President Trump once compared Obamacare to a ticking time bomb, suggesting his predecessor set it to detonate after he left office.
Congressional Republicans have certainly found that analogy apt when it comes to disassembling the healthcare law. Untangling its complicated web of subsidies and mandates is like deciding whether to cut the blue wire or the yellow wire. Every move you make could blow up in your face.
Now it's Senate Majority Leader Mitch McConnell's turn to oversee the bomb squad. The healthcare bill language to be unveiled Thursday could blow up the fragile unity among the 52 GOP senators. Even if McConnell succeeded, it could go on to explode in the House.
"I hope we are going to surprise you with a really good plan," Trump told a rally in Cedar Rapids, Iowa, Wednesday. "I've been talking about a plan with heart. I said, ‘Add some money to it!'"
Trump was speaking in a state where most counties are set to have only one insurance provider selling coverage on the individual market next year. That insurer announced it could only do so by increasing premiums by an average of 43.5 percent.
The White House unveiled a new website Wednesday pointing out problems with the healthcare system under Obamacare. But Republicans have lost whatever moral high ground they may have gained back in the seedy days of the "Cornhusker Kickback" and other gimmicks.
After years of jibes about Nancy Pelosi saying Democrats had to pass Obamacare to see what's in it, the Republican healthcare bill's drafting process has been so shrouded in secrecy it does not even meet the original Affordable Care Act's low level of transparency.
That's because so far Republicans have been able to please almost no one on healthcare. Not conservatives on Capitol Hill who want something as close to full repeal as they can advance through the reconciliation process to avoid Democratic filibusters. Not conservative healthcare policy wonks outside of Congress. Not jittery centrists from swing districts who, recent special election success aside, are afraid they are going to lose their seats over this.
Republicans have never really made the case for better-functioning markets in healthcare in any sustained way and are now paying the political price for their omission. They have either supported lower-cost knockoffs of Democratic healthcare policies, like President George W. Bush's Medicare prescription drug benefit or Massachusetts' Romneycare, or blocked liberal plans like Hillarycare.
The Republicans know as well as the Democrats that a key driver of reform's unpopularity in the past has been how it disrupts Americans' current healthcare arrangements and seeks to control costs in controversial ways. Now they will be the party creating uncertainty, not the Democrats.
Now the least-popular part of Obamacare, the aspect of the law that is most obviously collapsing, is its concession to markets (albeit in a highly regulated and bastardized form). The exchanges are failing. If Obamacare were just the Medicaid expansion, would there be any politically meaningful constituency for repeal?
Democrats are learning that lesson. That is why they are starting to talk about expanding Medicare at the same time Republicans warn about the program's unfunded liabilities. They are exploring single payer in deep blue states like California (despite its failure in Vermont) and in the Democratic presidential primaries, via socialist Bernie Sanders.
Obamacare has problems that can be solved either by markets or by further expanding the government's role in healthcare. The arguments for the latter are more intuitive because of international examples like Canada and Great Britain, not to mention homegrown programs like Medicare. And those arguments are being made by everyone from Democrats in Congress to the Republican president of the United States.
When the Congressional Budget Office scores Republican healthcare bills as covering millions of fewer people than Obamacare, GOP politicians are all over the place in their answers. Some argue the number of people with insurance isn't the right healthcare metric; some dispute the accuracy of the scores; some say this is the fruit of healthcare freedom.
But Republicans have been promising to repeal and replace Obamacare for seven years. And now that they have written a bill that they theoretically have enough power in Washington to make law, they now own part of healthcare. Democrats can be blamed for creating Obamacare, but Republicans have to take some responsibility for their inability to fix it or roll it back.
That's why Republicans have no choice but to defuse this bomb, even at the risk of members' political lives. The Democrats paid all the costs Republicans are faced with now, including the loss of their majorities between 2010 and 2014.
Except, so far, for one key difference: The Democrats have their vision of healthcare policy becoming law to show for it.