There's no doubt the vast majority of Republicans in Congress would repeal Obamacare if they could. Most GOP "alternative" bills begin with a clause to repeal the Affordable Care Act before proceeding to outline new policies to put in its place. Of course, GOP lawmakers don't have any hope of actually repealing the law as long as Barack Obama, and his veto pen, are in the White House.
Now some Republicans are looking at what might be done to undo as much as possible of the Democrats' national health care scheme without actually repealing it. If Obamacare's problems continue to mount -- and Republicans believe they will -- could the GOP create any political momentum behind proposals to limit the harm?
At the recent Senate Republican retreat at the Library of Congress, Sen. Ron Johnson presented an extensive PowerPoint proposal to "repair the damage" of Obamacare. Johnson had once hoped to repeal the law but conceded that now, after its implementation, "you don't just wave a wand and repeal it and it goes away." So he is collecting ideas for a bill he hopes would instead remove some of the most problematic parts of Obamacare. Johnson stressed that his proposal, in whatever final form it takes, will not be a systematic replacement but rather a set of individual fixes that could offer relief to some of the Americans most burdened by Obamacare.
Johnson outlined to his GOP colleagues a set of proposals that included doing away with all of Obamacare's mandates -- employer, individual, plus the requirement that all insurance policies contain specific government-dictated features. He also suggested what he calls "a true grandfather clause" -- a provision that would allow anyone to keep his or her health coverage. Yet another proposal would allow any state to opt out of Obamacare. Still another would end the "bailouts" of insurance companies.
Johnson is also considering some standard Republican policy suggestions, including allowing the sale of insurance across state lines and ending the tax penalty for those who purchase insurance on the individual market. He's also discussing the creation of high-risk pools to insure people with pre-existing conditions.
He stressed that a bill containing some narrowed-down combination of those proposals -- he would prefer that the final legislation include no more than three -- must first be something the Republican-controlled House would pass. Second, it should not be considered a substitute or GOP alternative to Obamacare -- "It should be far more modest in scope," Johnson told me later. And finally, it should "already enjoy supermajority public support."
"The elements should be designed to highlight the major flaws of, and damage being done by, Obamacare," Johnson said.
A critical point: Johnson would not end the flow of subsidies under Obamacare. "I think you almost have to (leave subsidies in place) until you start transitioning," he told me. "Realistically, could we just eliminate the subsidized care?" Johnson also plans to stay away from Obamacare's expansion of Medicaid. "I'm not dealing with that right now," he said.
Nevertheless, Democrats will see almost every one of Johnson's proposals as an attempt to destroy Obamacare, to repeal it without literally repealing it. And even if the House passes such a repair bill, Senate Majority Leader Harry Reid would certainly block it.
But what is wrong with presenting a set of limited plans to address specific problems created by Obamacare? Some Democrats are already campaigning for re-election by promising to "fix" the health care law. Shouldn't voters know there are Republican plans to deal with that, too?
"It's designed to attack Obamacare," Johnson said of his plan, "to keep that the issue, but in doing so, have some policy prescriptions that if passed would be actually helpful."
It's not clear that Republicans would unite behind Johnson's specific plan when it is finished. Perhaps some will want to stay focused on demanding repeal. But a senior Senate GOP aide stressed that calls for repeal are "not incompatible" with the goal of repairing the damage from Obamacare. "There's a recognition that repeal won't happen in the next two years," said the aide. "I think there's probably a pretty strong appetite among members, particularly those up for re-election, for (finding) how do you fix the problem that we face today."