When I was a teenager I served on a committee at my church. After a long and painful meeting another member told me: “When all is said and done, a great deal more is said than done.” I still laugh when I think of it
I’ve written several posts on the Republican promise to “repeal and replace” the Affordable Care Act. Perhaps it’s time to take a step back and look at how we got here.
From the 2nd half of the 20th Century different Presidential administrations have sought to make health care available to everyone. As far back as 1945 we’ve been hearing about this. In November of 1945, Democratic President Harry Truman (seven months into his first term) said this: “The health of American children, like their education, should be recognized as a definite public responsibility.”
Alas, he was not able to make this happen. But 20 years later Democratic President Lyndon Johnson signed into law Medicare (health care for those 65 and older) and Medicaid (health care for the poor).
It’s worth noting that the Republican Party fought hard against all three. You can read an excellent article here.
From his first days in office in 2009 President Obama pledged to provide health care to those who had previously been left out because they had pre-existing conditions, or worked for employers who didn’t offer health insurance, or couldn’t work. You can find an excellent timeline here. It wasn’t easy, but he signed the ACA bill on March 23, 2010.
When Social Security, Medicare, and Medicaid became the law of the land the Republicans soon learned that these programs were both popular and permanent. Both parties then learned to cooperate and make regular updates that benefited the American people.
Not so with the ACA. Republicans who wanted nothing other than President Obama’s defeat latched onto this as a path to destroy his Presidency. You can read about it here. Simply put, while they failed in the courts, they found moderate success in frightening insurance companies away from entering markets in states that declined the Medicaid expansion (and threw overboard their poorest citizens in favor of settling political scores).
Meanwhile they’ve spent the last seven years promising to replace the ACA with something “better and cheaper.” Five days before his inauguration President Trump promised insurance for everybody. But if we’ve learned anything from the last six months, we’ve learned that while the Republicans pledged to replace the ACA they’ve spent not one minute figuring out how to do it. No plan, no framework, no work at all.
In fairness they’ve enjoyed the luxury of making promises they never expected to have to keep. That all changed in November.
So here’s the problem: these Republicans now have to choose between a moral compass and their job security. I don’t envy them because it’s not a fair fight. They continue to claim that they serve their constituents but the latest national poll shows that most Americans support the ACA and only 12% of counties who voted for President Trump support the ACA’s replacement. This morning we learned that a group called the Senate Conservatives Fund are already targeting Republican Senators who didn’t support the latest Senate bill to replace the ACA.