The spectacular failure by the Republican majority in Congress to repeal and replace Obamacare must have been baffling to many foreign observers. Our democratic system is fairly uncommon in the world, after all — we have a strong president, but one who is checked by an independent judiciary and legislative branch.

The much more common system is for the majority in the legislative branch to form the government, either through an outright majority or with the help of smaller parties to form a coalition.

Viewed through this lens, it should have been easy for Republicans to repeal Obamacare — they control all of government. Indeed, many conservatives across this country expected it to easily come together once the GOP had control, since that’s what leadership had been telling them for years. Instead, it all came crashing down practically overnight, and now we’re left scratching our heads, wondering why and what’s next.

To understand the latter, one must first understand the former. The attempt to repeal and replace failed because, although the Republican Party has full control of the federal government, it’s not really unified control. Rather than having a scattering of small parties to either ignore or bring into coalition, Congress has two big-tent parties that each have their own factions. These factions — whether it’s the conservative House Freedom Caucus or the moderate “Tuesday group” — essentially function as small political parties on their own. That allows them a great deal of sway over any one vote, especially given the slim margin of control the GOP has.

The problem is that, though Republicans have been campaigning on “repeal-and-replace” for years, there’s never been a unified vision in the party for what “replace” means. Rather than drafting a specific, comprehensive plan to rally the party behind ahead of the election, leadership left it up to individual members — and voters — to imagine what the replacement might be. This meant that everyone from Susan Collins to Rand Paul could come up with their own vision to replace Obamacare. This was a mistake by leadership.

It’s understandable why they’d want to use this strategy, of course: It’s hard for your opponents to criticize a plan that doesn’t exist. However, last week that vagueness finally caught up to Republicans, as they were unable to come up with something that even unified their own party, let alone attracted any Democratic votes. The question now is, where do Republicans go from here? Is it back to the drawing board to find a new comprehensive approach, or do they basically ditch the “repeal and replace” rhetoric and just try to fix the worst parts of the Affordable Care Act?


If Republicans decide to try with a new comprehensive approach, they will have to pick which factions to please rather than try to make the entire party happy. Logic would suggest that they focus on satisfying the moderate members who had specific objections to the plan, rather than trying to appeal to hardliners who will support nothing less than a full repeal. Their objections are likely to mirror concerns that many of their Democratic colleagues will share as the bill moves through the legislative process — at least, those Democrats willing to consider any changes to Obamacare at all.

As a starting point, leadership should take a look at the replacement plan recently offered by Susan Collins and Bill Cassidy, Republican of Louisiana. That legislation would, essentially, let states keep Obamacare, ditch it, or come with their own plan to expand coverage (with federal funding). It’s a compromise, and though many members of Congress might have rejected it out of hand a month ago, now it might have more appeal. Of course, getting it passed won’t be easy, nor will the final version of the plan please everyone — but it might please just enough people in both parties to work.

The other option is to ditch the “repeal-and-replace” strategy, giving up on efforts for comprehensive reform. This might be advantageous legislatively, as it would be easier to fix the worst parts of the Affordable Care Act in a bipartisan way. However, it would more difficult politically, as Republicans could be (rightly) accused of breaking a key promise.

Regardless, it ought to be clear to everyone now that simply repealing Obamacare isn’t going to work. It’s time to set aside the rhetoric and come together to find real solutions to our spiraling health care costs. That’s what Americans expect from their representatives. Hopefully, both parties are up to it.

Jim Fossel, a conservative activist from Gardiner, worked for Sen. Susan Collins. He can be contacted at: [email protected]

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