The Heritage Uncertainty Principle In Action
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We will hold hearings in Washington and around the country. We will invite affected individuals and job creators to share their stories and solutions. We will look to the Constitution and common sense to guide legislation.
Replacing this law is a policy and a moral imperative.
The committees we lead will tackle these challenges with the seriousness and steadfastness of purpose they deserve.
Repeal is the first, not the last step. Compassionate, innovative and job-creating health care reform is what’s next.
Paul Ryan, 5 years later, after Congress passed a symbolic repeal of the ACA:
This week, House Republicans voted to repeal Obamacare and restore the health-care status quo. But what about replacing Obamacare with an alternative plan that does all of the wonderful stuff without any trade-offs, the one they’ve been promising since 2009? “Just wait,” a smiling Paul Ryan told reporters.
Today brings shocking news from Politico, which reports, “Senior House Republican aides and lawmakers say they do not plan to hold votes on many of the agenda items the party plans to unveil — such as a health care plan to replace Obamacare, or tax reform — because of a tight legislative calendar over the next few months and the reality that none of the bills would be signed by the president, anyway.”
Why, I’m beginning to think that not only do Republicans not favor Barack Obama’s Republican health care reform, they don’t favor any health care reform! Had Republicans been in charge of Congress in 1995, though, I bet they would have passed something.
Elsewhere in health care path dependence news, Bevin backing off plans to completely dismantle Kentucky’s Medicaid expansion is indeed a big deal. I wouldn’t get complacent about this — who knows what a Republican Congress and President Cruz would be willing to do — but it’s a positive sign, and good news for poor people in Kentucky (even granting that they are likely to be worse off under Bevin’s modified plan.) Bevin’s actions have also given us a perfect illustration of the eternal fact that nobody actually cares about federalism:
In Kentucky, newly elected governor Matt Bevin ran promising to destroy the hated law, which is working well in his state and demonstrably improving the health of its citizenry. Faced with a conflict between his ideology and reality, Bevin has chosen a bizarre compromise. He is turning the operations of Kynect, the popular, state-run insurance exchange, over to the federal government. And he is promising to put his state’s government in charge of the law’s Medicaid expansion. The background here is that Obamacare is designed to cover the poorest uninsured citizens by expanding Medicaid, a federal program, while offering coverage to more affluent people through state-run exchanges. Bevin is simply inverting that design out of sheer spite. Obamacare wants a federal program for the poor and a state program for the middle class? Well, then, he’ll insist on putting his state in charge of the program for the poor and making the federal government run the program for the middle class!
There is no ideological reason why a Republican would prefer to federalize one of those programs but not the other. It is simply a demonstration of spite, allowing Bevin to posture against the law without having to live with the costs of actually forgoing its benefits. Kentucky is a vision of Obamacare repeal-and-replace in action — a body lurching forward and thrashing about after its head has been cut off.
Such principled constitutionalism. Next, you’ll tell me that the radical shift that took place in Antonin Scalia’s interpretation of the necessary and proper clause between 2005 and 2012 was motivated rather by his substantive views of the federal government’s policy!