View: A Republican president would keep Obamacare

Other than hard-core partisan Republicans, no one would blame Obama if her insurance disappeared under President Scott Walker and a Republican Congress. Indeed, the dynamic would flip: Republicans would suddenly be blamed for every health-care policy problem, whether it was caused by repeal or not.

Even a successful replacement plan wouldn’t shield Republicans from blame — all legislation requires trade-offs, and most of the time the losers care more than the winners. But passing a successful replacement for Obamacare would be extraordinarily difficult.

Drum himself is an excellent example of the problem. A highly informed and liberal blogger, he’s unusually aware of how government policies affect his health care, so that’s atypical. But as a middle-class professional, he’s exactly the kind of citizen who votes reliably and sometimes engages more directly in politics. In sum, he’s the type of person elected officials prefer not to upset.

The crass truth: Cuts to Medicaid or other programs are resisted in large part because many middle-class and wealthier voters don’t want to hurt the poor. Their compassion is powerful enough to keep those programs going. But compassion can’t compare with their naked self-interest, which would be on the line in any Obamacare repeal.

See also: Republicans propose group health exclusion cap

I’d say there’s a 5 percent chance or so that Republicans —if they have the votes in 2017 — would just repeal Obamacare. Repeal and replace also has about a 5 percent shot. Much more likely would be relatively small, targeted cuts to benefits for the poorest, coupled with repeal of the tax increases that fund those benefits. And the most likely outcome? A total fudge. Either Republicans would “repeal” the Affordable Care Act (ACA) but keep it up and running until a genuine Republican replacement was finally ready, or they would “repeal” it and replace it with a virtual copy, albeit one blessed by a liberal (sorry) sprinkling of “liberty” and “free enterprise” and “Ronald Reagan” throughout the text.

In other words, under Republican government there’s a good chance that health-care subsidies would become less generous, Medicaid would grow more stingy and the fiscal situation would deteriorate badly. But repeal? Only if Republican politicians are even more trapped in their information bubble than I suspect.