Was the Fight Over Obamacare a GOP Scam All Along?

Please bear with me as I indulge in a flight of fancy, a reasoned rearrangement of existing facts into a theory that may or may not be provable.

I know, it sounds uncomfortably Republican, but hear me out. It’s not my intention to rewrite history, just to look at it from another angle. Which might just prove instructive.

I have always been puzzled by the failure of the GOP to kill the Affordable Care Act (ACA) — “Obamacare” — especially when they had their big chance in 2017.

They had a president (of sorts) who had repeatedly declared Obamacare “a total disaster.” They had a majority in both houses of Congress. They had the House pass a repeal bill — remember Paul Ryan toasting the tantalizing prospect of twenty million new uninsured? Repeal was just a Senate vote away.

Senate Republicans, meanwhile, had designed — using the budget “reconciliation” tactic we now know so well — a filibuster-proof bill, and they’d told the world they were on a mission to “repeal and replace” Obamacare.

History now records that Susan Collins and Lisa Murkowski bravely stuck to their principles and voted against repeal, but they were still one vote shy. Then, at the last minute, John McCain rode in on his white horse and single-handedly saved the day.

But was this the real history? What if that final vote — which seemed overly dramatic even then — was intended to fail? What if Mitch McConnell first indulged Collins and Murkowski, then gave McCain — who was known to be gravely ill — an opportunity to go out in a blaze of glory.

Knowing what I now know about all these characters, this feels totally plausible. Because the one thing all the repeal efforts had in common was that every single one failed. Despite overwhelming chances of success. Think about that.

Who among us thinks either Collins or Murkowski could have withstood real pressure from McConnell, had he really wanted to lean on them? Yes, they were facing political heat at home over the ACA, and that could explain their public position at the time. But compared to the heat McConnell could’ve brought down on them, that was nothing. Was Mitch giving them a pass? Was he strategically tolerating their opposition?

Consider that the heat was at least as intense later on, in the Kavanaugh nomination, when Collins went the opposite way, grovelling in such embarrassingly public fashion. Was that Mitch calling in a favor? Was that Collins saying thank you for letting her vote to keep Obamacare?

My theory is that McConnell wanted that repeal bill to fail, and that he designated — or at least permitted — Murkowski and Collins to vote against it. To that end, he still needed one more vote, and McCain was the perfect choice. McCain had nothing to lose and everything to gain by taking that “brave and non-partisan” stance. He got to secure his fading reputation both as a maverick and a hero. And McConnell got to keep Obamacare in place.

So why would Mitch want that?

That’s easy. The ACA, once it was implemented, posed a huge threat to the GOP. Republicans had famously removed themselves from the entire healthcare debate, and the ACA rollout — shaky as it was — was showing millions of people what real health insurance could mean to their lives.

By the time Obama left office, the ACA had steadily gained in popularity — nobody who has health insurance ever wants to be without it again. It was literally a life-or-death issue, and this put the GOP in a bind. How could they invest huge political capital in a repeal nobody wanted, and which could backfire catastrophically on their caucus?

When Trump took over, the “repeal and replace” plan was at least theoretically possible. But while the “repeal” part would be easy, the “replace” part was always a non-starter. It would require serious work from people who were neither serious enough nor smart enough to pull it off.

The work that had gone into the creation of Obamacare has been vastly underappreciated, lost as it was in the political miasma that has shrouded its entire history. But it was a massive effort from a multidisciplinary army of dedicated, intellectually rigorous technocrats — professionals all. And as if their job weren’t daunting enough, they had to perform it with the thousand-pound gorilla of Republican obstruction draped all over them. Because of that obstruction, the finished ACA was far more complex and clunky than it needed to be, a kludgy mash-up of public and private initiatives that we’ll be tinkering with for decades.

But it created a dilemma for Republicans. While they had no wish to design a national healthcare system from scratch, they could never admit to the success of anything a Democrat had accomplished, let alone a Black one.

So they came up with this scam. They’d get the whole party to trash Obamacare everywhere they could. They’d miss no opportunity to excoriate it as socialism or pedophilia, or whatever the dog whistle du jour was. And they could do it until the end of time.

The one — and only one — thing they must never, ever do to Obamacare is get rid of it.

It was brilliant, in a depraved way. It solved the “replace” problem. Their constituents got to keep their health insurance. The party got to insist that Obamacare is an ongoing disaster. And they got to blame that disaster on Democrats.

This could explain, I think, all the failures that, in retrospect, seem calculated. Think of all those crazed repeal votes they forced Obama to veto, secure in the knowledge that he would. Think of all those lawsuits that were so legally flimsy the Supreme Court had no choice but to toss them.

And this is not a new tactic for them. We’ve all marvelled at how Republican congressmen voted against the Biden rescue package, then had the gall to go home to their districts and brazenly take credit for it.

But they’ve also been playing a similar game with abortion for half a century. As long as Roe v. Wade remains in place, they have cover to be as loud and obnoxious on the subject as their red-meat voters want, knowing it costs them nothing politically. But if Roe goes, so does that cover — they’d have to talk about abortion to their voters, three-quarters of whom favor robust reproductive rights. Roe remains the GOP’s best friend, and they’ll sorely miss it when it’s gone.

So is it such a stretch to think they went to such great lengths to preserve Obamacare, even as they equated it with the end of civilization? To be sure, it might not have happened this way, but do any of us doubt that it could have?

It’s certainly not beneath the dignity of Republicans. Few things are.