This month, two developments have shaken the conventional wisdom that repealing President Obama’s healthcare law is an impossibility.
First, Republicans scored a historic election victory, not only taking control of the Senate but likely winning the most House seats since 1928 — the year before Ernest Hemingway published A Farewell to Arms.
Second, the Supreme Court took up another case on Obamacare, and if the justices rule against the administration, it would force a re-opening of the law.
This doesn’t even account for the recently released videos of one of Obamacare’s main architects, MIT economist Jonathan Gruber, conceding that Democrats misled the public to get the legislation passed, benefiting from “the stupidity of the American voter.”
The prospects of repealing Obamacare can now be better described, in the words of Rocco Lampone in The Godfather Part II, as “difficult, not impossible.”
But the hope of repealing Obamacare, however remote, is all the more reason for Republicans to begin coalescing around a real alternative to the law.
Due to their suspicions of Republicans, whenever anybody utters the phrases “Obamacare alternative” or “repeal and replace,” many conservatives tend to hear “Obamacare lite.”
However, not every alternative to Obamacare needs to be a watered-down version of the healthcare law. And in fact, it’s always worth keeping in mind that even before Obamacare, the United States did not have a free market healthcare system.
Returning to the pre-Obamacare status quo would still leave Americans with a system in which government is the dominant actor and rules and regulations stifle choices.
While that’s the policy and ideological argument for coalescing around an alternative, there is also the political rationale.
As a reminder, the case before the Supreme Court hinges on whether the section of the law that references health insurance subsidies flowing to “an exchange established by the state” means that subsidies cannot legally be given to residents of the 36 states that did not set up their own exchanges.
If the justices declare the federal exchange subsidies illegal, millions of Americans who were relying on the assistance to enable them to purchase insurance would have to cover the full cost of their premiums on their own, likely making coverage too costly for those with lower incomes. This is exacerbated because Obamacare regulations that have driven up the sticker price of insurance would still be on the books.
At the same time, it would mean that the requirement that employers provide insurance or pay a fine would be unenforceable in the states relying on the federal exchange. The reason is that the mandate is only triggered when a worker who is not offered coverage the Obama administration deems acceptable obtains subsidies to purchase insurance on an exchange.
The individual mandate would also be undermined, because it would no longer apply to those who can no longer afford the coverage (“affordable” is defined as costing less than 8 percent of taxable income).
Given these realities, Townhall’s Guy Benson took to Twitter to question whether Republicans would be forced to pass a “fix” to the problem, coupled with other changes that they may want (such as repealing the medical device tax or the individual mandate).
Benson’s fear is that if the Supreme Court rules against the Obama administration, whatever the merits of the decision, liberal media would portray it as a right-wing court ripping health insurance away from millions over a silly typo out of animosity for the poor. And if Republicans didn’t pass a simple fix to change the wording, they’d be accused of mass murder.
The problem for Republicans — which I tried to convey to Benson in a spirited exchange that followed — is that going along with such a “fix” would be rightly seen as a complete surrender by Republicans that would alienate conservatives and enshrine Obamacare forever.
Passing a “fix” would require Republicans to pass legislation that would boost spending by hundreds of billions of dollars — the cost of the subsidies — without any offsetting spending cuts. Republicans would be cleaning up a mess created by the terrible drafting decisions made by Democrats who authored the law and the illegal move by the administration to deliver benefits to people who were not entitled to them under the law as written.
That is why conservatives should push Republicans to have an alternative plan ready to pass should the Supreme Court strike down the federal subsidies — a decision that should come by late June.
If Republicans do not have an alternative to present when confronted by the political backlash, they will most assuredly buckle. Putting Republican leaders on record supporting one of the key aspects of Obamacare would almost certainly extinguish any glimmer of hope for repeal.