Late last month, President Trump remarked, “nobody knew that health care could be so complicated.” This, of course, is not true. Plenty of people know how complicated America’s health care system is.
Had the president taken time to talk to doctors, hospital administrators, nurses, patient advocates, insurance company executives, health care policy experts, or various other stakeholders, it would have been obvious just how complex health care is.
The disastrous end to the Republicans’ 17-day repeal-and-replace charade makes clear that the president didn’t have meaningful conversations with anyone who could have helped him understand what he was facing. The president did, however, take time to pretend to drive a big truck.
Trump also didn’t talk to another group of people who know exactly how complicated it is to reform an industry that touches the lives of every American and makes up one-sixth of the U.S. economy: Democrats.
Back in 2009, President Obama, Senate Majority Leader Harry Reid, and Speaker of the House Nancy Pelosi guided the Affordable Care Act through a lengthy legislative process. This process included getting buy-in from a wide variety of stakeholders, holding public hearings, accepting dozens of amendments, and holding town hall meetings with constituents.
Even though it took more than a year to enact Obamacare, Republicans railed that Democrats were moving too fast. On the night the bill passed the Senate, Minority Leader Mitch McConnell accused Democrats of “rushing it through Congress on Christmas Eve.”
This remained a persistent Republican talking point. As recently as last November, Arkansas Republican Senator Tom Cotton wrote in an op-ed for Fox News that “President Obama and Congressional Democrats rammed Obamacare through Congress in a series of late night votes.”
In the wake of Republicans’ failure to repeal and replace Obamacare, Sen. Cotton was singing a much different tune. In an interview with John Dickerson on CBS’s Face the Nation, Cotton criticized his fellow Republicans for trying to rush a repeal-and-replace bill through Congress. He contrasted the GOP approach with the one Democrats took in 2009 and 2010:
When the Democrats came to power in 2009, for 60 years, at least, they had been pursuing a national health care system, yet they didn’t introduce legislation for eight months. They didn’t pass it for over a year of Barack Obama’s first term. So it went through very public hearings and took testimony, developed a fact-based foundation of knowledge.
President Obama traveled around the country, hell town halls. He spoke to a joint session of Congress. I am not saying that we needed 14 months to do this, but I think a more careful and deliberate approach, which we now have time to do, because we are going to have to revisit health care anyway, would have gotten us further down the path towards a solution.
While it is nice to see Sen. Cotton finally being honest about how Obamacare became law, it demonstrates that Republicans were never interested in dealing in good faith on health care.
This is a fact that Mitch McConnell spoke openly about. In 2010, before President Obama had even signed his landmark domestic policy achievement, McConnell gloated to the New York Times that his explicit strategy of ensuring zero Republican support for Obama’s health reform bill was succeeding:
“It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out,” Mr. McConnell said about the health legislation in an interview, suggesting that even minimal Republican support could sway the public. “It’s either bipartisan or it isn’t.”
Republican lies about Obamacare were breathtaking and persistent. In 2009, Sarah Palin, in one Facebook post, ignited the “death panels” lie. In the two months following Palin’s Facebook post, the phrase “death panels” appeared in more than 6,000 news articles.
Despite earning the dubious honor of being named 2009’s “Lie of the Year” by PolitiFact, the death panel lie is still being spouted by Republicans. It made an appearance during a recent health care town hall hosted by Florida Republican Congressman Gus Bilirakis. Pasco County Republican Party Chairman Bill Atkins told the crowd, “there is a provision in there that anyone over the age of 74 has to go before what is effectively a death panel.”
Another persistent lie Republicans told about Obamacare is that it is a “government takeover of health care.” This was named PolitiFact’s 2010 “Lie of the Year.” This lie, while not as shocking and macabre as the death panels lie, is the one that really boxed Republicans in.
By any objective measure, the framework of Obamacare is rooted in conservative health policy. Indeed, the law was largely modeled after the 2006 health care reform law enacted by then-Governor Mitt Romney in Massachusetts.
By framing market-based, private health insurance reform as a “government takeover of health care,” Republicans gave themselves no place to go to find a conservative replacement for Obamacare. The only viable alternatives that would maintain the same coverage levels are a public option or single-payer, both of which are far more liberal ideas.
Lying about Obamacare allowed Republicans to pander to their base, while using partisan bickering to prevent the law from gaining popularity. It served to be a successful electoral strategy. Republicans now control the House, Senate, and White House.
But in the course of gaining that power, Republicans created an alternate universe in which they could easily replace government-run Obamacare with a free market alternative. Once Republicans were in a position to actually have to write and pass a bill that would achieve that goal, it turned out to be far more complicated than they had led anyone-including the president-to believe.