Repeal and Replace – Words Matter

So Republicans are struggling again to repeal and replace Obamacare. They’ve been promising this for years, yet even with Republican control of the presidency, the House, and the Senate, they can’t seem to follow through. Conservative Republicans feel the new bill is too similar to Obamacare. Moderate Republicans are concerned that their constituents who rely on Obamacare’s provisions will suffer. Democrats are demanding that Obamacare be improved, rather than repealed and replaced.

Let me make a suggestion. As the first order of business, let’s just change the name. Let’s not call it Obamacare, or even by its official name, the Affordable Care Act. Then maybe conservatives can stop rejecting out of hand anything that is currently part of the law, regardless of how reasonable it might be.

As I’ve said many times on this blog, words matter. The name ‘Obamacare’ matters, because it’s far more polarizing than ‘Affordable Care Act.’ In February a research and media company called “Morning Consult” conducted a poll about the existing health care law, and the results were remarkable. 80% of Republicans polled strongly disapproved of Obamacare, but only 60% of Republicans strongly disapproved of the Affordable Care Act. 35% of all people polled didn’t know they were the same thing. 45% didn’t know if repealing Obamacare would mean the Affordable Care Act would disappear.

So let’s just change the name to something neutral, like Bob. And then ask the Republicans to identify what it is they want to do. Because ‘repeal and replace Bob’ is not a viable legislative agenda.

The word ‘repeal’ matters. Repeal means to revoke or cancel. It means to remove the legal force of any law (in which case it’s no longer a law).

The big Republican promise for the last several years has been to repeal Bob. Bob attempts to provide affordable health care to all Americans. (I said attempt; my own family is on its second stint of going without health insurance since Bob became the law of the land, so I’m certainly not going deny its flaws and failures.) Does that mean Republicans don’t want affordable health care for all Americans? I fervently hope that’s not the case. In any case, I’ll go ahead and obey the eighth commandment and interpret everything my neighbor does in the best possible light. Let’s assume that Republicans do want affordable health care for all Americans, but they disagree with how Bob approaches it. Fine. Fair argument. I’m listening to your ideas, Republicans.

But all I’m hearing is REPEAL AND REPLACE!

Sen. Rand Paul (R-KY) objected to the Senate’s American Health Care Act proposal by saying, “[W]e want the bill to look more like a repeal [of the Affordable Care Act AKA ‘Obamacare’]. We’re afraid that when we read the bill, it actually looks more like a reiteration or a keeping of Obamacare…To my mind, the most important thing is [Republicans] promised to repeal Obamacare. The current bill looks like we’re keeping large parts of Obamacare.”  That was his objection, that and the fact that the subsidies to help people buy the insurance were too high and the whole thing would cost more than Obamacare Bob in the first year or two. The joint statement he made with Sens. Ron Johnson (R-WI), Ted Cruz (R-TX), and Mike Lee (R-UT), stated: “[I]t does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their health care costs.”

Is repealing Obamacare the most important thing the Republicans can do? Or would ensuring affordable health care for all rank slightly higher? To listen to these Republicans, the content and quality of the replacement bill are far less important than repealing the existing law, and that’s a problem. If that’s not the case, then Republicans need to do a much better job of choosing their words.

Lowering Americans’ health care costs is a fine goal–one shared by Bob, actually. But the emphasis on repeal and replace has been heavy on the repeal and short on any plan to replace it. In fact, as much as I want to obey that eighth commandment, I don’t have any real confidence that many Republicans in the House or Senate really do care about the health needs of the American people. And I base my lack of confidence not on their words, but on their actions. It’s based on the number of Republican congressional representatives who intentionally avoided facing their constituents after voting on the House bill in April. And it’s based on the fact that the Senate crafted their bill in secret and tried to put it to a vote before anyone could thoroughly read or analyze it. Are those the actions of people who are genuinely concerned about the needs and realities of the everyday people they’re supposed to represent?

Health policy is broken in the United States. It was broken before Bob, and it’s broken in a different way now. Fixing this situation is going to be difficult enough without getting caught up on what to call it. Words matter. For instance, health care and health insurance are two entirely different things, yet no one in government has acknowledged that fact. It seems to me that Democratic plans aim to provide health care to all, and Republican plans aim to control health insurance costs and premiums. Both are important, but not differentiating between the two is like rolling routine maintenance plans into insurance plans for vehicles and coming up with a single plan for everyone, regardless of whether you drive a Bentley, BMW, Honda, Dodge, or take the bus. It just doesn’t work. Until our legislators start talking about the same thing and agree on a common goal, this whole nightmare is only going to get worse for more and more people, and people are going to die.

Words matter, people. Lives matter more. Forget about repeal and replace. Forget about Obamacare and the Affordable Health Care Act. Forget about the American Health Care Act. Forget about Bob. Figure out what the people of this country need (the living, breathing people, not the corporations who have legal personhood and boatloads of money for lobbyists) and craft a plan to provide for their health and wellbeing. If you’ve been elected to office, listen to the constituents you’re supposed to represent. All of them. That means Sens. Paul and McConnell need to listen to the Democrats in Kentucky and Sen. Sanders needs to listen to the Republicans in Vermont. (Yes, there are Democrats in Kentucky and Republicans in Vermont.) Come to think of it, forget about Democrat and Republican. Forget about liberal and conservative. Let’s think as Americans.

Better yet, let’s think as humans. If we can recognize the humanity in each other, maybe we can stop all this demonizing and name-calling, and get to work at taking care of each other.


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