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The Trump administration and Republicans in Congress find themselves in a position they never wanted to be in: heading into the August recess having failed to repeal and replace the Affordable Care Act (ACA), and also without any significant legislative accomplishments since the November 2016 election.
Before charting a new course, the GOP needs to understand how they drove themselves into this political ditch.
The Initial Embrace of the Doomed “Repeal and Delay” Strategy.
In the weeks after the November 2016 election, elated Republicans planned a quick strike “repeal and delay” bill for the ACA. The idea was to follow the script the party used in 2015 to put a repeal-only bill on President Obama’s desk. With “repeal and delay,” the party could avoid the difficult internal discussions on how to reform health care and just focus on gutting the ACA, with delayed effective dates to allow time for the Congress to come up with a replacement plan later. This strategy was never going to work, but many conservatives argued that it should because of the successful test run of 2015 (a bill was sent to President Obama, who vetoed it). Conservatives made the case for months that a House or Senate member who voted for this approach in 2015 should do so again in 2017. But that is a disingenuous argument. It was obvious in 2015 that the repeal and delay bill was never going to become law, and so it was a way for the GOP to voice dissatisfaction with the ACA without having to replace its key provisions. It was clear then to anyone who paid attention that any repeal bill would have to include replacement provisions to have any chance of success because a repeal-only bill would instantly create a massive disruption in the marketplace for many millions of consumers. Still, some in the GOP who should know better convinced themselves that a repeal-only bill could work. The party wasted the first few precious months after the election on this doomed scheme.