnell had envisioned this panning out. Their idea of "replace" was to have the system in place before the ACA restored.
But it's a funny thing about Americans: once they see the federal or state government taking over a responsibility, they expect that government to honor the responsibility they've taken on. The firebombers can prattle all they want about slashing Medicare, turning Medicaid into block grants, handing Social Security over to Wall Street. Good luck with that. Those are established programs ingrained in the US body politic. Hundreds of millions of people depend on those programs. The GOP might be feeling its oats right now; those oats will be roasted once they start putting out real proposals.
We're seeing that with the Obamacare debate. Republicans may have voted to begin the process of unraveling the health care law. But many of them are loathe to pull the trigger without a replacement in place. And, if Senator Collins is any indication, a replacement should cover at least as many people as the ACA does now, if not more. (Sen. Collins' plan aims to cover 95% of Americans, more than even the ACA.)
What Pres. Obama did with the ACA was put it into the mind of citizens that health coverage was a right, not a privilege. Yes, you have the moronic Trump voters who didn't realize that "Obamacare" and the ACA were the same thing. But now that they do realize it, they're howling like hit dogs, realizing that the new program which has given them peace of mind is on the chopping block due to their decisions. If there's this much pushback on a program which is only six years old, imagine the firestorm once the third rails of Social Security, Medicare, and Medicaid are touched. And Democrats are rightly sitting on their hands. This puppy belongs to the GOP; they have to clean up the poop.
The Affordable Care Act is on life support. But its prognosis is ambiguous. The fact that there is so much turmoil in the GOP over how to proceed is indicative that they don't really want to pull the plug. And this portends even bloodier battles ahead over other safety net programs.
Governing. It's a pisser.