From the day President Obama signed the Affordable Care Act in April of 2010, the Republicans in Congress started a drumbeat of promises to repeal it.
You can read an excellent timeline here. It was published in 2014 and chronicles only the first four years of their attempt.
Republicans in both the House of Representatives and the Senate introduced bills to repeal the ACA. But by the next month they were already backpedaling; Tennessee Senator Bob Corker said this: “The fact is that’s [a repeal] not going to happen, OK?” There were parts of the ACA that everyone liked, (e.g. allowing children to remain on their parents’ policy until age 26 and preventing insurers from denying coverage for preexisting conditions).
The 2010 Congressional elections broke heavily Republican; they gained 63 seats in the House and 6 seats in the Senate. Republicans ran on a platform of repealing the ACA and they saw this victory as a mandate and vindication. Instead of looking for bipartisan ways to improve the ACA they elected to do nothing legislatively and instead keep beating the drum to repeal.
But as long as Barack Obama was President they could freely call for the ACA to be repealed, safe in the recognition that it wouldn’t happen and they wouldn’t be responsible for its consequences. As matter of fact, they passed a repeal bill that President Obama vetoed in January of 2016. At the time House Speaker Paul Ryan said this: “It’s no surprise that someone named Obama vetoed a bill repealing Obamacare. The idea that Obamacare is the law of the land for good is a myth. We have now shown that there is a clear path to repealing Obamacare without 60 votes in the Senate. So, next year, if we’re sending this bill to a Republican president, it will get signed into law.”
But on November 7, 2016 they found themselves in the spotlight. On that night the Republican party won the House, the Senate, and the Presidency. Suddenly they found themselves in a position where they needed to deliver on a promise they never expected to have to keep: repeal (and replace) something the American people had grown to love.
Candidate Trump promised to repeal and replace and made it sound easy. But it never occurred to him (or any of his allies) that it wouldn’t be easy.
Simply put, while the Republicans spent seven years promising to repeal the ACA, the rest of the country spent those years recognizing its value. By late 2016 6,400,000 Americans knew their health wasn’t in danger because they purchased insurance through the ACA.
And it surprised nobody but President Trump that health care reform is complicated.
Meanwhile, the ACA kept growing in popularity. In June we learned that 41% of Americans supported it while only 38% didn’t (presumably 21% weren’t certain). On the same poll only 16% supported the plan the House passed in April. In fairness, President Trump weighed in and called the House plan mean.
All during this time both Congress and the White House steamed on, determined to keep this promise regardless of its damage. In early May the House passed the American Health Care Act by a vote of 217-213. They took this vote before hearing from the nonpartisan Congressional Budget Office (CBO); when their report did come out the CBO predicted 24,000,000 would lose their health insurance over the next 10 years. Several members voted for the AHCA knowing it would not pass the Senate.
The Senate indicated they weren’t going to vote on the AHCA and drew up their own version that they called the Better Care Reconciliation Act (BCRA). The CBO determined that only 22,000,000 people would lose coverage in the next 10 years.
Like the House, several moderate Republicans voiced concerns. Majority Leader Mitch McConnell attempted to pressure his members to vote for this bill by essentially saying “we need to get something done.” When it became clear that it couldn’t pass, they came up with “skinny repeal”. This also failed, but only by one vote.
Their actions are both dishonest and irresponsible. Moderate Republicans have been bullied into voting for legislation they don’t support by being told “we’ll fix it later.”
What they need to do now is the thing they’ve refused for the last 7 years: work with Democrats. Nobody believes the ACA was perfect on its first try but it’s far from doomed. They need to put the health of the nation ahead of their political ambitions.