In the past six years, Republican congresses voted more than 60 times to repeal Obamacare. And repeal of Obamacare was the leading issue on the Republican side in both the 2014 and the 2016 congressional elections. The cliché of the month is that the Republican Party is like the dog who caught the bus and doesn’t know what to do with it. As one observer remarked, it may be even worse than this: the dog is now driving the bus.
Republicans have had six years to prepare an alternative to Obamacare, and they still don’t know what to do about health care. Asked about this issue, Sen. Bob Corker (R-Tenn) said that he has “no idea” when Republicans would start drafting an alternative to Obamacare and reported that “There’s not any real discussion taking place right now.”
The Republicans have a lot of tough policy issues to address. And as a recent Gallup survey shows, they also have a political problem that will make these challenges even harder.
As part of the promised replacement for Obamacare, Republicans led by Speaker Paul Ryan are determined to transform Medicaid into a block grant, strip it of most federal regulations, and send it to the states. Over a decade, this would result in a huge cut in overall Medicaid spending, forcing the states to reduce benefits and coverage.
But here’s the political problem: the states that Donald Trump carried in 2016 disproportionately benefitted from the expansion of Medicaid that was one of the building-blocks of Obamacare, and they will suffer disproportionately from Medicaid cuts.