Our Opinion: Repeal ACA bind gets tighter for GOP

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This week, congressional Republicans are supposed to begin — or at least begin to begin — the process of repealing the Affordable Care Act (ACA). But the reality of repeal votes with genuine consequences as opposed to years of meaningless votes to repeal under a Democratic president is hitting home with the GOP, along with the emptiness of catch campaign slogans ("Repeal Obamacare!") when compared with the impact on Americans' lives.

It appeared in December that Republican leaders in Washington had settled upon a strategy of voting to repeal the ACA while postponing the effective date of repeal indefinitely. This would enable Republicans to garner headlines while disguising the reality that no one in leadership — President-elect Donald Trump, Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan — has anything resembling a replacement plan, beyond the vague notion that it should be "market-based."

According to news reports, that strategy is being challenged by an unlikely combination of the few remaining Senate moderates, like Maine's Susan Collins and Tennessee's Bob Corker, and congressional tea partiers who indicate they will not vote to repeal before a replacement plan has been agreed to. The tea partiers led the call for the repeal of the ACA, but it is highly unlikely that all of the estimated 15 million Americans who get their health insurance through the ACA are Democrats, and congressional conservatives are surely hearing from constituents who may not have liked Obamacare in the abstract but need it in reality.

Some congressional Republicans want to take an a la carte approach to the Affordable Care Act, repealing sections they don't care for, such as the individual insurance mandate. However, the mandate is critical to funding the ACA and the plan would unravel without it, infuriating constituents who depend on the ACA.

Taking a glass-half-empty approach, Senate McConnell complains that the ACA doesn't provide insurance for everyone who needs it, which is true. But what is the Kentuckian's plan to insure both those who who would lose their insurance upon the ACA's repeal and those currently without insurance? It doesn't exist.

For years, President Obama invited congressional Republicans to offer ways to improve the ACA but they preferred to conduct irrelevant repeal votes and use Obamacare as red meat in political campaigns. Those Republicans are now in a bind, and their best way out may to be keep the ACA and belatedly take up the president's offer to explore ways of making it work more efficiently. If they go ahead with repeal, they may have to answer to infuriated constituents demanding: "Keep your big government hands off my Obamacare!"




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