Though it looks like the Republicans have failed spectacularly to follow through on their promise to repeal Obamacare and replace it with something that works, the effort is far from over. Don't believe the headlines. The GOP has not yet begun to fight.
That said, there's a lot of blame to go around as to why it has proven so difficult. Chief among those deserving such blame are the conservative and Republican political operatives who have approached the whole business as a way to raise money, make themselves prominent in political circles and win campaigns. They liked the idea of victory much more than they wanted to win and, in the end, it showed.
In Congress, things were not much better. That congressional leaders could let things get so far in seven years without developing a coherent plan to actually repeal and replace Obamacare supported by majorities in both chambers is unconscionable. It's as though leadership was so committed to looking smart – from a policy perspective – they actually forgot to be smart when it came to the politics of the thing.
And the White House? Well, the less said the better as far as that goes.
There are still a number of ways to go about dismantling the national nightmare health care has become under Obamacare. It will be a slow process of unwinding things, beginning perhaps with the abolition of the individual mandate, which may in fact accelerate the collapse of the exchanges and leave people crying for relief.
As painful as that might be, both in human terms and as a political matter, the sorry truth is the Republicans who stood for Obamacare repeal stopped talking to the American people a long time ago. They wanted to do a Washington deal – and Arizona Sen. John McCain was right to criticize the lack of regular order in the process of developing a repeal package, even as he was wrong to vote against what all his Republican Senate colleagues save two were willing to vote for – without creating the kind of public pressure campaign that almost killed Obamacare in its cradle. This, of course, is what happens when you have a leadership – particularly in the House – who got there because of their policy leanings and not because they know how to manage the legislative process (even if the bill that eventually got through the House was considerably more substantive than the one on which the Senate took, for the moment, its final vote).
President Donald Trump, Speaker Paul Ryan and Senate Majority Leader Mitch McConnell can pivot to tax reform – based on principles that may be too ambitious for the current political climate – but health care isn't going away. Trump can get it back on the calendar quite quickly by directing the U.S. Office of Personnel Management to review the status of congressional staffers under Obamacare.
It's a suggestion Heather Higgins, the founder of the Repeal & Reform Coalition and president and CEO of Independent Women's Voice, has made numerous times. Simply put, she wants OPM to declare that the Obama administration's special exemption for congressional staffers is no longer in force and that "whatever remains from the Affordable Care Act will apply to Congress and all their staff the same as it does to all other Americans on the exchanges, as the law intended. "
"Strategically removing the exemptions and subsidies would mean that Congress would know they will have to eat their own cooking – something members and staff, of both parties, have tried frantically to avoid, since the law was first implemented in 2013," she said. "Nothing would create a greater incentive than personal skin in the game to genuine reform that will actually lower costs, improve choices and deliver the real reforms that voters expected."
She's right, of course. Nothing moves the average member of Congress as much as the need to protect one of their own perks – and staff is a perk. As presently constituted, few people working in the House and Senate, in member personal offices and on committees, could afford to stay if the government wasn't subsidizing their health care to the degree it is. The howls of pain coming from everyone from staff directors to legislative correspondents would be so loud it would lift the dome off the Capitol.
The debate over repeal and replace isn't over, it's just stalled. Saying otherwise would be like reporting the Japanese won the war on December 7, 1941. One defeat does not necessarily a victory for the other side make. Few people thought repeal would get as far as it did, while many actually predicted it wouldn't ever get off the ground. There are still miles to go before anyone sleeps.