Repeal and Replace, Remix, Repeat

Photo by The White House from Washington, DC, Public domain, via Wikimedia Commons

Rarely these days, as the Republican presidential primary hurtles towards the American electorate, can Ron DeSantis and Donald Trump be found singing off the same song sheet, but there is at least one golden oldie from the GOP songbook they recently harmonized on. Floundering in the polls and with his affiliated PAC having chaos and turnover, Florida Governor Ron DeSantis reached into Ye Olde Bag of Republican Talking Points and busted out…repeal and replace.

Seriously. And he wasn’t the only one.

NY Times:

Gov. Ron DeSantis of Florida said on Sunday that, if elected president, he would pursue legislation that would “supersede” the Affordable Care Act, echoing former President Donald J. Trump’s comments, which Democrats seized upon last week.

“What I think they’re going to need to do is have a plan that will supersede Obamacare, that will lower prices for people so that they can afford health care, while also making sure that people with pre-existing conditions are protected,” Mr. DeSantis said on NBC’s “Meet the Press.” He went on to say that repealing and replacing the Affordable Care Act was a broken promise from Mr. Trump’s 2016 campaign.

“We’re going to look at the big institutions that are causing prices to be high — big pharma, big insurance and big government — but it’s going to need to be where you have a reform package that’s going to be put in place,” he said. “Obamacare promised lower premiums. It didn’t deliver that,” he added. “We know we need to go in a different direction, but it’s going to be done by having a plan that’s going to be able to supersede it.”

Mr. Trump called for the same thing last week, writing on his social media platform that he was “seriously looking at alternatives” to the Affordable Care Act. After President Biden’s campaign denounced the statement, Mr. Trump wrote: “I don’t want to terminate Obamacare, I want to REPLACE IT with MUCH BETTER HEALTHCARE. Obamacare Sucks!!!”

Except they don’t, can’t, won’t, and would never get the opportunity anyway.

When Republicans had majorities in congress and one of their own in the White House, they didn’t even try to do anything with the ACA/Obamacare. While in the fundraising and rhetoric “repeal and replace” was a big buzzword pulling big dollars into the cause and firing up the base, there was zero discernable action to actually do so. Meanwhile in the last decade, the ACA has never been more popular, and even if Republicans somehow got a trifecta and majorities enough to do so, politically the will to go after something pushing 60% approval is a steep hill to climb for congress critters.

So why are DeSantis and Trump bringing it up?

Some of it is habit, some of it is trying to find some traction in a news cycle that is bored to death with the current blowout Trump is putting together with only 40-odd days until the Hawkeye Cauci voting stars, and some of it is that someone told them this would be a great thing to talk about. But mostly, ACA/Obamacare is very unpopular with the voting base of the GOP primaries, and unpopular things are good things for candidates who want to open checkbooks and get responses from a saturated and worn-out primary voter populace.

A KFF poll in May found that 59 percent of Americans supported the A.C.A. Mr. DeSantis and Mr. Trump’s calls to replace it could play well in the Republican primary — only 26 percent of Republicans support the health law, according to the poll — but could become a liability in the general election because 89 percent of Democrats and 62 percent of independents support the health law.

That second part is why any and all versions of “repeal and replace” are, have been, and always will be nonsense smokescreens. Astute observers understood during the run-up to the ACA passage that once implemented, it was never going to go away, only expand, since once folks were used to it Obamacare would become another untouchable program that folks who vote come to depend on, flaws and all. Once the Supreme Court blessed it, that was essentially that. With 41 states having adopted the Medicaid expansion of ACA and the other 10 all in some kind of process/fight over doing so, growth is not only now becoming the status quo, but a widely voted upon status quo.

Florida, currently headed by Governor Ron DeSantis, is one of the states that has fended off Medicaid expansion thus far. To be fair to DeSantis, he is being consistent here; as a congressman he did vote on several healthcare measures aimed at the ACA, including the non-binding “budget resolution to begin the process of repealing the ACA” in 2017. His position is — at least on paper — stronger than Donald Trump’s, who had majorities in the US House and Senate when he became president and proceeded to do precious little legislatively with that advantage, let alone major healthcare reform. Nevertheless, the American people have heard for over a decade now various versions, covers, remixes, and revivals of the same song of ACA repeal and replace promising such if just enough Team Red members get elected in this upcoming most important election of our lifetime coming in (fill in the blank for the year here.)

Guess how that is working out.

Playing well to a base or not, the “repeal and replace” rhetoric was an empty lie ten years ago and is a more blatant, hollow promise now. It isn’t happening. And someone who was there the first time like Ron DeSantis especially knows it isn’t happening. But it is something that has to be said to get the nomination of the party of Lincoln these days. One item on a long list of things that “have to be said” even though the speaker of said thing knows well and good it isn’t going to happen.

In a normal, functional world with a functional press, such proffers would be immediately met with questions about how that would be done with a split House and Senate, against public opinion, and with various other more pressing issues going to take up the very limited window of legislative opportunity when a new congress comes in. But we don’t live in that world. We live in the world where “repeal and replace” will probably live on forever in the GOP lexicon while the actual ACA lives on forever as a government program that will do what most government programs do, especially popular ones: grow, expand, evolve.

Accept it, recognize the rhapsodic rhetoric of repetitious rubbish, hit skip, and adjust accordingly.