Forced and Unforced Errors

Published May 12, 2017 9:30am ET



The Republican party’s dream of an Obamacare replacement might yet become reality. But the House-passed American Health Care Act is a nightmare: a labyrinth of policy trade-offs and academic ideas the public has resisted entering. It’s currently polling in the 30s—a relative achievement, given that an earlier survey showed 17 percent support for the original legislation. Why all the low regard? Bedeviling the details. As the Washington Post’s Dave Weigel observed during a town hall for constituents of Rep. Tom MacArthur, who authored a key AHCA amendment that led to the bill’s passage, “Hearing MacArthur describe all this really hits home how difficult it is to beat something simple (single payer) with a pile of wonkiness.”

The GOP itself is much to blame. It rushed a complicated plan to a vote even though disunity abounded in its conference. Vice President Mike Pence said in January the majority’s goal was to replace the health care law in an “orderly” manner. That necessitates members falling in line, not out of it, as unsatisfied conservatives and uneasy moderates did before House speaker Paul Ryan pulled the legislation two months ago. But those same individuals have been fighting misperceptions about the bill. A prime example accompanied the release of a Congressional Budget Office estimate in mid-March. The CBO projected there would be 28 million uninsured Americans in 2026 under Obamacare, compared with 52 million if the AHCA were enacted. The higher estimate was largely based on people opting not to purchase coverage and a medium-term reduction in Medicaid spending. But Democratic lawmakers and commentators warped these forecasts to mean 24 million would people “lose” insurance thanks to Republican legislation. A credulous media adopted the talking point. By late-March, Americans opposed the bill 3-to-1.

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