Bernie Sanders didn't win the 2016 presidential race. He didn't even win the Democratic presidential nomination. Yet the United States may have just taken a bigger step toward the left-wing dream of single-payer health care than if the Vermont socialist had indeed become America's 45th president.
And who can Democrats and progressives thank for this surprise gift? House Republicans.
After years of Republicans criticizing ObamaCare and calling for its repeal and replacement, Americans finally found out what's in GOPCare: something for just about everyone to hate and precious little to love. As many Democrats predicted, the Republican replacement bill, also known as the American Health Care Act, seems likely to destabilize the individual insurance market and lead to less insurance coverage for the older, sicker, and poorer. So yeah, progressives really hate it.
But many folks on the right are equally disdainful, calling the plan ObamaCare Lite. This is not a compliment. Oh sure, the GOP's plan has fewer regulations. And less federal spending. But basically it's the same-old, same-old big government thinking. Conservative activist Michael Needham of Heritage Action said the proposal "not only accepts the flawed progressive premises of ObamaCare but expands upon them." The Club for Growth labeled the plan "RyanCare," before slamming it as a "warmed-over substitute for government-run health care." In other words, the AHCA is already in dire political straits. And conservative health-policy wonk Philip Klein of the Washington Examiner delivered the rhetorical coup de grâce: "In releasing their health-care plan on Monday, House Republican leaders sent a signal loud and clear: Liberalism has already won."
A smart, comprehensive, center-right plan would have tried to significantly expand the role of markets and consumer choice in the American health-care system. Many conservatives, for instance, wanted a plan that would give Americans more control over their health-care spending and allow them to take their plan from job to job. But the AHCA won't offer its new tax credits for those currently offered workplace insurance. Nor does it put U.S. health care on such a path.
Others on the right envisioned a dramatically deregulated ObamaCare that eventually would have swallowed up Medicare and Medicaid. Yet the House GOP plan mostly keeps the "essential health benefits" regulations of ObamaCare that dictate what benefit plans purchased on the exchanges must offer.
Nearly seven years after President Obama signed the Patient Protection and Affordable Care Act, House Republicans have failed in their big attempt to offer FreeMarketCare. And this may well have been their final chance to do so. Health care isn't the only item on the GOP agenda, after all. Congressional Republicans are also desperate to cut business taxes, while the Trump White House keeps promising a major infrastructure plan. And don't forget Ivanka Trump's pricey paid leave and child care ideas.
Meanwhile, the ACA remains desperately in need of reform as too few of the young and healthy sign up. "ObamaCare is so poorly constructed it is literally an anti-selection machine," health-care analyst Bob Laszewski writes at his popular blog, adding,"The Republican proposal is worse."
Well, Sanders had an answer for that — he called his version "Medicare for All" — and it's an answer that many Democrats wanted all along. Indeed, one way Obama sold Democrats on health reform that kept for-profit, private insurance central was by suggesting it was merely a way station to single payer. That idea is probably looking better and better to Democrats right about now, especially as the party continues to drift left. And maybe to the Republican president, too.
Don't forget that Trump is a single-payer fan from way back. Plan beats no plan, and Republicans have so far been unable to cobble together an economically sound, politically acceptable ObamaCare alternative. The rollout of the AHCA inspires little confidence they ever will.
But the U.S. health-care system still needs fixing. There's a policy vacuum that Democrats will be eager to fill should they get the chance. And the GOP's failure to deliver on its top promise raises the odds that Democrats will get a chance.