On the Repeal of Health Care Reform

Today, the House of Representatives will be voting on the “Repeal the Job Killing Health Care Law Act.” This bill, written by House Majority Leader Eric Cantor, would repeal the Patient Protection and Affordable Care Act that was passed by the last Congress, and, despite some requests that, in the wake of the Tuscon shootings that severely injured Congresswoman Gabrielle Giffords and killed six others, the bill be renamed to take the word “killing” out of its name, Cantor has chosen to keep the name, even though the bill does not, in fact, “kill jobs.”

The vote on the bill is seen as a symbolic act; Alex Wagner of Politics Daily writes that “It stands little chance of coming before the Senate for a vote — where a Democratic majority is firmly in place — and it faces the threat of a presidential veto should it actually pass both houses,” and her analysis matches that of NPR, ABC, MSNBC, and many other outlets. The bill, as the news presenters and pundits tell us, will die in the Senate.

Republicans ran in the summer and autumn on a platform of “Repeal and Replace,” thanks to the Tea Party movement, which was so energized by the health care debate in late 2009 and early 2010. Today marks a step along the road to the Republicans’ “Repeal,” but as for “Replace,” the Republicans have nothing on the horizon. Indeed, the Republicans have no plan, consensus or otherwise, for what “replace” even means.

The Republican Party has chosen to repeal a bill that, fifteen years ago, even five years ago, its rank-and-file would have supported. The Patient Protection Act is similar to the bill that Bob Dole and John Chafee offered as an alternative to Bill Clinton’s plan in 1993, it’s similar to the bill passed in Massachusetts by Mitt Romney. Indeed, the idea in the bill that most offends Republicans — the individual mandate — is a Republican idea, originally formulated by the very conservative Heritage Foundation. To oppose the Patient Protection Act, the Republican Party has had to essentially oppose its own positions — and suggest that health care, and the access to it, is a privilege, not a right.

The Patient Protection Act isn’t perfect by any means. It’s too supportive of the for-profit health care industry, and it doesn’t do enough to restrain runaway costs and to bend the cost curve. It is a start, though, but that doesn’t mean that it’s finished. And treating the House vote today as a symbolic act that will simply languish in the Senate strikes me as the wrong move.

President Obama should take the opportunity to revisit the health care debate. Senator Charles Schumer said earlier this week that the House vote gives health care reform a second chance to make a first impression. And, because the Republicans campaigned — and won — the House on a mantra of “Repeal and Replace,” the ball is in their court. If they want to repeal the Patient Protection Act, let’s see what they want to replace it with.

And President Obama should make that very public and very clear.

The Patient Protection Act, as a whole, is not popular. But its individual provisions, such as no lifetime caps on benefits, no denial of coverage due to pre-existing conditions, really everything except the individual mandate, are popular with and supported by the American public.

President Obama should say something along these lines:

“I want to congratulate Speaker John Boehner and House Majority Leader Eric Cantor on the passage of a bill that will repeal the Patient Protection Act. I have spoken with Senator Reid about the need for the Senate to take up this bill when, and only when, the House of Representatives passes a bill that will replace the Patient Protection Act with a bill that achieves the same goals as Patient Protection Act — universal, affordable health care for every American. When the House of Representatives passes a bill that guarantees that by 2014 no American will go without health coverage, that no American can be denied health coverage due to pre-existing conditions, that the “donut hole” in Medicare will not bankrupt our seniors, and that all Americans can afford health coverage through subsidies and/or tax breaks, I look forward to working with the Senate to pass both the bill that repeals the Patient Protection Act and the bill that replaces it.”

Put the ball in the Republicans’ court, Mr. President.

If the Republicans truly have no ideas on health care reform nor any inclination to take up the issue, that will be made abundantly clear as they flail and wail.

If, however, they truly want to replace the Patient Protection Act, as they claimed in their campaign rhetoric, make them live up to that rhetoric. Give them a mark to reach and challenge them to reach it. The Patient Protection Act’s goals set the standard; can their “replace” bill reach those goals?

Also, if President Obama states that he will sign into law the repeal act, he boxes the Republican Party in between their Tea Party base and the health care lobby, especially the insurance companies. While the insurance companies, who cut the big corporate donor checks, like the Patient Protection Act because it compels millions of Americans to purchase health insurance from them, the Tea Party movement is opposed to the Patient Protection Act for precisely the same reason. Trapped between their donors and their foot soldiers, the Republicans would find themselves in a Faustian bind if the repeal bill had any chance of becoming law.

Letting the House have its symbolic vote to appease the Tea Party movement and then letting the bill languish and die is a waste of political optics and opportunity. Use the optics to paint a true difference between the two parties, and use the opportunity to demonstrate to the American people that health care reform is in the long-term interests of the country.

And, while I don’t expect it to happen, a “replace” bill could turn out to be better for the country than the Patient Protection Act. We could get the public option or the Medicare buy-in out of it.

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