Repeal, Replace, or Repeal and Replace Obamacare. Which Is It?

I will admit that I was frustrated when Sens. Rand Paul (R-KY), Ted Cruz (R-TX), Ron Johnson (R-WI), and Mike Lee (R-UT) released a joint statement opposing the Senate’s Obamacare replacement bill.

Understand, though, that my frustration was not exclusively reserved for the four GOP senators. Rather, I was finding it difficult to conflate President Trump’s public support for the bill with the senators’ opposition to it.

The President came out strongly in support of the Senate’s bill on Thursday.

Notice that the President uses “very” in his tweet to describe his support for the bill. Very is an intensifier. Intensifiers — also known as qualifiers — can add meaning to adverbs or adjectives. It wasn’t enough to be supportive of the Senate’s healthcare proposal. Instead, the President made it clear that he is “very supportive” of the bill.

Why is that important? Well, it’s important because the President is throwing his full support behind a bill that notable Republican senators are staunchly opposed to in its current form.

Here’s where I think the hang up is.

There are two purveying theories, known as “Repeal Theory” and “Replace Theory,” of what post-Obamacare legislation should look like. Both theories are self-explanatory.

“Repeal Theory” states that you entirely repeal Obamacare. This is what then-candidate Trump called for on the campaign trail numerous times. As a point of reference, consider this tweet that the President sent on Feb. 19 of last year:

On the other hand, “Replace Theory” argues that you replace Obamacare with an alternative insurance marketplace. Trump also advocated for this proposal in a second tweet posted one minute after he tweeted about repealing the ACA:

It seems the President is attempting to marry the two theories. This can certainly be accomplished; however, the details are critical. Not to mention, expecting legislators to compromise on something as significant as healthcare is a tall order in itself.

For starters, there are some Republicans who are simply overly fond of the word “repeal” and are finding it difficult to reconcile that with the “replace” language they hear coming from the White House and others on Capitol Hill.

Notice what Sen. Rand Paul (R-KY) said in his statement on the Senate’s healthcare bill yesterday:

The current bill does not repeal Obamacare. It does not keep our promises to the American people. I will oppose it coming to the floor in its current form, but I remain open to negotiations.”

That is the entirety of his statement. Short and to the point.

Here’s the problem: Sen. Paul is looking at the current bill through the singular prism of “repeal,” which is totally acceptable if you adhere to the Repeal Theory, but difficult to gather traction if you have a two-seat majority in the Senate and are forced to compromise with other senators who feel as passionately about the Replace Theory.

Now pay attention to the wording of Sen. Cruz’s statement:

“I want to get to yes, but this first draft doesn’t get the job done. Over the next week and beyond, I will continue working to bring Republicans together to honor our promise, repeal Obamacare, and adopt common-sense, consensus reforms that can actually be passed into law.”

Again, perfectly acceptable language if you adhere to the Repeal Theory. But the same issue exists here: there are too many Republican senators who don’t want to entirely repeal Obamacare.

I’m not going to tell you which theory has better arguments, or which theory poses a greater risk to the uninsured — that is for you to decide. What I can tell you is that tax reform, tax cuts and infrastructure spending will remain on the backburner until the healthcare dilemma is solved.

To solve for this roadblock in Congress, President Trump is trying to convince members of his own party to adopt a third theory — the “Repeal and Replace Theory.” Also, pretty self-explanatory.

Trump’s favored approach would eliminate the Obamacare mandate, lower health insurance premiums and establish a new marketplace to replace the exploding Obamacare exchanges. But it would also leave in place a few elements of the Affordable Care Act to ensure millions of Americans are not instantly thrown off their health insurance plans.

Here’s why this theory is a winner: passing a healthcare bill is only the first part of making it a successful piece of legislation; selling the law comes next. President Trump understands the importance of persuading Americans on the merits of a law. Likewise, President Obama understood that he never would have been able to pass Obamacare without promising voters that they could keep their doctors and their plans.

Whether it’s repealing, replacing, or repealing and replacing Obamacare, the American people have placed their trust in Republican members of Congress to remedy the current healthcare disaster plaguing the country. As a result, failure to pass a law that repairs America’s broken healthcare system will absolutely end up costing the GOP in the 2018 midterm elections — and perhaps well beyond.

CNN created an infographic that compares some of the principal components of Obamacare, the House healthcare bill and the Senate proposal. This is a helpful way to examine how all three stack up against each other.

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