President Trump has indicated that he wants to make replacing Obamacare a key issue in the 2020 campaign, with a vote on a new plan to be held following the election, assuming Republicans take back full control of Washington. The problem: Republicans have already fooled voters with that message too many times.
Whatever your preferred adage (Abraham Lincoln‘s about not being able to fool all the people all the time or the “fool me twice” warning), recent political history will provide a significant obstacle to any attempt by Trump or Republicans to run on replacing Obamacare.
Republicans ran on repealing and replacing Obamacare in 2010, 2012, 2014, and 2016. Yet they kept moving the goalposts as they accumulated power. When Republicans took over the House in 2010, they said nothing could be done without also controlling the Senate. When they gained control of the Senate in 2014, they said they couldn’t do anything until they also had the White House. Yet even when they entered 2017 with unified control of Washington, they failed to deliver.
At the time, I called it the biggest broken promise in political history. Try to think of another example of a pledge to voters made in four consecutive election cycles, and not just by a few candidates — by an entire party, including those seeking office at the federal, state, and local level.
The reason why Republicans failed is, at its core, the same reason I have been shouting about since 2008: they don’t care about the details of healthcare policy enough to resolve their differences and unify around any given plan. The only times Republicans can unify is in opposition to Democratic proposals to expand the role of government when they are out of power. This was the case in 1993 and 1994 when they fought the Clinton administration’s push for national healthcare, and then again with Obamacare.
Republicans will be able to score points in 2020 by running against efforts to impose a socialist health insurance scheme on the United States, which is currently being branded as “Medicare for all.” They might also be able to make some headway if they have specific plans to address specific concerns about Obamacare. For instance, they can explain in real terms how Obamacare’s regulations drive up premiums and restrict choice and how they could address those concerns with specific policy changes.
But if Trump and Republicans insist again of speaking vaguely about getting rid of Obamacare and replacing it with some mythical great plan, they will face a skeptical public that isn’t likely to be fooled again.