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Horowitz: On Obamacare - Trump Given Another Opportunity to Miss an Opportunity

Tuesday, December 18, 2018


The great Israelis diplomat Abba Eban, who served as Foreign Minister among other posts, during the decisive series of Arab-Israeli wars, famously said, “The Arabs never miss an opportunity to miss an opportunity.”

That phrase perfectly describes President Trump and the Congressional Republicans’ approach to Obamacare--where they have failed to seize countless opportunities to advance bi-partisan fixes that would have been politically popular. Instead, they have mounted countless fruitless attempts to repeal the now popular law or kill it through bureaucratic maneuvers, despite the fact that they have never offered a credible replacement.

Well, Judge Reed O’Connor’s ruling this past Friday that the law is unconstitutional provides one more opportunity for the Republicans to make a course correction. While the law will stay in place during the appeals process and there is a consensus among legal experts that the federal district court judge's decision, based on thin legal logic, is unlikely to stand, it does provide more impetus for bi-partisan improvements that also address any lingering constitutional vulnerability.

President Trump and the Congressional Republicans should especially feel the need to act, since this ill-advised ruling is a result of legal actions brought by Republican State Attorney Generals, aided by the White House’s decision not to defend the existing law in Court. Even before this ruling, Republican Congressional candidates paid dearly for this legal action to do away with Obamacare, including protections for people with pre-conditions. because it was continually cited by Democratic candidates, adding fuel to their highly successful health care argument, which was a major factor in a pickup of 40 seats in the mid-term elections--the most since Watergate.  Health care was the most important issue to mid-term voters and the overwhelming majority of voters who believed it was the most important issue voted for the Democratic candidate for Congress, according to the Exit Polls.

A majority of Americans now approve of Obamacare, because they recognize it is by and large working, providing health insurance for millions of Americans who before the law went without it and ensuring that people with medical pre-conditions can be insured, among other significant patient protections. Voters in Idaho, Nebraska, and Utah--red states all--decisively approved the expansion of Medicaid under Obamacare in the November mid-term elections.  But as with all large-scale reforms, the Affordable Care Act is far from perfect and would benefit from policy tweaks. A package of incremental substantive changes that includes some ideas preferred by Republicans, such as the ability to sell health insurance across state lines and incentives for small businesses to band together in purchasing pools that create economies of scale, would be both substantively and politically smart.

Let’s see if President Trump and/or Congressional Republicans seize the moment and work out a principled bi-partisan compromise or continue to "never miss an opportunity to miss an opportunity."  I am hoping for the former, but unfortunately, expecting the latter.

Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.


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