Republicans Totally Unprepared If SCOTUS Overturns Obamacare Subsidies
Republicans have no contingency plans in place should their constituents lose health coverage in the event the Supreme Court rules against Obamacare subsidies. In spite of years of rhetoric that they’d like to “repeal and replace” they have worked only on repeal. While busly voting unsuccessfully to repeal the Affordable Care Act more than 50 times, they have no plan about what to do if the ACA is gutted.
Republicans’ history of promising and then not delivering comprehensive health care legislation — a history, after all, that goes back decades — hints at a deep, fundamental disagreement with the entire idea. Republicans will talk up the importance of helping people with pre-existing conditions or providing financial assistance to people for whom insurance is too expensive. But creating a truly universal coverage system — in which everybody has access, regardless of income or health — requires taking steps that many conservatives simply can’t abide.
Specifically, universal coverage requires some combination of regulation, taxes and redistribution (from healthy to sick, and from rich to poor) that Republicans tend to find economically destructive, morally noxious or both. That’s true of wholly nationalized, single-payer systems like you find in France or Taiwan. It’s true of universal schemes of regulated private insurance, like they have in the Netherlands, Singapore and Switzerland. It’s even true of programs in the U.S. that have existed for a long time — not just Medicare but also, to some extent, employer-sponsored insurance.
The hostility Republicans feel toward the principles of universal health care could be defended intellectually, and maybe even politically — although the fact that GOP lawmakers can’t repeal Obamacare on their own, without a court order from friendly conservative judges, suggests otherwise. But if that’s what Republican leaders think, it’d be nice if more of them came out and admitted it. They should make clear they preferred the world as it existed before Obamacare — a world in which more people suffered because they didn’t have money to pay for medical care — rather than carrying on with the illusion that they’re busily thinking up some better alternative and just waiting for the right moment to unveil it.