Senator Rand Paul has been vocally opposed to the GOP's plan to repeal and replace ObamaCare. He's critiqued it (unfairly) as 'ObamaCare Lite.' Paul's position, joined by a few other Republicans like Rep. Mark Meadows, is that Congress should repeal ObamaCare in its entirety first and then have a debate over how to replace it.
“Nobody wants ObamaCare repealed more than we do,” Meadows and Paul wrote in a Fox News op-ed earlier this month. “We think the only way to repeal ObamaCare is to separate repeal from replace.”
Except, just two months ago, both Senator Paul and Congressman Meadows were singing an entirely different tune. Both leaders publicly stressed not only their support for a same day repeal-and-replace, but why that approach was strategically fundamental. Rand Paul, warning that repealing without replacing would be a disaster, told MSNBC in January:
“We need to think through how we do this, and it's a huge mistake for Republicans if they do not vote for replacement on the same day as we vote for repeal."
He tweeted it, too.
Why the procedural flip flop from these two critics? Perhaps they don't have the leverage they thought they had. It might be that they've come to terms with the fact that their version of “repeal and replace” would not pass the Senate nor would it be allowable under that chamber's reconciliation rules. But they also can't back down now - not after their short-sighted labeling of the bill as ObamaCare 2.0.
So instead, they're throwing a Hail Mary to avoid the question of “replace” entirely and slowly edge off the political cliff they've backed themselves up to.
That's just a guess.
Paul's excuse for the shift in strategy is that there's no consensus among Congressional Republicans on a replace bill, a situation which presumably still would not change after a repeal bill is passed. There's also still the fact that a clean repeal bill cannot legally pass the Senate under reconciliation rules.
But even if it could, a repeal-only approach would be disastrous. The CBO scored Rand Paul's repeal-only proposal at the beginning of the year. The numbers pale in comparison to the relatively great score of the AHCA:
- The number of uninsured would be 32 million higher (8 million more than the AHCA).
- Premiums would increase 200% by 2026 (the AHCA decreases them).
- Consumers would have fewer insurance products to buy; some would have none.
On top of all of that, we still wouldn't be getting any of the historic and conservative Medicaid entitlement reform that the GOP plan achieves.
Moderates are already skittish about the AHCA's changes to Medicaid eligibility; a repeal of Paul's magnitude would send them running over each other towards the exits.
Rand Paul is perhaps starting to realize that the Speaker wasn't lying when he claimed that the House GOP plan is the last, best chance we'll have to repeal and replace ObamaCare. So they're trying to extricate themselves from the political knot they've tied themselves into by changing their demands, which is not something you do if you're winning. That's an encouraging sign for the AHCA.