For years now, undeterred by an imposing level of conservative schadenfreude, a handful of us have argued that the introduction of Affordable Care Act benefits in January would flip the politics of Obamacare, and the GOP's repeal platform would collapse.
It's April now and that worm is turning before our eyes, both on on Capitol Hill and in states across the country.
Republicans have replaced an unabashed "full repeal!" mantra with a deluge of weasel words meant to conceal the fact that "repeal" is still the beginning and end of their health-care reform agenda. It's still the goal—they're just a little ashamed of it now. And that places an onus on Dems (and reporters and anyone else who believes politicians should own the consequences of their policies) to be extremely explicit about the benefits Obamacare is conferring, and what an unvarnished rendering of GOP health policy would really look like.
As Greg Sargent has been documenting over at The Washington Post, the ACA's optional Medicaid expansion is wrong-footing Republican Senate candidates in expansion states like Arkansas, Michigan, and New Hampshire, because their position (repeal) now entails kicking tens or hundreds of thousands of people in their states off of Medicaid.
Rather than own up to that, Representative Tom Cotton, the Republican who's challenging incumbent Senator Mark Pryor in Arkansas, served up the following word salad: "We would repeal Obamacare and replace it entirely with many reforms for our health care program…. We want every Arkansan, we want every American, to have quality, affordable access to health care."
The reality of the Medicaid expansion is sucking the oxygen out of the GOP's broader Obamacare strategy, and Cotton, along with Scott Brown in New Hampshire and Terri Lynn Land in Michigan, are caged canaries finding out the hard way.
In non-expansion states, the other coverage mechanisms are just as tricky for Republicans to navigate. North Carolina's House Speaker Thom Tillis, who's running against Senator Kay Hagan, has used the state legislature as a laboratory for some of the most conservative, anti-ACA policies in the country. Yet here's how he defends his position.
"The focus of the attack ads, where Thom Tillis is against having some sort of safety net for pre-existing conditions, and for kids under 26 years old being under their [parents'] policies—Republicans have made those proposals before," he said. "It's not about that. It's about everything else in Obamacare that doesn't work."
At a glance, Tillis is just defining Obamacare down—hiving off the stuff people like and claiming those things aren't actually Obamacare, or that they're distinguishable from GOP policy. And if he and other Republicans were genuinely prepared to insulate the ACA's core benefits from his party's nominal "repeal" position, it would be an astounding development.
But if it were true, he wouldn't be using equivocal phrases like "some sort of." Obamacare creates an actual safety net for people with pre-existing conditions. It is now unlawful for insurance companies to discriminate against them in the marketplace. Tillis wants to make it lawful again. Some Republicans say they'd support a program of publicly financed health insurance for high-risk individuals, but they're all long on rhetoric and short on any commitment of funds, which would be considerable.
Tillis is actually being just as evasive as Cotton. Using different rhetorical tactics, both of them want to convince you that Republicans would hold Obamacare's new beneficiaries harmless. But in truth Republican candidates don't have anything substantial to offer them.
Though I suspect we'll get there eventually, Republicans for now aren't weening themselves off of full repeal by narrowing the scope of provisions they actually propose to eliminate. They are instead expressing appreciation for a variety Obamacare's actualized goals and then, in the next breath, a hushed desire to undo every one of them. All without offering anything that would recreate those achievements using different mechanisms.
It's a grand swindle.
The good news is that it will fail if Democrats are prepared to remind the public that Obamacare created these benefits; Republicans voted against Obamacare, to a person; they are still trying to repeal it; and they have a long record of opposing its means and its ends in equal measure. But the awful truth is that if Democrats are determined to avoid thoroughgoing debates about Obamacare, and at times they appear to be, then it might just work.