Two years and eight days ago, David Frum reflected on Congress' almost entirely Democrat-led passage of the Affordable Care Act, and declared "Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s."
"Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections," Frum wrote, "But...legislative majorities come and go. This healthcare bill is forever."
At the time, this was considered a bit of political tough love. Instead of contributing to the passage of health care reform, Republicans fought it aggressively, hoping to score a quick political buzz, and wound up on the wrong side of the biggest legislative achievement in a generation.
Frum's analysis looks different now. Obamacare's opponents have been more successful at tarnishing it, and the President, than Frum or anyone else imagined, exemplified by the fact that even Obama now calls it Obamacare. And as we suspect from looking the crystal ball known Anthony Kennedy's tone of voice, the law is in serious danger of being struck down, in whole or in part, by the Supreme Court.
But the heart of Frum's point--that Republicans have not engaged in any sort of health care reform--still stands. Can anyone detail the GOP's health care proposals, or name a single Republican official who has put forth a health care reform plan? The example that comes most readily to mind is Ron Paul's assertion that an uninsured man be turned away by an emergency room. That drew cheers from a Republican debate crowd (for some reason), but it's not a serious answer to an extremely serious problem.
Greg Sargeant goes to the putative GOP nominee and finds a void:
When pressed by Jay Leno(!) as to how to handle an uninsured man who gets sick, Romney responded, "You don't want everyone saying, 'I'm going to sit back until I get sick and then go buy insurance.' That doesn’t make sense. But you have to find rules that get people in that are playing by the rules." As Sargenat points out, that's exactly the problem:
Romney himself detailed exactly the problem that the individual mandate is designed to fix: If people wait until they get sick before getting insurance, it fouls up the system. As he puts it, this “you’ve got to get insurance when you’re well.” Romney’s recognition of the policy problem, of course, is why he passed a mandate at the state level in Massachusetts.
But now Romney is obliged by GOP primary politics (and perhaps by his actual beliefs) to insist that a federal mandate is an unconstitutional usurpation of American freedom. So he’s forced to give a nonsensical answer to the core policy and moral question that’s left behind if we do away with Obamacare: What should the federal government do about those who can’t get insurance covarge, thanks to preexisting conditions?
Until Romney details otherwise, his answer, for all practical purposes, is: Nothing.
This problem isn't just contained to Romney. Nobody on the right knows what to do with a sick person who can't afford insurance. Don't expect an answer anytime soon, either: Republicans plan to spend the general election strawmanning Obamacare for political points, and the last thing they want to do is propose any plans of their own.
So thanks to their determination to destroy all things Obama, the Republican Party may have torpedoed the only substantive health care reform legislation ever to pass into law. They have nothing to offer in place of this plan. What now?
(For the record, Frum stands by his analysis, and adds that if Obamacare is upheld, the Republicans are screwed in November.)
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Related: Will Obamacare Be Struck Down?
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