Back in 2016, Republicans in Congress passed a clean repeal of the Affordable Care Act. Obama quickly vetoed the legislation and Republicans lacked the votes to overturn it.

It was a cynical move. The Republicans who voted for the bill knew that it would be vetoed and that they wouldn’t have to suffer the consequences. According to the Congressional Budget Office, repeal would strip 32 million Americans of their insurance and cause premiums to double in ten years.

Now, though, Republicans might have to face the music. After the latest collapse of a repeal-and-replace bill in the Senate, Senate Majority Leader Mitch McConnell is calling on the Senate to vote on the same bill Obama vetoed. That puts GOP Senators in a difficult place. They either vote for the clean repeal and suffer the wrath of the people who will be hurt or they vote against it, angering their base and exposing the hypocrisy and cynicism of their earlier vote.

Republicans clearly overplayed their hand on repealing Obamacare. After seven years of telling Americans the new law would wreck the economy and leave insurance unaffordable, none of their doomsday predictions have come true. Instead, the law is more popular than ever. While premiums are still increasing, they’re going up far more slowly than before the Affordable Care Act. The number of people uninsured is at an all-time low. Even Republican governors are embracing the law’s Medicaid expansion.

Instead of repealing Obamacare, Republicans should fix it. They might anger their base but they also would show the American people that they know how to govern, something they’ve yet to prove. They desperately need some sort of legislative victory before the mid-term elections next year.

The whole episode is a reminder of the political precariousness of tackling health care. For two cycles last decade, reform of health care led Democrats to take control of both Houses of Congress and the presidency. While the 2006 wave election was as much about the incompetence of the Bush administration, weariness with the Iraq War and a host of scandals as anything, health care reform was central to the Democrats’ domestic agenda. In 2008, the Obama-Clinton primary focused on the details of how to overhaul the system.

Once Democrats had power, consensus on how to fix the system was far more difficult than party leaders anticipated. The drawn-out debate opened-up the sausage factory and people saw up close the unseemly legislative deals that make Congress work. Republicans had little to lose from bashing the process and all aspects of the bill. The years-long implementation process created extended uncertainty and kept Obamacare a political hot potato that fueled the GOP’s successes up and down the ballot.

Today, though, few of the worst fears of Obamacare have materialized. The market is stabilizing and many people are enjoying health care they’ve long been unable to afford. Few people want to go through another seven years of restructuring our health care system again. They’re tired and ready to move on.

Expanding access to health care has been a Democratic goal for decades. Under Obama, they got it done. It’s clear now that some form of the Affordable Care Act will guide our health care policy for the foreseeable future. We won’t go back to the days of a steadily increasing uninsured rate and dramatically increasing premiums.

The victory came at a steep political cost. Democrats lost election after election at all levels of government. Today, they need to revisit who they are. Their success in 2006 and 2008 reflected a broadly based consensus that our health care system was broken, particularly for working class Americans. Democrats championing health care showed they understood the concerns of their blue-collar base. They need to reconnect with that constituency again.

Republicans, for their part, should learn a lesson. Instead of trying to undo a signature Democratic accomplishment, they should focus on some their primary goals. With both Houses of Congress and the Presidency, they could reel-in the debt that they so abhor. They could reduce increases in spending on Social Security and Medicare instead of just talking about it. Like health care reform, making hard decisions about contentious legislation will probably come with a steep political cost, but it will also give them an accomplishment for the ages. Right now, they just look incompetent.

 

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