The Republican effort to repeal and replace ObamaCare is plagiarism.
Remember those kids in high school who would always ask to copy your homework? I was not exactly a distinguished student before I dropped out, but I did get As in all the classes I wasn't failing. My response to these requests was invariably the same: "Sure, but just be sure to change a few things so that Mr. Young doesn't notice." That's what the GOP effort to repeal and replace ObamaCare has become. At some unspoken level, Republicans realize that the Affordable Care Act is an A paper. Now they just have to find some wrong answers to add.
I like to think of our esteemed bicameral legislature as a typical American high school. It has its nerds (Paul Ryan), its jocks (surely you can imagine Chuck Schumer snapping somebody's waistband), its insufferably earnest class presidents (Ben Sasse), its shorts-wearing stoner bros (Rand "Aqua Buddha" Paul), its class clowns (does anyone doubt that Louis Gohmert is an expert in fart noises?), that weird girl who wears wolf sweaters and has horses and always kills it doing Shania Twain karaoke at the annual talent show (Claire McCaskill).
A lot of worksheet copying takes place in Washington. Republicans want to find a more or less workable middle ground between single-payer health care and the absolute free market for medical services that we are never going back to — even Ted Cruz only wants to raise funds off the insinuation that we could eliminate the welfare state altogether. Unfortunately, the Affordable Care Act did exactly that, which is why after seven years Republicans have been unable to come up with anything substantially different. Paul Krugman is right when he says that the GOP's response when asked what they want to accomplish with the American Health Care Act have basically amounted to "‘Er. Ah. Um.'" But that's not because their last-minute secret revisions to their replacement package represent some sinister plot. They are clumsy, random, and painfully desperate.
The Republicans are stupid, not deliberately cruel. Embracing single payer, the obvious and straightforward solution that long ago presented itself to our hockey-loving, beer-chugging, hunting and fishing neighbors to the north, is unacceptable to their fire-breathing geriatric constituents, who simultaneously loathe government and don't want to see anything happen to Medicare. In front of them is a plan devised by the Heritage Foundation in the '90s that is messy but not ipso facto unacceptable. The only problem is that it was passed by a guy with a D behind his name.
Time to get out the eraser. Going line by line through what we know of the AHCA reminds me of the occasional glances I would get at what became of my impeccably phrased responses to such questions as "What was the significance of the Montgomery Bus Boycott?" and requests to "Name five policies associated with post-bellum Radical Republicans."
"Should we have an individual mandate enforced by a tax penalty in order to prevent free-riders and maintain the size and scope of risk pools?" Yes — err, no, we should let insurers charge a fee when people let coverage lapse.
"Should the federal government give the states money to fund the expansion of Medicaid, which has done far more to ensure that people don't fall through the cracks than the messy system of exchanges ever will?" Well, hmm, yes, but, well, no — what's a phrase we've heard before? "Block grants." Yes, those.
"What about a tax credit based on income?" Ugh, let's scrap it and replace it with one based on — what's a thing? Age? Yeah, age. That'll look like we're trying.
"Is the so-called Cadillac tax on actually good employer-provided insurance bad?" Yes, at least it is through 2025: We just won't collect the revenues. Oh, and let's be sure to get a few things deliberately wrong: health savings accounts, so far from being useless for poor people, are, uhhh, good and useful. Okay, time to hand in the paper.
The AHCA is not an actual health-care plan. It is a lazy student's cop-out, a truth so blinkeringly obvious that no amount of sloppy pencil work will conceal it. It certainly would not have fooled Mr. Young, a very indulgent and obliging man. This is not true of the party's libertarian right wing, which loathes the new bill as much as the rest of us do.
ObamaCare will never be truly replaced because it is already the replacement Republicans want — they just can't admit it without getting an F.