Republicans Try Splitting The Obamacare Baby

The latest example:

Ohio Gov. John Kasich (R) raised some eyebrows on Monday when the Associated Press reported that he said Obamacare repeal wasn’t going to happen and opposition to the law was purely political. It was practically heresy for a Republican — which probably explains why Kasich was quickly walking the comments back just a few hours after the report.

He started by saying the AP had misquoted him, but then his defense became truly puzzling. Kasich said he was talking about Medicaid expansion, which his state has implemented at his urging, not Obamacare — and he doesn’t see the two as related.

But Beutler welcomes Kasich’s remarks:

Liberals are predictably reveling in Kasich’s contradictionthe Medicaid expansion was a huge piece of the Affordable Care Act’s overall coverage schemeand in the contortions he’s had to undergo to assure conservatives that his Obamacare apostasy extends only so far. But I don’t actually see much of a contradiction here. And more to the point, millions of poor Americans would be much better off if more Republicans adopted Kasich’s position that states should adopt the ACA’s Medicaid expansion while tilting at windmills to topple its private sector program. …

[I]f it became the GOP consensus, approximately five million poor people would be lifted out of the coverage gap and become insured almost immediately. The political fight over Obamacare would settle around the private sector coverage expansion, where there’s more room for horse trading, experimentation, and improvement. The potential damage a Republican president could do to the end of universal coverage would be greatly diminished.

David Graham examines Kasich’s predicament:

Even if Obamacare is irreversible, it’s not politically tenable to say such a thing in today’s Republican Party. Even if it’s not clear that Kasich’s hasty walkback makes a lot of sense as policy, it does seem—as Philip Klein notes—like another indication that Kasich would like to run for president in 2016. If he does, he’ll continue to be caught in a vise by Obamacare. Candidate Kasich would wish to appeal to Democrats and moderates by pointing out that he successfully governed in a purple state and expanded healthcare for needy citizens; maybe comments like this could even position him as a bold truthteller, conservative but coldly realistic. Yet he’d also want to appeal to Republican primary voters who abhor the Affordable Care Act. Those are two hard masters to serve.

Douthat thinks “the controversy around Kasich’s comments are a useful reminder that not only is there no Republican consensus on how to actually replace the health care law, but almost no G.O.P. Senate candidates are actually campaigning on a politically credible replacement plan”:

The one major exception is Ed Gillespie, running against Mark Warner in Virginia, whose plan Ramesh Ponnuru has commented on and defended here and here. … But Gillespie is also, per current polling, unlikely to join a Republican Senate majority next year, whereas many G.O.P. candidates — the potential Majority Leader included — who have hemmed and hawed or talked in anti-Obamacare boilerplate and vague generalities when asked about health care policy are more likely to pull their races out. Which will be seen by some, no doubt, as vindicating the risk-averse, somewhat cynical approach to health policy that Republicans have taken throughout the health care debate …

… except, of course, that in this cycle that debate is happening against the backdrop of a political map that heavily favors the G.O.P., whereas in 2016 (as in 2012) the map will be different, tougher, and the health care law (while no doubt still unpopular overall) will be more locked-in, more a part of people’s ordinary experience, and the promise of full repeal will look even sketchier than it does now. At which point a Republican Party that wants to be competitive nationally will start to feel a lot of pressure (probably not quite enough to counteract the influence of the primary electorate, but we’ll see) to drift toward something like Kasich’s (quite popular, in a purple state) position, which basically amounts to “if you like the single-payer part of Obamacare, you can keep the single-payer part of Obamacare, and let’s talk about the other stuff later.”

Suderman makes related points:

This is why it was so important to have a replacement plan, some alternative, or even just an explanation, ready. The question of what to do and what to say after the coverage expansion kicked in was never answered, or at least not answered effectively, and the result is clear enough. We see some Republicans refusing to answer questions about Medicaid; we see Kasich claiming that Medicaid isn’t really part of Obamacare and should be saved; and we see Sen. Mitch McConnell (R-Ky.) arguing that Kentucky’s exchange, which doles out subsidies funded by Obamacare, is not really part of the law either. Republicans don’t know what to do, because they didn’t come up with a plan in advance.