When congressional Republicans went off to Philadelphia for a retreat this week, they hoped to make at least some progress toward a consensus about how to proceed with repealing and replacing Obamacare.
However, secret recordings of closed-door discussions at the retreat obtained by the Washington Post’s Mike DeBonis reveal that the party remains divided, uncertain, and deeply concerned about how to move forward.
It’s long been clear that there are a great many unsettled questions regarding the legislative and policy details of the GOP’s repeal effort. These include:
- How quickly should repeal go into effect?
- What, exactly, would the replacement be — can Republicans come up with a replacement that would be affordable for sick people who need insurance?
- Should Obamacare’s Medicaid expansion be repealed?
- Should the rest of Medicaid be transformed into a “block grant,” program as Paul Ryan has long supported, which would almost surely mean major reductions in the number of people it serves?
- Should an Obamacare repeal bill also defund Planned Parenthood?
- Does Donald Trump’s administration have a plan, or can his aides offer any more specifics about what they want policy-wise?
The Post’s report reveals that every single one of these questions remains completely unsettled, and that at least some within the party have grave concerns about all of them.
Republican House members representing blue states appear to be particularly worried. Rep. Tom MacArthur of New Jersey worried about pulling “the rug out from under” people covered by Obamacare, Rep. Tom McClintock of California warned that the GOP would own “the market we’ve created ... lock, stock and barrel,” and Rep. John Faso of New York said defunding Planned Parenthood in a repeal bill would mean “walking into a gigantic political trap” that could end up with “millions of people on social media” protesting repeal.
Meanwhile, Trump’s top domestic policy staffer, Andrew Bremberg, is quoted speaking in only the vaguest banalities and broadest strokes, offering no substantive guidance whatsoever besides saying that HHS Secretary nominee Tom Price is a “compassionate” guy and a good doctor.
There is no master plan
All in all, the leaked recording should inspire confidence in Democrats about the politics of Obamacare repeal, which seems like far from a sure thing at this point.
Though “repeal and replace Obamacare” is a simple, clear, crisp campaign slogan, in practice it’s incredibly complicated. A plethora of different committees, many different factions of the party, powerful interest groups, activists, and many other players all have to end up agreeing on one specific plan and advance it through a political gauntlet. (To enact a full replacement, at least eight Senate Democrats would probably have to be won over too.)
Yet even the most very basic points about exactly what should be repealed and what it should be replaced with remain unsettled at this point. And even though the proposal’s current vagueness means Republicans in Congress don’t have to defend any specific points that are unpopular, they’re clearly worried already. Check out DeBonis’s piece for more details.