WASHINGTON – Now that Republicans finally have a chance to get rid of Obamacare, they are practically in a state of civil war over how to do it.
The situation appears dire: The stakes couldn’t be much greater, tensions are rising, and even the success of the Trump presidency may be at risk before it’s barely begun, given that the administration is backing an Obamacare replacement plan severely criticized by many prominent conservatives.
But conservative icon Rush Limbaugh counseled, “I would just be a little patient and confident.”
He concluded during his Wednesday radio show: “Time will tell on all this. But if you trust Trump, if that’s been your state of mind since the campaign, if you trust Trump, then it’s not time to abandon him. He doesn’t deserve being abandoned. He’s still, I think, wise to invest in.”
To outline Limbaugh’s thinking in more detail, it may be instructive to first show how the GOP got to this point.
After seven years of loudly promising to repeal and replace Obamacare if given the chance, now that they have the chance, Republicans are on the spot to deliver but seem to be almost hopelessly divided.
GOP lawmakers are fighting over whether to back a House bill, supported by the president, to repeal and replace Obamacare. They are also fighting over how to fix the bill, or whether to scrap it altogether, because it stands little chance of making it through the Senate in its current form.
Essentially, there are two camps in the GOP.
One camp does not want to repeal Obamacare without simultaneously replacing it. Led by House Speaker Paul Ryan, R-Wis., these Republicans are pushing the House bill called the American Health Care Act, or AHCA, which would replace the Affordable Care Act, also known as Obamacare. The White House supports the bill but has said it is open to changes in it.
The other camp favors repealing Obamacare immediately, then replacing it as best possible in the days to come. This is favored by many leading conservatives, including prominent House members such as Rep. Jim Jordan, R-Ohio. They do not support the House bill but want the GOP to keep the promise it made to voters to jettison Obamacare as quickly as possible.
The repeal camp
Sen. Rand Paul, R-Ky., who has emerged as one of the leading critics of the House bill, colorfully explained his reasoning in an commentary piece published Wednesday in Breitbart.
Paul wrote that he “would love to give the middle finger to the man that profits off of government bailouts and forces his or her monopoly brand of insurance schemes on an often worried and defenseless public.”
Ridiculing the House bill as “Obamacare Lite,” he scorched it for “keeping insurance subsidies, mandates, taxes and insurance company bailouts.”
Paul charged the bill would bail out insurance companies “when any of their customers become sick,” as well as force patients “to pay a penalty” if they can’t afford insurance.
“I am a career physician. I spent years training and learning to be a doctor. I did it for patients. I don’t give a flip about guaranteeing the profits of insurance companies. And as a senator, I shouldn’t, either,” wrote Paul.
He charged that the debate had become about getting people insurance instead of getting people health care. He said health insurance is not the same as health care, as evidenced by Obamacare recipients with $6,000 deductibles.
“I’m sick of the insurance companies putting me on hold and telling me to talk to their representative in a foreign country. Screw that.”
Obviously pulling no punches, Paul added, “I’m sick of the government telling me I have to buy their crappy product, and I’m sick of watching us go into more and more debt to do it.”
Instead, the senator wants “the consumer (aka patient) to be king. I want to empower the patient to get the health care they want at the price they want.”
Paul said allowing every American to join a co-op to buy health care would return the buying power to the patients.
“Instead of patients having to kiss the boots of insurance company executives, my plan would have insurance executives come on bended knee to the patient.”
He explained how the patient, “as part of a large buying group, would be able to negotiate lower prices and a policy where you can’t be dropped or ripped off if you become sick.”
“The patient would be able to purchase exactly the type of coverage that suited her needs, without government mandates telling her what she must buy.”
Paul wrote that, as a physician and as a patient, “I hate Obamacare. Obamacare jacked up insurance rates and created insurance monopolies.”
But the answer, he advised, “is not replacing the government mandate with an insurance mandate, which is exactly what Obamacare Lite does.”
Paul echoed the sentiment of many conservatives in concluding that if the House bill were to become law it would not be keeping Republicans’ promise to get rid of Obamacare.
The senator also warned President Trump, who had promised to drain the swamp in Washington, that “he is being taken for a ride through the swamp right now on ‘Obamacare Lite.’”
The repeal and replace camp
In a series of appearances on Fox News over the last few weeks, columnist Charles Krauthammer has explained the deep fears held by GOP leaders as to what would happen if Obamacare were to be repealed without being immediately replaced.
He ominously warned Republicans they must find a way to cover everyone who might lose their health care coverage “one way or the other, or you will have a PR and political catastrophe.”
And Republicans would end up watching an endless stream of suffering people on the evening news telling tales of woe about lost coverage.
“What the Republicans have to do,” Krauthammer advised, “is to make sure there are not a huge number of people who are hurt by the transition. That’s the reason they are daunted.”
“And the left has a genius for ratcheting up dependency and government largess and then daring Republicans when they come into power to undo it because it’s extremely unpopular.”
Krauthammer said the only choice was to spend whatever it takes to cover everyone who loses coverage, and forget about deficits for the short run, because “you can’t be counting your pennies now when there can be so many stories out there of people who are hurt and really hurting as a result of the reform.”
Krauthammer said it would also be catastrophic if Republicans did not repeal Obamacare because it would be the ultimate betrayal of Trump voters.
“So, it has to get done. The problem is, if you get it done, you own the entire system of American medicine. Obamacare is 2,000 pages. It’s not one reform. It’s 1,000 reforms whose interactions are complex, contradictory and unpredictable. And that’s what were stuck with now. And it’s collapsing.”
But, he said the GOP also had no choice but to replace Obamacare, even if it could not really be fully repealed because, “You cannot retract an entitlement once it’s been granted.”
He called that the “genius” of the left.
Krauthammer said he agreed with Sen. Paul that the GOP leadership’s replacement plan really is “Obamacare Lite.”
But that’s the best that can be done, he argued, and he said Republicans should settle for the best deal they can get through Congress.
Krauthammer warned conservatives they “are gonna have to fall on their swords” and settle for less, because if they did fully repeal Obamacare, “I think it would destroy the presidency.”
He basically said conservatives must surrender because, “They’re going to have to concede the fact that Obama created an entitlement. And they’re now gonna transmute it into something different.”
A third way?
Limbaugh had a different take, and he didn’t really see the choices as necessarily limited to the two options above.
He speculated, “What if Trump has a long-term plan, and what if it is to let these nimrods in the House and Senate have their turn at it and then announce they can’t do anything?”
And then, he continued, “Trump refuses to accept failure and comes in with his own salvation or his own plan, after Congress has thrown up its hands in frustration and defeat and said we can’t do it.”
Limbaugh speculated the strategy might be to make sure the bill passes in the House, but to “load it up with so much the Democrats object to it and send it to the Senate, where they kill it. And that way, the Democrats get blamed for it, not the Republicans.”
Limbaugh suspects Trump may have a hidden card up his sleeve largely because the talk-radio kingpin just can’t buy the line of thinking reflected in Paul’s assertion (above) that the president “is being taken for a ride through the swamp right now on ‘Obamacare Lite.’”
The radio host noted the senator wasn’t alone, and that there are all kinds of supporters of the president “who are writing op-eds warning Trump how the Republicans are tricking him.”
Limbaugh scoffed at the thought.
“As though Trump can’t figure it out, as though (presidential adviser Steve) Bannon can’t figure out what’s happening, as though (presidential adviser) Kellyanne Conway is … All these people say, ‘Donald! President Trump! Be careful! They’re tricking you! Ryan’s screwing you! Ryan’s … (stammering) President Trump, wake up,’ as though Trump doesn’t know what’s going on.”
Limbaugh argued, “And to believe that you have to believe that all of a sudden Trump has gone stupid, and yet people are willing to accept that that’s possible.”
“I can’t just that easily accept,” he asserted, “that Donald Trump, who ran rings around all these people for a year-and-a-half and got elected, has all of a sudden becoming the biggest neophyte in town. I’m just having trouble accepting that.”
Limbaugh stated: “My only point is my confidence in Trump is not shaken. My view is that Trump is triumphing time after time after time, like last night on this tax return business.”
“How many of you people, let me just ask you, whenever you heard, if you did last night, if you heard about or saw Rachel Maddow’s tweet, ‘We’ve got Trump’s tax return,’ how many of you people had your heart sink?”
And yet, Limbaugh noted, look at how it ended up.
“Trump has the trophy again. Trump gets the hardware. These people, it blew up in their face.”
And that was why he concluded conservatives should have faith in the Trump track record, and “just be a little patient and confident.”