WASHINGTON -- It took President Barack Obama and the Democratic Congress 14 months to pass the Affordable Care Act in 2009 and 2010. In about five times as many months, congressional Republicans have produced the following: a set of warmed-over talking points that fits on less than two printed pages.
Yes, it's true. More than seven years into Obama's presidency -- an era during which health care reform has been one of the defining issues in domestic politics -- a group of GOP lawmakers hand-picked by House Speaker Paul Ryan (R-Wis.) released a "mission statement" on Thursday. It is 251 words long.
The House Republican Health Care Task Force is holding an "ideas forum" the same day. That's fortunate for the GOP conference, since the mission statement is light on ideas. Take care not to confuse this task force with the one from last year, or any of the other House-leadership-sanctioned exercises in failure to achieve consensus on an Obamacare "replacement."
So, what do Budget Committee Chairman Tom Price (R-Ga.), Education and the Workforce Committee Chairman John Kline (R-Minn.), Energy and Commerce Committee Chairman Fred Upton (R-Mich.) and Ways and Means Committee Chairman Kevin Brady (R-Texas) have to show the American people? Let's begin with the preamble:
Mission Statement: To modernize American health care with patient-centered solutions that improve access, choice, and quality, lower costs, promote innovation, and strengthen the safety net for the most vulnerable.
Obamacare is proof that putting the government at the center of our health care system harms patients, families, providers, and businesses. This is why we need to replace Obamacare’s obsolete, one-size-fits-all approach with innovative, market-based, patient-centered solutions.
This is a good start, because all of those words are words. And it's hard to argue with any of the the items on this wish list. Who doesn't want all those great things?
Of course, that's part of the problem. These aspirations are so universal they would apply to almost any health care plan. If you squint a little, it even looks like they could describe the Affordable Care Act or the single-payer program Sen. Bernie Sanders (I-Vt.) is promoting on the presidential campaign trail.
But what's really notable about this opening is that it reads as though it was copied and pasted from a memo Republican messaging guru Frank Luntz wrote in 2009 to advise GOP lawmakers how to kill health care reform without making it look like they were killing health care reform.
Here are excepts from the Luntz memo from seven years ago (emphasis his):
Americans will expect the government to look out for those who truly can’t afford healthcare. Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: “A balanced, common sense approach that provides assistance to those who truly need it and keeps healthcare patient-centered rather than government-centered for everyone.”
The arguments against the Democrats’ healthcare plan must center around “politicians,” “bureaucrats,” and “Washington” … not the free market, tax incentives, or competition. Stop talking economic theory and start personalizing the impact of a government takeover of healthcare. They don’t want to hear that you’re opposed to government healthcare because it’s too expensive (any help from the government to lower costs will be embraced) or because it’s anti-competitive (they don’t know about or care about current limits to competition). But they are deathly afraid that a government takeover will lower their quality of care -- so they are extremely receptive to the anti-Washington approach. It’s not an economic issue. It’s a bureaucratic issue.
Luntz goes on like that for a while. In fact, the memo is considerably lengthier than the House GOP task force's mission statement, though Luntz wrote it without the benefit of Obamacare being law for almost six years.
The document Ryan and his lieutenants issued on Thursday continues with what looks like a promise to spell out what Republicans want to do about the health care system, beyond just trying to repeal the Affordable Care Act for the umpteenth time.
To achieve the best outcomes and get results for the American people, this task force will follow key principles of patient-centered health care:
This is the moment health care wonks, anyone who's benefited or been harmed by Obamacare, and Republican voters have been waiting for! Drum roll...
To that end, the Chairmen of the House Ways & Means Committee, Energy & Commerce Committee, Education & the Workforce Committee, and Budget Committee are focused on building consensus around specific health care policies that reflect these principles and will hold hearings to advance real patient-centered reforms, including:
- Empower every American with the ability to gain access to coverage that is affordable and portable.
- Provide Americans with more choices, not mandates, so they have the freedom to pick plans and providers that best fit their unique health care needs.
- Protect the quality of care for all patients -- including those with pre-existing conditions.
- Promote innovation to improve competition, harness the power of new technologies, lower prices, and foster better cures and treatments for patients.
- Save Medicare and Medicaid to strengthen health care security for seniors and America’s most vulnerable.
- Innovations in employer-provided health care coverage
- Health tax expenditures
- Reforming broken insurance markets
- Increasing state flexibility and sustainability in the Medicaid program
- Saving and strengthening Medicare.
To the extent this can be translated into policy positions, based mostly on things House Republicans have always more or less favored, they seem to be moving toward deregulating the health insurance industry, deregulating the pharmaceutical and medical device industries, slashing Medicare and Medicaid spending and doing some other stuff, maybe?
In the fairest reading of this mission statement, it's a sign that congressional Republicans are beginning a formal process to arrive at a consensus about replacing Obamacare -- a process made all the more vital because the party has no control over its leading presidential contender, Donald Trump, and would like to start defining the issues before he has a chance to lock up the nomination.
And yet! There is reason to be skeptical, mostly because there has never been a Republican consensus on how to fix the biggest problems in the health care system -- things like tens of millions of uninsured Americans, or people being denied coverage because of pre-existing conditions -- either before or after Obamacare.
What's more, Republicans in Congress have been making this same promise since the Obamacare debate started in 2009, and have never come through. It can't be repeated enough that this, alone, is cause to doubt it'll be different this year.
But at least now there's a mission statement GOP lawmakers can tweet out, so that's something.