Purity and politics

Readers of a certain age may recall ads for Ivory Soap, which claimed to be 99 and 44/100ths percent pure. If the soap could have reached 100 percent purity, the company would likely have made the claim.

Purity, apparently, is what some conservative Republicans are demanding in a health insurance bill, which could come up for a vote this week. Supporters of the GOP’s evolving House bill emphasize that this is only the first step in repealing and replacing Obamacare. Republican leaders are touting a three-step process designed to get what virtually all conservatives want, a more cost-effective health plan. But some conservatives are demanding that first step be a wholesale repeal of Obamacare—a clean slate, nothing less. Taking an all-or-nothing approach is likely to guarantee they will get nothing.

Other conservatives, meanwhile, note that Obamacare is collapsing under its own weight. “Just let it collapse,” they say. “Democrats will get the blame, and we’ll get credit for saving the day!” That might be a political winner for Republicans, but it risks leaving millions of people in the lurch until a replacement healthcare system is installed.

Taking an all-or-nothing approach is likely to guarantee they will get nothing.

During an interview in his office, Vice President Mike Pence told me, “The president is determined to keep his promise to repeal and replace Obamacare.” Due to what he called “the arcane rules of the Senate on budgeting bills, it likely will take two pieces of legislation to do that, and a significant amount of administrative action by [Health and Human Services] Secretary Tom Price. We really believe a combination of those efforts by this spring will repeal Obamacare once and for all and replace it with healthcare reform that gives people the freedom to choose whether to have health insurance that lowers [its] cost for every American and creates a national marketplace where people have the ability to buy health insurance the way they buy car and life insurance, and gives the states the ability to improve Medicaid with state-based innovation and reform.”

Pence calls Medicaid “deeply flawed” and notes “many doctors and hospitals don’t take Medicaid patients anymore.” What about the politics of this, I ask, noting the Congressional Budget Office’s estimate that millions will lose their health insurance under this reform? Are Republicans asking for big trouble in next year’s midterm elections?

“CBO was wrong about the numbers of Obamacare,” he said, “and we think they’re wrong about this plan. CBO projected last year there would be another 8 million people covered, so we take issue with their modeling.”

Pence mentioned what he calls “the fundamental difference” between Obamacare and the president’s proposal. Under Obamacare, he said, the government ordered everyone to have health insurance and people to pay for services they would never use. President Trump’s goal, he said, is to expand choice and allow people to choose policies—or not—tailored to their needs. The poor would get tax credits to help them purchase policies, should they choose to.

“Amendments” to the House bill, Pence said, “will be forthcoming” in an effort to get conservative lawmakers on board with the measure.

A recent Wall Street Journal editorial gets the politics right. “If conservatives fumble this repeal and replace moment,” the WSJ wrote, “they won’t get another chance. And they’ll have squandered their best opening in a generation to control the size and scope of the federal Leviathan.”

If a Republican majority in Congress and a Republican president can’t use their power of persuasion to convince enough members of their party to repeal and replace Obamacare, it will leave many people wondering why they are needed.

Failure to at least take the first step in replacing a deeply flawed, government-mandated insurance program will leave a stain on the Republican Party that even the strongest and purest “soap” will not be able to remove.

Listen to Cal Thomas’ commentary on the March 21 edition of The World and Everything in It.