(Bloomberg) — Some Republicans in Congress are starting to talk more about trying to “repair” Obamacare, rather than simply calling for “repeal and replace.”
There’s good reason for that.
The repair language was discussed by Republicans during their closed-door policy retreat in Philadelphia last week as a better way to brand their strategy. Some of that discussion flowed from views that Republicans may not be headed toward a total replacement, said one conservative House lawmaker who didn’t want to be identified.
Using the word repair “captures exactly what the large majority of the American people want,” said Frank Luntz, a prominent Republican consultant and pollster who addressed GOP lawmakers at their retreat.
“The public is particularly hostile about skyrocketing costs, and they demand immediate change,” Luntz said in an e-mail response to questions. “Repair is a less partisan but no less action-oriented phrase that Americans overwhelmingly embrace.”
Republicans are grappling with their party’s desire — and President Donald Trump’s promise — to dismantle Obamacare, as well as the political disaster that could ensue if millions of Americans lose coverage as a result of legislation.
One question is what exactly the term “Obamacare” includes. Some Republican repeal proposals have called for repealing all of the Affordable Care Act package, including all of the Patient Protection and Affordable Care Act of 2010, and the health-related parts of PPACA’s companion law, the Health Care and Education Reconciliation Act of 2010. But many lawmakers and members of the public seem to use the term to refer only to the ACA public exchange plan system, the ACA commercial health insurance rules and the ACA Medicaid expansion program.
A Jan. 6 Kaiser Family Foundation poll found that 75 percent of Americans either are opposed to Congress repealing Obamacare or want lawmakers to wait until they have a replacement ready before repealing it. While Trump has promised a plan of his own, Republicans have yet to coalesce around any of the plans that have been floated in recent years to end Obamacare while maintaining a stable insurance market.
‘Repair the damage’
“Our goal is to repair the damage caused by Obamacare where we find damage,” Senate Health, Education, Labor and Pensions Chairman Lamar Alexander, a Tennessee Republican, said at the start of a hearing he held Wednesday on the individual insurance market.
Sen. Susan Collins, a Maine Republican, echoed Alexander during the hearing: “Regardless of who was elected president, we were going to have to do major repairs on the Affordable Care Act.”
While Trump ran on the promise he would repeal Obamacare, he appears to have softened his view a bit after the election. Lately, he has pivoted to pledging insurance for everyone.
House Speaker Paul Ryan, a Wisconsin Republican, has also tried out “repair.”
“We’ve been working with the administration on a daily basis to map out and plan a very bold and aggressive agenda to make good on our campaign promises and to fix these problems — to repeal and replace and repair our broken health care system,” Ryan said at a news conference during the Philadelphia retreat.
Ryan was asked about the “repair” strategy Thursday on Fox & Friends and said there was a “miscommunication.”
“So what kind of got going on here is, I’ve got a confluence of words,” Ryan said during the television interview. “To repair the American health care system, you have to repeal and replace this law, and that’s what we’re doing.”
Some members saw this shift coming, including House Rules Chairman Pete Sessions of Texas, who has proposed his own Obamacare “fix.”
“I’ve been saying this for a long time,” Sessions said. While some of his Republican colleagues continue to say that Obamacare needs to be torn out from its roots, Sessions protests, “Not from me, you’ve never heard that.”
Sessions says he believes “fix” or “repair” would be the right words, especially if the plan doesn’t fully repeal Obamacare and some of the same funding resources and other parts of health care are kept. Of his own bill, Sessions said, “We actually affixed a plan to where we kept Obamacare, and used the resources that are there and gave people an option,” including whether to keep the Obamacare coverage they have now.
Certainly, not all Republicans are following the recommendation on using “repair.” The House member who asked not to be identified said it was offered as advice, not a directive, and he isn’t using it.
Conservatives have voiced frustrations about the slow pace of repeal, aiming to get rid of the law as soon as possible and figure out a replacement later, if at all.
“I’m out there saying repeal and no replace — that’s as pretty strong as it gets,” Rep. Roger Williams, a Texas Republican, said in an interview. He said he believes things should “just go back the way they were” before Obamacare.
Repeal isn’t off the table for lawmakers embracing repair either. They just want to fix the parts they can first.
“You have to know what you’re going to replace it with, before you have an effective repeal,” Alexander said at the end of his committee’s hearing on the individual insurance market.
“We’re more interested in the future and identifying what needs to be done to give people more affordable choices of insurance,” he added. “No one’s talking about repealing anything until there is a concrete practical alternative to offer Americans in its place.”
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