REPUBLICANS APPEAR TO BE preparing another run at repealing and replacing the Affordable Care Act. The New York Times reported Tuesday that a new version of the wildly unpopular American Health Care Act may be in the works. The initial bill was pulled last month after it lost support on both the right and left ends of the Republican caucus. The last poll before the Republican bill went off life support showed just 17 percent of voters supported the proposal. If the new bill is anything like what the Times report suggests, it may be just as much of a political loser.
That’s because Republicans love Obamacare.
They like being able to keep young people on their parents’ insurance (82 percent), prohibiting denials due to pre-existing conditions (63 percent), the health care exchanges (72 percent), and even the Medicaid expansion (67 percent). In fact, a November poll from the Kaiser Family Foundation foreshadowed the deeply problematic politics of repeal, finding over 60 percent support among Republicans for all but two of Obamacare’s key provisions. Only the individual mandate and employer fines fail to earn majority support across party lines.
The compromise, according to the Times UpShot report, “would effectively cast the Affordable Care Act’s pre-existing conditions provision aside.” House Speaker Paul Ryan acknowledged Tuesday that discussions about a new bill are ongoing, but seemed to distance himself from reports of policy details, saying the talks were at “a conceptual stage.” But if pre-existing condition protections are on the bargaining table, it could trigger a new round of objections from GOP moderates nervously eyeing reelection.
While the House Freedom Caucus, a group of couple dozen of the most conservative Republican members, drew the most attention for their role in killing the first version of the GOP health care bill, moderate Republicans objected to the proposal for other reasons. A new bill that would strip another popular provision of Obamacare pushes the bill closer to the pure repeal that the Freedom Caucus wants, but could sacrifice support at the other end of the party’s political spectrum. Among all voters, 69 percent approve of the pre-existing conditions provision, including 65 percent of the independents whose votes moderate Republicans will soon be courting.
Even if a new version more to the liking of the Freedom Caucus could pass the House, the Senate presents another key hurdle. Key Senate Republicans called the House’s first attempt at a bill dead on arrival. Pushing the replacement bill even further to the right and killing off still more popular provisions of the original law seems unlikely to improve the prospects of a deal.
The whole idea of repeal and replace is less popular than it once was. After years of talking about the concept, Republicans took office right as support for the package of the Affordable Care Act slowly groaned upward into positive territory. The latest average shows 49 percent support the law, while 42 percent oppose it. And this is before diving into the specifics, which the Kaiser poll and others have found to be popular.
All this makes it hard to see a political upside to this new proposal. It’s not even clear that a Freedom Caucus-approved bill could win enough moderate GOP support to pass the House.
It’s not as if their voters are egging them on. The Kaiser poll found only 7 percent of Trump voters listed health care as their most important policy priority in November, and it remains a second tier priority today. Far more were motivated by the economy (19 percent) and the general direction of the country (38 percent).
The timing is also difficult for Republicans. Lawmakers are about to go on recess until April 25. Bringing health care back from the dead increases the chances that they’ll hear more about it from angry constituents while back in their districts. Angry town hall videos are easy fodder for cable news talking heads looking for tea leaves to read. As House Republicans debate taking away popular benefits, they shouldn’t be surprised if the angry voters include their own supporters.