Bernstein on Politics: Call Obamacare Fix Whatever You Want

I suppose if anyone is entitled to write about this, I am:

After months of hammering Republicans over their failure to repeal Obamacare, President Donald Trump huddled this week with moderate House Democrats and Republicans who were trying to sell him on a fix to the health care law.

Upon hearing it had bipartisan support, the president had one question: "Can I call it 'repeal and replace'?"

"You can call it whatever you want, Mr. President," a Democratic lawmaker told Trump, eliciting laughter throughout the room.

As I've said all year, and as far back as Barack Obama's first term, the best option all along for Republicans on health care may well be to just call "Obamacare" something else and call it a day — a "pretend and rename" strategy. The only thing foolish about Trump's question here was that it was a question at all. Democrats certainly should be willing to turn over authorship of the Affordable Care Act to Republicans in return for an end to efforts to repeal or undermine it.

As for Republicans, we've known since at least 2012, when the party chose to nominate for president the one Republican politician in the whole nation most closely associated with Obamacare-style reform, that most of them really don't care about the substance. Yes, there are a handful of sincere small-government Republicans who have a strong principled objection to government involvement in health care reform. And there's a much larger group of Republicans who don't care very much about any of the principles involved but do sincerely object to the way Obamacare does income redistribution. But almost everyone in that latter group would rather just pass regressive tax cuts than find a way to redesign the entire health care system.

The other reason "pretend and rename" is so appealing is that the nature of the Affordable Care Act is that much of it is essentially invisible to consumers, or at any rate not easily identified as "Obamacare." Medicaid expansion puts people into, well, Medicaid. And the exchanges put people into private — albeit for many subsidized — insurance plans. That's one reason that Obamacare hasn't been popular, but it also means that Republicans could falsely claim to have "repealed and replaced" it and most people wouldn't notice. Indeed, all of the Republican plans this year have retained various pieces of Obamacare, and so a certain amount of "pretend" was going to accompany "repeal" even with a real replacement.

So passing a bill to make Obamacare work better but calling it "repeal and replace"? Why not?

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