Last week the 115th Congress began it’s business. The Republican wishlist is audaciously dark, promising the “the most ambitious conservative policy agenda since the 1920s.” There should be no section of public interest left untouched by a party that has become much more ideologically entrenched in the decade since they last controlled this much of the federal government. Whether by intention or unavoidable subtext, their targets—people of color, the bottom 90 percent of the income distribution, immigrants, woman, children, workers, the elderly, the sick, etc—have been well-established by years of warped resentment. Their goal is to fundamentally reshape the state to overwhelmingly benefit the needs of those with the most. In so many ways this year will represent the beginning of an end.
Yet it remains to be seen exactly how much of this will come to pass. Too much, to be sure, but even with the rare unilateral power the Republicans find themselves holding they will rediscover that such governance is difficult. After a head-scratching initial push to weaken congressional ethics oversight, though, a priority in which President-elect Trump questioned, no part of their agenda appears more pressing than that of repealing Obamacare. Details, like a timeline or what will replace it, are unsurprisingly scarce. But for all the uncertainty surrounding how it will change this week saw the first moves towards making their years-long desire a reality. The Affordable Care Act, what was supposed to be President Obama’s legacy accomplishment, will cease to exist as we know it right now.
The question will be how drastically our national health care system will change. There’s some not-insubstantial disagreement within the Republican party over how to precede. Repealing the ACA now and replacing it some time later seems the most desirable move for them now, but that’s getting pushback from some party members and various institutional actors precisely because they do not have a consensus replacement.
The Democrats appropriated their long-time advocacy of markets in everything (which still persists in their ideas to privatize veterans healthcare and voucherize Medicare) for a less-than-ideal result. It didn’t go far enough to cushion middle-income families from the type of increasingly burdensome cost-sharing that mirrors trends in employment-provided health insurance. Folks really are struggling with having too much ‘skin-in-the-game,’ but Republicans are actually big fans of this so they’re left with proposing even crappier versions that would make this reality much worse. It may be humorous to some that those upset with the types of plans offered in the ACA marketplaces thought Trump would make it better are in for a rude awakening, but they don’t deserve it. No one does.
The tension between finally cashing in on the political kudos of repeal but no longer being protected from the subsequent consequences by an opposing executive branch will throw the GOP into the unfamiliar territory of actively grappling with systemic health care reform. This is the real deal and I don’t think they’re prepared for it, which makes it an ideal time to hammer them with the inconsistency between their desires and popular discontent.
Bernie Sanders seems to understand this—the rest of the Democratic leadership does not. The cynic in me thinks they’d be totally okay with some convoluted mess emanating from the sewer as long as they were confidant a lame dad joke slogan could be derived from the result. Share a chuckle or two for that dangerous cluelessness too. Hopefully they’ll come around to the larger project of organizing pressure when and where it can be most effective. Right now Republicans are their own worst enemy, and with a concentrated push from the opposition we may all be the better for it.