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Friday, March 24, 2017

Affordable Care Act (ACA) Repeal and Replace

As I write this, the news of the U.S. House of Representatives not voting on a replacement for the ACA is still fresh.  If anything, this is an important moment for several reasons:

1.  Theatrics.  How many times did the U.S. House vote to repeal the ACA during the Obama administration?  One thing is now remarkably clear now:  Those votes were theatrics, and the GOP knew it.  They were counting of losing, mostly because they knew then, and have been reminded now, that actually replacing the ACA is about governing, not politics.  Which brings me to the following...

2.  Governing.  The GOP can be masterful as an opposition party.  Seriously, they have that locked down.  Governing?  That is, as Ben Hoon observed, "Hard".  They are not prepared.

3.  There is no GOP.  There are GOPs.  There is no single Republican Party.  It's pretty clear now that the party is fractured along ideological lines, as Trump lost the votes of moderates in order to appease ultra-conservatives.

4.  It's Not Reality TV.  The debate about healthcare in this country isn't some slick commercial that runs 60 seconds or slogan that's repeated over and over again at a Trump rally.  No, it's deeply personal for many Americans.  It's about what happens when your grandmother gets sick.  Or when poor women need care.  Or when the middle class have to declare bankruptcy because of catastrophic medical bills.  The lobbyists and the inside the beltway spin doctors can grease all the palms they want, but in the end, healthcare is a common denominator in this country and it can't be "fixed" by a group of congressmen in two months.  Which brings me to the following...

5.  No, They Had Replacement.  There never a serious replacement alternative before Trump's election.  None.  Zero.  Zilch.  They made it up over the course of two months.

6.  This Isn't the Democrats Loss.  Trump is already blaming the failure of passing an ACA replacement at the feet of the Democrats.  That is, to be blunt, horse$hit.  The House could have passed the ACA replacement with just GOP votes.  They simply didn't.

This is a multi-dimensional failure that will have repercussions for a long time to come.  The ACA is deeply flawed, needlessly complex, and divisive.  It needs to be replaced.  The fact that the GOP couldn't execute when given such an opportunity speaks volumes about how ideology can get in the way of substance.

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