Republicans aren’t serious about healthcare reform

By Rich Moniak

During an interview with Nathanial Hertz of the Northern Journal last January, Sen. Lisa Murkowski predicted “there would be real pressure coming on this administration and the Congress” to extend the enhanced tax credits of the Affordable Care Act (Obamacare). Republicans didn’t listen. 

Now, faced with the backlash of rising insurance premiums caused by letting the credits expire at the end of the year, Sen. Dan Sullivan wants us to believe he’s “working very diligently on reforms and extensions.”

So is Sen. Rick Scott (R-Fla). And Sen. Bill Cassidy (R-La.). According to Speaker Mike Johnson (R-La.), House Republicans “have many ideas and proposals that go to the root causes of the dramatic rise in healthcare.”

But without giving us clues as to what’s in their plans, they turn to the script they’ve used for 15 years to convince Americans to hate Obamacare as much as they do. 

And as Murkowski emphasized, they also “hated the American Rescue Plan.” And “hate, hate, hate the Inflation Reduction Act.” Those are the two bills signed by President Joe Biden in 2021 that created the enhanced tax credits that are set to expire. 

Between 2010 and 2017, the Republican-controlled House attempted to repeal parts or all of Obamacare more than 60 times.  

Republican governors in 28 states challenged the law’s individual mandate in court. In a legal analysis prepared when he was Alaska’s Attorney General, Sullivan made the far-fetched argument that if the courts ruled it was constitutional, Congress may be empowered “to require all Americans to purchase a federally-approved gym membership.”  

As a candidate for the presidency, Donald Trump joined the unserious Republican chorus. 

In March 2016, he posted a seven-point plan to replace Obamacare on his campaign website. And just before the election he promised it would be done “very quickly.”  

But in a meeting with the nation’s governors a month after taking office, he confessed it wasn’t so simple. “I have to tell you, it’s an unbelievably complex subject,” he said. “Nobody knew that health care could be so complicated.”

During the next few months, Republican majorities in the House and Senate prepared and debated four other healthcare bills, none of which would have fully repealed Obamacare or replaced any of the provisions that would have been repealed. 

In other words, they spent seven years complaining, but put no serious effort into crafting new legislation.

They did manage to eliminate the individual mandate as part of the Tax Cuts and Jobs Act they passed in December 2017. It resulted in reducing the cost of government subsidies. But because fewer people purchased individual coverage, insurance premiums rose for those who did.

That’s the same effect the expiring tax credits will have. Only it’ll be worse because many more people are expected to opt out.  

Murkowski wasn’t the only Republican who saw this coming. But the rest seemed to believe Americans wouldn’t notice. Otherwise, they would have spent a good part of the past 11 months working on legislation to reform the system.  

Trump is in a class of his own though. 

“I have concepts of a plan,” he said when asked about healthcare during last September’s presidential debate. “I would only change it if we come up with something better and less expensive. And there are concepts and options we have to do that. And you'll be hearing about it in the not-too-distant future.”

It’s been more than a year and instead of a plan, he now says he’ll only support sending money “directly back to the people” so they can negotiate with big insurance companies to “buy their own, much better insurance.”

Trump approaches every problem like it’s the 10-minute cognitive test he frequently brags about passing with a perfect score. He was going to bring consumer prices down and end the war in Ukraine on Day 1. Tariffs wouldn’t be inflationary, but they bring manufacturing jobs back to America and miraculously end deficit spending at the same time. This month, he proposed making homes more affordable by letting banks offer 50-year mortgages. 

But if you wonder how Republicans wound up with a simple-minded celebrity leading their party, it may be because they’ve devoted more time to hating legislation enacted by Democrats than making a serious effort to address the problems confronting the people they were elected to serve. 

• Rich Moniak is a Juneau resident and retired civil engineer with more than 25 years of experience working in the public sector.