Landmines Abound for Republicans in Obamacare Replacement

 

© 2017 Steve Feinstein. All rights reserved.

Now that Republicans control of both houses of Congress as well as the presidency, the process of Obamacare repeal and replacement has begun in earnest. Once the ACA is formally, officially repealed, the Republicans will “own” the healthcare issue and the pressure will be on for them to deliver something better than Obamacare.

As the alternatives for a new Act fly back and forth, the obvious trap for Republicans is crafting a piece of health legislation that is actually better, not merely different. Wider coverage, easier access, more provider choices, lower costs, more provider accountability, less wasted mandated coverage (no maternity coverage for post-menopausal women, for example), no religious/moral/Government mandate conflicts, etc.

The list of must-have items for a successful replacement plan is long. Crafting a plan that satisfies all those requirements is a monumental task and will likely take several iterations past this initial effort.

However, regardless of the details of the actual replacement plan, gaining widespread public acceptance and overcoming structural anti-Republican bias is going to be at least as big a challenge as crafting the legislation itself.

There are three essential public relations issues with the Republican alternative to Obamacare that are problematic, any one of which by itself could spell doom in terms of widespread public acceptance. All three together mean disaster.

  1. Obamacare is President Obama’s “signature domestic achievement” as they call it. It’s his crowning glory. Supporters claim it comes closer to providing universal health care than anything that has come before. it’s President Obama’s achievement. He personally gets the credit for it. His supporters and cheerleaders love this, and do not want his so-called legacy jeopardized by having it dismantled. To repeal it will leave millions without medical coverage in the immediate short term, and because of the potential administrative and logistical time lag before a replacement plan is in place, millions may fall through the cracks and be left without any workable, affordable coverage whatsoever. Republicans must deal with this quickly and effectively.
  1. The liberal mainstream media is virulently anti-Republican/anti-Trump and is loathe to run stories that cast either the President or Republicans in a good light. These media outlets include not only the traditional liberal media like the broadcast networks, major papers like the NY Times, Washington Post and Boston Globe, cable news like CNN, MSNBC, but also social media sources like Zuckerberg’s Facebook, which has been exposed for downplaying conservative stories, and the supposedly “neutral” Internet resources like Snopes, a “fact-finding” site which has been caught multiple times putting forth a liberally-sympathetic version of the facts and being very slow to change when the conservative-favoring side of the story proves to be true. Any proposed Republican alternative to Obamacare, regardless of its actual merits, will be dismissed by the liberal mainstream media as unacceptable, in order to preserve their pro-Obama narrative.

The liberal media is always going to highlight and key in on any aspect of a new Republican plan that they deem inferior to the existing ACA, while ignoring any benefits or advantages. We’re already seeing headlines like, “Why Republicans’ health-care plans are bad deals for Americans” (Washington Post 3/9), “GOP health-care bill would drop addiction treatment” (Washington Post 3/10), “Doctors, hospitals rip health plan” (Providence Journal, 3/10).

Liberal media headlines like these are as predictable as a Brady win in the playoffs.

  1. The Republicans always seem focus on tax credits as a way to help pay for healthcare insurance. In order to receive tax credits, an individual or family must earn enough money such that offsetting the tax they owe is a relevant and attractive proposition. In the Hartford Courant on 3/10, they reported, “CT Lt. Governor Nancy Wyman (D) criticized the tax credits proposed by House Republicans to subsidize health care as useless to Connecticut’s poorest residents. ‘If you don’t pay taxes, what do you get a credit for?’ she asked.”

The underlying, undeniable-but-rarely-admitted liberal position is that Obamacare—which is essentially just affordable insurance that the Government will largely pay for if the party can’t afford to pay for it on their own—is a partway measure at best. What the Democrats really want to do is to find a way to flat-out give healthcare away to everyone, regardless of their tax status or income. Democrats want single-payer (Government-run) healthcare, not the private system involving for-profit insurance companies that we have now.

Any of these three—a threat to Obama’s legacy, relentlessly inaccurate, biased reporting by the liberal mainstream media or the perception that the Republicans are against the poor because their favored tax credit-based approach assumes employment and sufficient earnings—give Democratic lawmakers more than enough ammunition for high-profile public grandstanding.

How do Republicans avoid their usual PR disaster?

First, the final version must be a good bill, a legitimate improvement over the existing ACA. This submission is the first step, but it won’t be the final bill.

Then, the Republicans need to learn a lesson that they seem incapable of learning: They need to understand that the merits of the issue do not carry the day in the court of public opinion. It’s the 10-second soundbite that wins the attention of the casually-attentive swing voter. Democrats are very good at that—“Tax cuts for the rich,” “Bush lied, people died,” “Big pharmaceutical companies are ripping you off,” etc.—especially since the liberal media never hold the Democrats to account for the veracity of their statements. Republicans have the challenge of not only crafting a 10-second soundbite that distils the complex essentials down into an easily-memorable clip, but they also have to be accurate and truthful, because the liberal media will not let them get away with the same fuzzy math that they let slide for the Democrats. Tall order, but it’s about time Republicans learned how to play this game.

Third, they must be unified. They need to avoid the destructive public infighting that gives the liberal media the opportunity to say, “See? Even the Republicans don’t like it.” When Rand Paul declares that the House version is “Dead on arrival” in the Senate, he plays right into the Democrats’ hands and the liberal media pounces right on cue. The Democrats are much better at standing unified on legislative issues than the Republicans are, and this works against the Republicans’ PR interests.

Fourth, strike first and strike often. Set the tone and terms of the public healthcare discussion. Be proactive in speaking about why the new bill is a huge improvement, point out the current ACA’s shortcomings and failures again and again and keep the pressure on the Democrats about that. Make the Democrats respond to you, not the other way around. They are already behind the curve on this, but they can reverse that with something as basic as calling a press conference—today!!—and outlining their plan’s advantages. Then, all of a sudden, the Democrats will be forced to play, “But wait….” catch up.

The actual ACA replacement bill is an interesting proposition, but even more fascinating to veteran political observers will be watching how the Republicans present and defend the progress of their bill, and how they deal with the inevitable negative reaction of the liberal media.

 

 

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