In an interview broadcast on “60 Minutes” Sunday night, House Speaker Paul Ryan put on a brave, confident face. The very first bill that he and the House will take up come January, he said, will be legislation that repeals Obamacare.
In that same interview, Ryan promised that he and his fellow Republicans would not “pull the rug out from under” the many Americans who previously did not have health insurance but now do thanks to Obamacare. “We will give everyone access to affordable healthcare coverage,” he said, promising a plan to provide “better coverage at a better price.”
Yet that is not reality, and Ryan knows it is not reality.
Yes, we now have a Republican president-elect who campaigned on an explicit promise to repeal Obamacare. We have a GOP House and a GOP Senate, and every single Republican member of those chambers has publicly committed to repeal Obamacare. Theoretically speaking, nothing stands in the way of a full and immediate repeal of the program that Republicans have treated as a dire threat to all that is good and true in America.
Yet it’s not going to happen. Oh, there will be a repeal vote in January, but it will be nothing more than a show vote, exactly as productive and meaningful as the more than 50 previous repeal votes taken in the House since Obamacare was signed into law. The legislation that passes that day will be vague and without content; it won’t even get consideration in the Republican Senate. In the end, it will have all the impact of an empty piece of paper wadded up and tossed in a trash can.
Here’s another guarantee: The legislation to be voted on in January won’t contain a plan to replace Obamacare, because even after all these years, House Republicans can’t agree even among themselves on what such a replacement plan would look like. Theoretically, they want a conservative plan, a plan that costs nothing and that “gets the federal government out of health care.” But as Ryan’s comments make clear, and as Republican senators have made even more clear, they also know that going backward is not politically plausible.
They know that today, an additional 20 million Americans now have health insurance thanks to Obamacare. The percentage of Americans without coverage has dropped to an all-time low of roughly 9 percent, which is half the rate of uninsured in 2010. And they know that there is no conservative alternative that is both capable of passing a GOP Congress and that will maintain affordable coverage for all of those 20 million.
Or most of those 20 million. Or a majority of those 20 million. Or even a significant minority of those 20 million. And that’s a problem.
The Kaiser Family Foundation has conducted a tracking poll on health-care issues since 2010. In its November poll, taken a week after the election, it found that the percentage of American voters wanting a full repeal of Obamacare had fallen to 26 percent, down from 32 percent in October. If 2o million Americans lose coverage as a result, support for repeal falls to just 20 percent.
And while 52 percent of Republican voters now say they want a full repeal, that represents quite a sharp drop from October, when 69 percent demanded full repeal. All of a sudden, when this becomes real rather than theoretical, when it’s not just a partisan rallying cry, the consequences become real as well. Ryan needs a GOP replacement that can pass the House and pass the Senate and prevent tens of millions of Americans from losing their insurance, and that is an impossibility squared.