Everybody knows it but most Republicans won't admit it.
Now House Speaker Paul Ryan has acknowledged that if Democratic presidential nominee Hillary Clinton wins today's election, as most polls indicate she will, Republican hopes to repeal the Affordable Care Act are dead.
That admission came Monday when Milwaukee talk radio host Jay Weber asked Ryan questions focusing on “hard truths” about what's at stake if Republican nominee Donald Trump loses his bid for the White House, and Republicans lose control of the Senate.
Weber presented the question this way: “Obamacare doesn't get repealed, likely ever, if Hillary wins. Doesn't get repealed. Agree?
“Yes. Yes, I do agree,” Ryan replied. “Hillary's talking about a public option, which is basically a double-down on government-run healthcare. That's the opposite of what we're offering. We actually have a plan to replace Obamacare. All of us have basically gotten to consensus on what our plan is, but we have to win an election to put it in place.”
A Ryan spokesman confirmed the meaning of the speaker's words. “Under a Hillary Clinton presidency, Obamacare will not be repealed,” she told The Hill. Ryan “was underscoring the stakes of this election.”
That apparently was the first time Ryan—who outlined a conservative model of healthcare reform in June featuring refundable tax credits to help people buy health insurance—publicly recognized that the ACA is here to stay if Clinton wins.
A Clinton victory doesn't mean, however, that congressional Republicans won't keep talking repeal. “They'll continue to use the rhetoric of repeal, and they'll call it HillaryCare,” said Joseph Antos, a health policy expert at the conservative-leaning American Enterprise Institute who favors a more free-market reform model such as the one Ryan is proposing. “They'll continue to talk tough because a certain part of their base loves to hear that. But talk is cheap, and they won't be able to move on that.”
He predicts that even as they play that “political game,” Republicans would actually be looking to cut a deal with a Clinton administration on targeted healthcare issues such as the ACA's tax on high-value employer health plans.
Michael Leavitt, former Republican governor of Utah and HHS secretary in the George W. Bush administration, agreed. “The repeal-and-replace phrase probably will live on, but it will have multiple definitions,” he said. While some Republicans may continue introducing bills to repeal the law, those won't go anywhere.
Still, he has hopes for Republican efforts to “repeal portions of the law that don't work and replace them with things that do.”
Antos said that even if Republicans could make some kind of healthcare deal with Clinton, his sweeping vision for a conservative reform makeover is dead for the duration of her administration. "The whole package of a much more market-oriented system with less federal regulation is on the other side of the moon as far as the Clinton administration is concerned," he said.
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