When Republicans were campaigning against the Affordable Care Act, they often made it sound like the system was such a monstrosity, such a disaster, so big and overwhelming it was crushing the entirety of the the U.S. health care system and responsible for skyrocketing premiums in every sector of the insurance market. Now that they’re on the verge of upending Obamacare, they are claiming that its reach is not so big after all. Suddenly, Obamacare’s problems – and the number of people that repealing it will affect – are “relatively small.”
This reduction in rhetorical scope is striking, given the language Republicans used to denounce the Affordable Care Act for the last six years.
“Obamacare is a malignant tumor that feeds and metastasizes on American liberty,” Rep. Steve King (R-IA) once said of the law.
“Obamacare is doing tremendous damage across America, and in Utah in particular,” Sen. Orrin Hatch (R-UT) said a year ago.
Reacting to a major 2012 Supreme Court decision upholding Obamacare, then-Rep. Mike Pence (R-IN) gravely pronounced: “This ruling erodes the freedom of every American, opening the door for the federal government to legislate, regulate, and mandate nearly every aspect of our daily lives under the guise of its taxing power.”
“If we don’t repeal and replace Obamacare, we will destroy health care in America,” Donald Trump warned a week before the election.
That was then.
This is now:
“It’s a relatively small number of people who really are involved here,” Hatch told reporters earlier this month when he was being pressed for specifics about the GOP plan to repeal and maybe eventually replace Obamacare.
The sudden change in tone comes as the Obamacare buck, as it were, has been passed on to Republicans, who have vowed to repeal it as soon as the new Congress convenes in January. GOP lawmakers are now facing a bevy of concerns about what their current plan – repeal and delay – could mean for the individual markets, which health policy experts warn could collapse in the so-called transition period. The threat of rising premiums and disappearing choices, which has provided much of the ammo for Republican ACA attacks under Obama, is not so panic-worthy given individuals on the exchanges make up just 4 percent insurer market, their new refrain goes.
”We have an Obamacare emergency in a relatively small part of the insurance market, the individual — people who buy insurance individually. That’s about 6 percent of all of the insurance that is bought in the country, 4 percent … is through the exchanges,” Sen. Lamar Alexander (R-TN), who is the chairman of the Health, Education, Labor and Pensions Committee, told TPM last week.
Republicans are right that Obamacare’s exchanges implicate a relatively small part of the overall health insurance market, though it still affects millions of people. But the shift is notable as the nuance and hedging were largely absent from discussions over the last six years when Obamacare’s problems were not GOP lawmakers’ to fix.
Some Republicans, like Sen. Bob Corker (R-TN), have said the limited number of people in the exchanges should actually make it easier to repeal and replace the law in relatively short order.
“It doesn’t seem to me that it would really take that long to come up with a replacement and so that is the debate,” said Sen. Bob Corker (R-TN), who said Alexander’s own analysis had informed his. “Are we better off through reconciliation, ending it in three years and then working toward that? You know that is a long time. Momentum can get lost. Or are we better off on the front end right now just replacing it and being done with it?”
As insurers warn the GOP about the impending crisis coming and the public becomes more aware of what a repeal of Obamacare will really mean, Republicans are the first to point out that the law is complicated and voters need to exercise patience as they wait on Republicans to carry out their six-year-long campaign promise.
“They have to look at the complexity of the problem here, and hopefully [voters] recognize that it’s not quite so simple,” Sen Ron Johnson (R-WI) told reporters about how it may take a bit of time to actually follow through with the promise.
Johnson added that “there are plenty of people who had some advantage with this and I don’t think anybody wants to pull the rug out from under them” before he began pointing out his list of problems with Obamacare.
It’s a major rhetorical backflip for Republicans who have been shouting for years that Obamacare has very few redeeming qualities.
“The party in power owns what happens in the health care system, good and bad, regardless of whether their policies are the cause. And so, when there was all this hullabaloo about big premium increases in the ACA marketplaces, Democrats were pointing to it being a small sliver of the population and Republicans were trying to suggest that everyone’s premiums were going up,” said Larry Levitt, a senior vice president for special initiatives at the Kaiser Family Foundation. “Now that Republicans are on the hot seat to figure out what to do with people who have been covered by the ACA, the shoe is on the other foot. I expect the talking points of both parties will switch.”
The very reasons Republicans are eyeing a long transition for the Affordable Care Act is that they want to try everything they can to stop any effects of an Obamacare repeal from being felt while they grapple with a replacement bill.
“There is no particular reason to put people in needless stress that something is going to happen to their health care they do have, no matter how happy or unhappy they might be with it,” said one Republicans senator who spoke with TPM on background in order to talk freely about Republicans’ strategy to repeal and replace the Affordable Care Act.