Would A Republican President Really Throw 18 Million Off Health Insurance in 2017?

By Robert Kraig, executive director

At the Families USA Health Action Conference 2016 last week, which brought together the leading national and state advocates for health reform, there was some interesting speculation about what would happen if Republicans control the White House and both houses of Congress in 2017. Republicans have made unconditional opposition to the Affordable Care Act a defining issue of what it means to be a conservative. All of their presidential contenders have repeatedly promised immediate repeal from the stump and in every debate.

As I have said many times before, this is a question of the highest order of magnitude. We are talking about taking health care away from over 18 million people who do not have access to good coverage at work. This is a wide range of Americans at risk including people with pre-existing conditions, working families whose low-road employers tend to provide no affordable health coverage, early retirees, and young adults just starting their careers.

There is some grounds for hope that a Republican president would not follow through on their deadly threat to force this many people off of their health coverage. During the run up to the U.S. Supreme Court’s King v. Burwell decision it was widely reported that many GOP strategists were quietly hoping to lose the decision. They realized that taking health care away from people is a completely different matter than blocking reform in the first place, and feared sparking a public backlash against conservative elected leaders. This is why conservatives went all in so early to try to destroy the ACA before it could be established.

I said repeatedly during the months leading up to the Supreme Court decision that this level of violation, literally taking the freedom of access to health care away from millions of families, could be a Waterloo for the conservative movement, revealing their true nature to the public as has not be done since the Goldwater debacle in 1964. The 60 plus repeal votes that have taken place so far were safe votes, because everyone knew Obama would exercise his veto.

With this in mind, at a media availability session for bloggers, I asked Ron Pollack, the Executive Director of Families USA, whether Republicans would actually go through with all-out repeal. Ron is one of the principal leaders of the health care reform movement in America.

Ron started the interview session by saying that the 2016 election was the most important in the history of health care reform because of the conservative obsession with repeal. But when I asked him would they really take health care away from over 18 million people, Pollack said “it is hard to believe they could get away with it.” He pointed out that in Kentucky where a hard right Tea Party Governor was recently elected, the new Governor has already started pulling back on complete repeal of the state’s successful state exchange and Medicaid expansion. Pollack said it is very hard to take coverage away from people who already have it, and that many interest groups with great influence in the GOP (business, hospitals, pharma, insurance) would oppose full repeal out of economic self-interest.

Pollack’s remarks reinforced something I have been tempted to believe for some time, that when the rubber meets the road and conservatives actually have to pull the trigger, they may find a way not to throw over 18 million people off their health care. A newly elected conservative president would fear destroying his administration over the consequences of such a damaging act, and would step back from the brink.

This sense of cautious optimism came crashing down in the last plenary of the conference Saturday which included Tom Scully, a long time advisor to Republican presidents on health care, who served in both Bush administrations. He is extremely well connected, and knows most of the GOP presidential contenders personally.

Scully said he thought it was a mistake to repeal the ACA, that the basic structure was sound and based on ideas developed by conservative elected officials and think tanks. However, because conservatives leaders had opposed ObamaCare for political reasons, and “built a title wave of hostility and anger” in their right-wing base against it, they would have no choice but to follow through on repeal. He concluded that they “will probably blow themselves up doing it, and will probably lose the next election [2018] because of it.” Scully said repeal will be “very stupid,” but given the politics of it and the way both sides now hate each other in Washington, they will do it anyway.

As unbelievable as it sounds, Scully is probably right. Conservatives have made repeal of ObamaCare such a defining issue, it may be impossible for a new Republican President to pull back. It reminds me a bit of Lyndon Johnson and Richard Nixon on Vietnam. They both knew the war was ill advised and unwinnable, and that the war would hopelessly divide their political parties, but still would not risk the political consequences of being soft on the alleged containment of communism. It did not matter that the war in Vietnam had nothing to do with geopolitics, both parties had staked too much of their political positions on the silly domino theory, and created a public opinion that could be mobilized to punish any national leader who lost ground to communism.

This brings us back to Ron Pollack’s original point that the 2016 election is the most important in the history of health care reform. The question is will Progressives make the consequences clear and emotionally compelling to average voters across the political spectrum. Will we make a compelling case that a Republican victory means taking health coverage away from over 18 million people who do not have access to good coverage at work? We are talking about hard working Americans trying to work their way up the economic ladder, people with cancer and other pre-existing conditions, young adults just getting a start, early retirees, small business owners, anyone who wants or needs to take time off from work, and many many others who need health care to have the real freedom to pursue the American Dream. We are talking about virtually everyone, because even if you have good health care at work, you are vulnerable to losing it sometime before you turn 65 and are eligible for Medicare.

It’s up to us in 2016 to make health care one of the top issues, and educate voters on the real life consequences of what the Republicans are promising they will do.


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