Friday, March 3, 2017

Bialystock's Paradox: Obamacare edition

I'm sure others have noted this, but reading Jonathan's Chait's account of the GOP's struggles to craft a health care plan that is satisfactory to the party and not wildly unpopular with the general electorate, I was struck by a familiar dynamic.

Eleven days before Donald Trump took office, I wrote a column with the slightly hedged but still hyperbolic headline “Obamacare Repeal Might Have Just Died Tonight.” While the “might” was doing a lot of work, my argument was that the GOP’s clearest and easiest path for repealing Obamacare had fallen short, which would force Republicans to attempt to forge a vastly more difficult path. That is what has happened since, and that is why the cause of repeal has been dying a slow and painful death. John Boehner — who repeatedly led his party to election victories on the promise that they would repeal Obamacare! — has now admitted repeal is “not going to happen” and “most of the framework of the Affordable Care Act” would remain in place.

As long as they lost the presidency, the Republican leadership was able to squeeze a lot of votes and dollars out of opposition to Obamacare, but the election changed the dynamic.

Republicans were able to paper over this yawning chasm between what their base demands and what their elites are offering for the last eight years only because they have been able to avoid a specific alternative. Republicans attacked Obamacare for its high deductibles, and Trump promised a replacement that would give everybody better coverage for less money. But their proposals would do the opposite. Multiple sources report that the House Republican replacement plan was supposed to come out this week, but was delayed after an initial analysis by the Congressional Budget Office yielded a horrific score. Their plan would cut the average subsidy level for a person buying insurance on the exchanges from $6,314 to $3,643, according to a preliminary calculation by the liberal Center for American Progress.

When you win, people expect you to start fulfilling obligations, and when you've been making promises you can't keep...

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