Opinion

President Trump is right about ObamaCare

Congressional Republicans would be smart to listen to him

Republican officials, particularly in Congress, still have no idea how to deal with President Donald Trump. He has a tendency to say one thing, and then the opposite thing, and then to make things up entirely. He is erratic. But over the course of his strange rise through politics, there have been a number of themes or ideas on which his views are consistent, and he has formidable political instincts.

This brings me to the strange and sad story of Republicans' efforts to repeal (and replace?) ObamaCare. Right now, the plan endorsed by Senate Majority Leader Mitch McConnell, which is the default plan for Republicans, is to use a process known as budget reconciliation, which allows the Senate to vote on budgetary items with a simple majority vote, to quickly repeal ObamaCare, and then pass a replacement plan later through reconciliation.

Meanwhile, congressional Republicans still haven't come around to a specific plan, or even the outline of one, to replace ObamaCare. There are actually plenty of good replacement ideas out there, from groups such as the Conservative Reform Network and the Foundation for Research on Equal Opportunity. But as of yet, congressional Republicans aren't on board with any of them. On the one hand, it's still early in the legislative process and it's normal for a lot of things to be up in the air at this point. On the other, it is embarrassing that after eight years of saying they're going to "replace" ObamaCare, Republicans still aren't clear on how.

Where is Trump in all this? Congressional Republicans have essentially been ignoring him. This is a mistake, because he actually has some good points. Indeed, when it comes to ObamaCare, Trump seems to have a preternatural talent for sensing the mood of the country.

Trump doesn't want any of this repeal-now-maybe-get-around-to-replacing-sometime nonsense. And he's right. On the policy merits, it should be noted that the Republican plan involves the "repeal" part only kicking in once the "replace" part has been voted on later. It's not like Republicans are planning on actually erasing ObamaCare and then doing nothing about it. Still, this is a very perilous situation. Even if on paper ObamaCare is still in force, there's a strong chance that knowing a repeal is in the cards will cause insurers to flee the ObamaCare exchanges even faster — and this time Republicans, not Democrats, will get blamed for the law's further unraveling. What's more, there's no telling what the political situation will be like a year or two from now when it's time to write the replacement bill. The more Republicans "own" the quickly-unraveling ObamaCare, the harder it will be to do anything about it.

This is typical Washington nonsense, and Trump is right to call it out. Republicans are engaging in bad policy — and terrible politics.

Trump has also insisted that a replacement plan must cover at least as many people as ObamaCare. He's absolutely right about this. A big complaint Republicans have about ObamaCare is that plenty of people got plans that they liked yanked from them before being forced on the exchanges to buy plans that were both inferior and more expensive. Republicans cannot turn around and then yank plans from those same people. Especially people with pre-existing conditions.

But there's a more fundamental point here, which is that, as 2016 proved beyond any reasonable doubt, the majority of Americans are not purebred ideological conservatives. For an ObamaCare replacement plan to be politically popular, it has to not just be better in the ways that us free-marketers want, it has to also feel better to most Americans. That means not being denied coverage for pre-existing conditions. That means enabling them to get coverage in a broad network (if "networks" are still going to be a thing), and so on. In other words, the ObamaCare replacement plan needs to actually cover Americans with good health insurance.

It's time to stop being schooled on politics by Trump. Republicans need to just get it done.

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