A publication of the Kentucky Center for Public Service Journalism

Health care debate shifts away from politics with Obama gone, moves toward care, Guthrie says

“With President Barack Obama out of office, the debate over ‘Obamacare’ is becoming less about ‘Obama’ and more about ‘care,’ greatly complicating the issue for Republican lawmakers,” writes Jonathan Martin, national political correspondent in the Washington Bureau of The New York Times.

“Polling indicates that more Republicans want to make fixes to the law rather than do away with it. President Trump, who remains popular on the right, has mused about a replacement plan that is even more expansive than the original.”

That’s a contrast with the last seven years, when “few issues have animated conservative voters as much as the repeal of the Affordable Care Act,” Martin notes. “As liberals overwhelm congressional town hall-style meetings and deluge the Capitol phone system with pleas to protect the health law, there is no similar clamor for dismantling it.”

Rep. Brett Guthrie, R-2nd

Republicans in Congress told Martin that there is “significantly less intensity,” as he puts it, among Obamacare opponents now that Obama is no longer president.

Rep. Brett Guthrie of Bowling Green and Kentucky’s 2nd District, who is on two health subcommittees in the House, said “I was here in 2009 and 2010, and we’re not getting the anti-Obamacare calls like that. I think people are going to hold us accountable for making sure we not only repeal, but we have a law in place that creates a better opportunity for people.”

Martin writes, “The demands from conservative-leaning constituents in districts like Mr. Guthrie’s are plainly shifting. In a nationwide CBS News poll last month, 53 percent of Republicans said they wanted to change the law to make it work better while 41 percent said they wanted to abolish it. Overhauling the law, however, is far more politically complicated than simply scrapping it.”

The law passed with no votes from Republicans, and they have campaigned against it ever since. Now that they control the government, except the lack of a filibuster-proof majority in the Senate, the debate has “shifted from the theoretical to the tangible,” Martin reports.

“It was easy for conservatives to rally against a law identified with a president they despised when he was capable of vetoing any repeal,” he writes. “Now that he is gone and the law’s benefits appear to be on the chopping block, the people who stand to lose the most are the most vocal.”

The “wild card” in the process is President Trump, who “has said multiple times that he is uneasy about depriving anybody of health insurance, and he may bridle if Democrats attack any Republican plan that may lead to that,” Martin writes. “As Democrats note, Mr. Trump owes his victory in part to voters who have benefited from the law.”

Kentucky is an example of that. More than half a million Kentuckians, the great majority of them on expanded Medicaid, are among the 20 million Americans who gained coverage under the law. By some measures, the state has had the largest percentage decrease of people without health insurance.

Senate Majority Leader Mitch McConnell said Friday that Republicans will have to repeal and replace the law without Democratic help or votes. “It’s clear that in the early months it’s going to be a Republicans-only exercise,” he said. “We don’t expect any Democratic cooperation on the replacement of Obamacare. . . . Clearly this is not one of those bipartisan ‘Kumbaya’ moments.”

But Republicans may still need Democrats. The GOP can pass budget- and tax-related measures with a simple majority, under budget-reconciliation rules, but it remains to be seen how that can be done with the rest of the law.

From Kentucky Health News

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