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Health Care Repeal And The GOP Suicide Squad

A National Review editorial urges Republicans to unite around a simple bill repealing the Affordable Care Act:

We understand that House Republicans are divided among several repeal bills, and that some House Republicans believe legislation should replace as well as repeal Obamacare. In our judgment, replacing Obamacare with workable conservative reforms should remain part of the conservative platform without being part of this year’s repeal legislation. All House Republicans have already gone on record supporting various health-care reforms, so the charge that they have no alternatives to Obamacare should not sting.

At this moment, the principal problem in American health care, and the principal obstacle to all conservative reforms to it, is the looming menace of Obamacare.

I hope they follow this advice. Here's the conundrum. The health care system is very, very unpopular. Republicans never allowed themselves to be seen as advocates of the status quo. Their public position was always to do all the popular parts of health care reform without the unpopular parts, banking on the public's failure to understand that the unpopular parts were necessary to make the popular parts work. Republicans never argued outright for defeating health care reform, either. Their line was to "start over," implying that a fresh start could produce a health care reform that included all the good stuff without the bad.

Of course, Republicans never produced such a bill, because it was and is impossible. The strategy worked as long as it was an imaginary hypothetical. But if Republicans were actually running Congress, they would have a choice. They could package repeal with a replacement bill. That would force them to come up with a majority for an actual proposal and grapple with the fact that their bill could not actually solve the problems they said it could. NR recognizes that requiring Republicans to formulate an alternative that gains the support of a majority in both houses of Congress (including a Senate supermajority) means repeal will never happen.

Alternatively, they could either repeal the bill, full stop, as NR advises, and then worry about what to replace it with later. That would put them on record as voting to strip thirty million Americans of their health insurance, allow insurers to deny coverage to anybody who has had a preexisting condition, or a family member with one, and so on. In other words, it would force Republicans to do what they sensibly avoided doing for more than a year, which is take an affirmative vote for the unreformed status quo.

Update: Dave Weigel flags a new NBC/WSJ poll question showing people prefer giving the Affordable Care Act time to work over "repeal and start over":

"That's a 13-point margin for 'give it a chance,' which is not the argument conservatives want to go to the electorate with," says Weigel.