A Replacement for Obamacare will look a lot like Obamacare


Frankly, Republicans need to just let it go. There’s no getting out of this “Repeal and Replace” conundrum they are in over health care. They might be able to pull off “Repeal,” if not in fact then at least in policy by sabotaging the exchanges and funding. The political consequences of this will be dire as millions of people will then learn just how important the Affordable Care Act is to them and will almost certainly retaliate during the elections. But at least Republicans could then turn and say to whoever is left among their supporters that they fulfilled their promise to get rid of the mindlessly hated Obamacare.

But no. Republicans under The Orange Don (TOD), had to add the “Replace” component, with their leader in the White House complicating matters by promising better and cheaper health care that covers everyone. They’ve raised expectations in a way that a corporate conservative party can never achieve. Disappointment is the only possible political outcome.

For Republicans, the problem is two-fold. First, generations of anti-socialist propaganda have instilled in most age cohorts (not the younger cohorts, I might mention) an irrational fear of anything that might be…you know…socialisticky. Everyone knows that market approaches are superior to socialized approaches. Government is not the solution. Government is the problem. Any evidence to the contrary is nothing more than elite liberal propaganda trying to cleverly nudge the nation into a soviet style dystopia–because that’s just how liberals role.

When it comes to health care, however, people may conceptually want a market-based solution, but they want it to work like socialized medicine. That’s a bit of a problem. A problem for which Obamacare is about as close as we can get to a solution. It’s the three-legged stool described by Paul Krugman. If you want everyone to be covered, you have to require insurance companies to cover everyone. If you are going to require insurance companies to provide coverage, you have to mandate that everyone purchase coverage. If you are going to mandate that everyone purchase coverage, you have to provide subsidies. There’s no other way around it.

Republican “Repeal and Replace” is loser politics. It’s one of those promises that a party makes when it thinks there’s no chance of being in a position to actually enact such a thing. But Trump won and Republicans control congress. There’s just no excuse for failing to “Repeal and Replace” as promised…unless, of course, they were full of shit from the beginning. Republicans are stuck with a loser option of just repealing, which would be catastrophic for their party, or replacing it with some variation of Obamacare, which would alienate their purist base. Kobiashi Maru, baby!

Best thing the Republican Party can do is just forget it. Come up with some bipartisan fixes for some of the ACA’s shortcomings and control for damage among the right wing. But the ideologues will not let the party let it go. This is some serious red meat driving Dr. Moreau’s Monsters.


  1. Obama care was always a failure. Obamacare failed because the penalties for going uncovered are too low when stacked against its skyrocketing premium costs.The penalty for staying uninsured is $695 per adult, this being an “Affordable care act” $695 per adult is not something a family on the poverty line could afford. The unlucky people who have big health problems reap much better than the people who remain healthy and stay out of the doctor’s office. This is why whatever the government installs as “Affordable care act” it will still be better than Obama care.


    1. “Whatever the government installs as “affordable care act” it will still be better than Obamacare.” That’s demonstrably untrue. By your own analysis, if the penalty for not signing up is too low, then it will fail. Republicans have now produced two health care plans to replace the ACA. What do you like about these two plans that you think will make them an improvement over the ACA?


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