Repeal and regroup? The vote that was never going to happen anyway
WASHINGTON – It wasn't quite a wicked-witch-is-dead Munchkin happy dance, but the white noise of foregone conclusions drowned out Republicans' relatively muted regret over their failure to repeal and replace Obamacare.
It was never gonna happen. Not no how.
Partly this is because the GOP version of reform would have first done harm to our most vulnerable citizens – the elderly, the disabled and the poor. Maine Republican Sen. Susan Collins cited drastic Medicaid cuts as her reason for withholding support of the so-called "Better Health Reconciliation Act." Kentucky Sen. Rand Paul also said he wouldn't support the bill, because it didn't go far enough in repealing Obamacare.
When two more GOP senators – Mike Lee of Utah and Jerry Moran of Kansas – defected Monday night, the deal was undone. Lee said the bill failed to repeal all of the Obamacare taxes. He also said the bill didn't go far enough in lowering premiums for middle-class families or in loosening costly regulations.
Thus, the weeks-long tornado of hot tempers and chill winds culminated Tuesday morning when Senate Majority Leader Mitch McConnell realized he didn't have enough votes.
Health care is such a mind-numbing boondoggle that one must take frequent breaks from thinking about it. Therefore, let us pause for a moment to applaud the relatively unknown L. Frank Baum (1856-1919), author of "The Wonderful Wizard of Oz." Neither the passage of time nor the contempt usually bred by familiarity seems to dim the popularity or the seemingly eternal applications of his masterwork. In my experience as a columnist, I've found few issues, characters or moments – whether writing about Bill Clinton's steamy White House encounters or McConnell's bland ruminations on regret – that don't benefit from Baum's contextual frameworks.
There. Now to yawn-inspiring health care reform in all its failed foregone-ness.
During almost a decade of writing sporadically about health care in its various iterations, I've interviewed dozens of people from a mix of related fields – medical, business, legislative and political. Not once have I found a single person who thought the GOP could pull off a repeal and replace. Why?
Firstly, because the vast majority of Americans are fundamentally opposed to allowing others to suffer. And secondly, sort of, the ACA affects one-sixth of the U.S. economy. How does one untangle a knot of 20 million strings? Why not just repeal and replace California and call it a day? It would be easier.
The fact is, Obamacare was never perfect nor should anyone have expected it to be. Today, we have a health care system in pitiful disrepair, as insurance companies opt out of exchanges, premiums continue to climb, and healthy, young people forgo insurance premiums that would have subsidized coverage for unhealthy, older Americans and the less fortunate.
Therein lies the crux of the least solvable problem inherent in such a gargantuan, multifaceted overhaul: It denies, emphatically, the nature part of being human, which is in constant tension with government-mandated insurance coverage. The central question is: How do you make it both cost-effective as well as fair?
Many Americans simply don't see the fairness in a system that requires them to pay high premiums for others' poor health, some of which is, let's face it, earned. Not deserved, but sometimes resulting from poor lifestyle choices. Why, indeed, should a single, childless 30-year-old male who runs three miles a day, eats rationally, doesn't drink, smoke or take drugs, be saddled with insurance premiums to cover pregnancy, abortion, alcoholism, addiction, or an abundance of health consequences resulting from obesity and inertia?
For that matter, why should women have to subsidize men's sexual dysfunction curatives when, by the way, men don't have to pony up for women's corresponding, post-menopausal, medically appropriate intercessions. Here you see one of the finer-print dilemmas. We'd rather force nuns to concede tacit approval of abortion than insist that insurance subsidies be tied to healthy behaviors.
I'm sorry if this sounds heartless; the brain calls it reality. No wonder Obamacare was so difficult to craft and a replacement equally so. There are simply too many moving parts to make the sucker float – and too many reasons to not sink it.
Since McConnell's repeal-only idea seemed doomed Tuesday afternoon after GOP Sens. Collins, Shelley Moore Capito and Lisa Murkowski said they oppose immediate repeal, perhaps, finally, Republicans and Democrats can snap on their wizard hats and cobble something workable together. After all, it's the only thing they haven't tried yet.