What’s in a name?
Sometimes a lot. Take the name Obamacare. While the Affordable Care Act (ACA) has been a tremendous success at bringing healthcare to millions of previously uninsured, reducing the rate of increase of healthcare costs, extending the solvency of Medicare, reducing drug costs for seniors, and eliminating unfair practices like cutting off coverage for people as soon as they get sick, while most of its individual features are wildly popular in themselves, the pejorative nickname “Obamacare” given to its insurance marketplace reforms by Tea Party radicals and anti-government professional know-nothings have made it an easy target for misleading propaganda.
Congressional Republicans rode to victory in 2010 on a package of outright lies about the ACA, abetted by prejudice against the first black President and the usual low voter turnout in midterm elections. They’ve spent the next six years taking repeated meaningless votes to repeal the dreaded mythical “government takeover” of medical care. Now that they control all branches of the federal government, they find themselves having to deliver on their pledges to repeal and replace.
This presents the GOP with a serious problem. They can’t repeal the ACA without throwing millions of their own base voters back into a dysfunctional unregulated health insurance market. They’ve promised to replace the ACA with a different plan that won’t take away anyone’s current coverage, but they have no such plan.
The ACA already is the Republican healthcare plan. They call it Obamacare, but it’s more accurately “Romneycare” or “GOPcare” or “HeritageCare”. With a very few changes, the plan Obama pushed through Congress in his first term was the plan the rightwing think tank Heritage Foundation came up with as an alternative to “Hillarycare”, the comprehensive health care package created under the First Lady’s leadership in the ’90s. They managed to get it implemented in Massachusetts under Governor Mitt Romney, and though it was far from comprehensive and left control of healthcare in the hands of the insurance and pharmaceutical industries, it’s been enough of an improvement over the chaotic unregulated system it replaced to enjoy wide popular and political support. It’s the only plan the Republicans have ever had.
With the Pussygrabber-in-Chief promising to preserve popular features of the ACA like pre-existing condition coverage and extended eligibilty for young adult children on their parents’ plans, with hospitals in the rural areas of red states that serve the heart of the Republican coalition in danger of collapse if the ACA is repealed, with insurance companies ready to pull out of the market if the individual mandate is taken away, the Congressional Republicans are facing a massive backlash if they don’t fulfill their promise to repeal, and a catastrophic collapse if they abandon the only alternative plan they’ve ever been able to come with, the plan they love to call “Obamacare”.
Here’s my modest proposal.
Forget about “Repeal and Replace”. Go for “Repair and Rename”. Fix the problems around the edges of the ACA that have become apparent to anyone paying attention during the rollout over the last six years. and then rebrand it as “Trumpcare”.
Let the Republicans have their old market-based health care plan back. It was never the plan progressive Democrats wanted anyway, Let them call modest repairs a “repeal” if they want to, give them the comfortable fiction that continuity under a new name is “replacement”. Let them own the individual mandate, and the profit guarantees for private insurance companies, and the price-gouging by Big Pharma. Stop calling it Obamacare, free the Democrats from having to defend it, and let us pursue the real alternatives to for-profit health care, starting with competitive public options on any blue-state exchanges where we can get them implemented, and a renewed commitment by the DNC for a national single-payer system.
Call it Trumpcare, let the Twit-in-Chief claim all the credit for it, he will anyway. Who cares what nickname the system carries, as long as we don’t throw tens of millions of struggling families to the wolves. Who knows, if we let Drumpf and the GOP hog the credit, some of those red state governors who’ve refused to accept federally-funded expansion of Medicaid out of spite might start allowing their less-fortunate constituents to have the same benefits enjoyed by their blue-state brothers and sisters. Millions more could get health insurance coverage just by giving the GOP back their own plan.
Really, what’s in a name? The ACA by any other name would smell as . . . well, smelly.