GOP's health care waiting game: Republicans (once again) say their Obamacare replacement is on the way

After years of broken promises, Paul Ryan and the GOP insist they're a "month or so" away from a health care "plan"

Published April 18, 2016 4:48PM (EDT)

Paul Ryan   (Reuters/Gary Cameron)
Paul Ryan (Reuters/Gary Cameron)

Let’s travel back in time to January 2014, to a news conference John Boehner held where the then-speaker of the house discussed the House GOP’s agenda for the coming year.

“I think you’ll see Republicans come forward with a plan to replace Obamacare,” Boehner said. “A plan that will actually reduce costs for the American people and make health insurance more accessible.” That same month, Eric Cantor, then the House majority leader, pledged that “we will rally around an alternative to Obamacare and pass it on the floor of the House.” Well, time passed, Cantor got booted from his seat in Congress, and the promised Obamacare replacement never materialized.

Let’s now jump ahead to January 2015. The Republicans had just won a Senate majority and had big plans for the coming session of Congress, and John Boehner once again promised that House Republicans would crank out an Obamacare replacement bill. “There will be an alternative,” Boehner pledged on Fox News, “and you’re going to get to see it.” Well, time passed, the Affordable Care Act survived a Supreme Court challenge, Boehner booted himself from his seat in Congress, and the promised Obamacare replacement once again failed to materialize.

That brings us to the present, and to new Speaker Paul Ryan’s role as the new promiser of Obamacare alternatives. In December, Ryan declared that the need for such a replacement (after six years of nothing but broken pledges) was “urgent,” and he said that this time – THIS TIME – the House GOP’s health care plan was really in the works. “Next year, we are going to unveil a plan to replace every word of Obamacare,” Ryan said. To that end, he tasked four committee chairs with devising “a patient-centered system that gives patients more choice and control, increases quality, and reduces costs.”

This week, one of those chairmen, Fred Upton, head of the Energy and Commerce Committee, announced that the task force as successfully developed a plan to have a plan – they just need a bit more time. From The Hill:

"Give us a little time, another month or so," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) told reporters this week. "I think we’ll be pretty close to a Republican alternative."

Upton is one member of a four-person task force that is supposed to come up with a replacement plan for the healthcare law, at the behest of Speaker Paul Ryan (R-Wis.). For now, the group is still in "listening mode," Upton said. When asked who they are listening to, Upton said: "You name it – the world."

The GOP has had several years to mull over these questions, and Upton’s task force has had several months to work, and right now the best they can say is that they’re still listening to “the world” to get some ideas about health care reform. But after another month of intent listening, they’ll be “pretty close” to a healthcare plan. What does “pretty close” mean? Who knows! But according to Ryan’s office, it means that whatever they come up with will stop well short of being actual legislation:

Even now, the health care reform task force is not expected to produce an actual bill to replace the law, Ryan’s office said Friday.

“[Legislative] text is not necessary to show exactly what you’re going to do,” spokeswoman AshLee Strong said. “The point is not to have a vote on the floor and have it go nowhere.”

That’s an ironic statement given that the point of pretty much all Republican health care policy since 2011 has been to have a vote on the floor and have it go nowhere.

As for what this “plan” will look like, it seems safe to assume that we’re in for a repeat of what we saw in the run-up to the King v. Burwell decision in 2015. Republicans – Paul Ryan in particular – were insistent that the party should have an Obamacare replacement plan ready if the Supreme Court voted to gut the law’s insurance subsidies, but the party was massively divided on what the best approach should be. As such, the “plans” that were offered (usually in the form of an op-ed) were impossibly vague and amounted to little more than rote repetition of long-since stale talking points. Eventually Republican leaders began arguing that it wouldn’t be appropriate to release a replacement plan before the court voted. After the Court upheld the law, and the entire discussion was dropped.

Perhaps they’ve made significant progress since then and this forthcoming “plan” will finally reveal once and for all what the Republicans in Congress have in mind for health care reform. But the fact that the working group members are still in “listening mode” and the Speaker’s office is downplaying expectations suggest that the old divisions and obstacles are still in place, and the GOP’s health care product will, once again, not live up to its promise.

By Simon Maloy

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Related Topics ------------------------------------------

Affordable Care Act Fred Upton Healthcare Reform House Gop John Boehner Obamacare Paul Ryan Republicans