I’m going to write something fairly controversial sounding to begin with, but I hope you will hear me out on this:
Democrats should get on board with GOP plans to fully repeal Obamacare.
But why would and should democrats get on board with this seemingly insane sounding plan? There are two very good reasons why they have an incentive to do so.
The first has to do with the GOP’s options regarding how they can dismantle Obamacare. If democrats put up a fight and try to filibuster Obamacare repeal, the GOP will be faced with doing one of two things.
The first thing they can do is just get rid of the filibuster. However, I’m not so certain that the GOP will pull the trigger on nuking the entire filibuster as some people believe they will. Yes, it will be tempting, but the GOP just came out of a 6 year stretch where using and abusing the filibuster has now put them into power in both houses of Congress and the Presidency. They also realize that Trump, being a very weak and unpopular President-elect to begin with, may face a very uphill battle for re-election in 2020, assuming he even runs for it. That means if Democrats retake the White House in 2020, republicans may suddenly find the filibuster useful again, and so they may not be so eager to get rid of it.
The second — and I think perhaps more likely — thing they may try to do is gut what parts of Obamacare they can via reconciliation. And they can still do a lot. They can strip out medicaid expansion. They can get rid of the mandate and the taxes implemented in the law. The problem with doing this, however, is that they can’t get rid of things like coverage requirements for pre-existing conditions.
Keeping these coverage requirements while getting rid of the mandate would create a situation that could completely collapse the insurance industry as we know it, not only making health care unaffordable for those who can’t afford insurance, but even for those who currently can. And this time there is no possibility of single payer coming to the rescue to save us.
So democrats are looking at two pretty bad options: losing the filibuster, which they might like to have in future battles, to save a law that the GOP can get rid of anyway, or they are looking at allowing the GOP to set up a system that could make the health care system even more unaffordable and unstable than it was before the Affordable Care Act was implemented in the first place.
On top of this, resisting republican attempts to repeal Obamacare will likely mean that democrats have little to no say in any plan to replace it.
So what do democrats do? The most pragmatic move may very well be to go to republicans and say: “OK, fine. We will allow you to repeal Obamacare. But in exchange we want a seat at the table when it comes to coming up with a replacement.” Whatever replacement that comes will certainly be nowhere as good as Obamacare and will be a very bitter pill to swallow, but it may very well still be better than the alternatives that democrats face.
I know there will be a knee jerk reaction of “we have to fight this no matter what. We have to stick to our principles. Etc.” However, my more pragmatic view is this: If “sticking to our principles” results in a health care system that is demonstrably worse than one that existed pre-2008 and which results in a system where health care is not only unaffordable to the poor but for everyone who isn’t objectively rich, what, exactly, have you gained? A good feeling inside that you fought the best you could? That will be little consolation to those who will die as a result.
Anyway, I think this is a possiblity that democrats should at least be open to considering. Obviously the overall context of the situation when this finally comes up will dictate whether this is a viable plan or not. But I think it is certainly a situation we may very well face.
