Health Care Legislation Medicare

Incremental Health-Care Reform Is A Smarter Bet Than Obamacare Repeal For The GOP

In the long run, Republicans will need to develop a health-care vision. In the meantime, baby-step efforts to fix flaws in the existing system are what’s needed.

When congressional Republicans rebuffed President Trump’s renewed push to repeal and replace the Affordable Care Act (ACA) on April 2, Trump suggested a plan to pursue another repeal vote after his reelection in 2020. Then, on April 9, the Department of Justice moved to accelerate the appeals process in a court case that it hopes will invalidate the whole ACA as unconstitutional.

Obamacare repeal was deeply unpopular among voters and hurt Republicans in the 2018 midterm elections. Making it a top reelection priority would only bring the losing issue back into the spotlight. Instead, the GOP would be wise to counter the progressive push for Medicare for All with small, incremental reforms.

To begin with, Medicare for All is only superficially popular. According to a Kaiser poll, 56 percent of the public supports and 42 percent are opposed. But when respondents learn about its downsides, support wanes rapidly: Only 37 percent support Medicare for All when told it would eliminate private insurance or raise their taxes, and only 26 percent support it when told it would lead to delays in medical treatment. (It would do all of these things and more.)


Americans deserve a better alternative.

Recent elections show that the party of the health-care status quo tends to have the political edge. Largely thanks to public opposition to the then-new ACA, Republicans trounced Democrats in the 2010 midterms. On the flip side, opposition to ACA repeal helped the Democrats win 40 House seats in the 2018 midterms. For the GOP, making 2020 about “undoing Obamacare,” instead of about Medicare for All’s radical overhaul of the health-care system, would be foolish. By the same token, Republicans can’t afford to defend the status quo, given that a vast majority of Americans view the existing system as seriously flawed.

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