# What is the GOP's endgame with the American Healthcare Act? **URL:** \ **Category:** Politics & Elections\ **Created:** [March 10, 2017, 9:20pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904 "2017-03-10T21:20:45Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [March 13, 2017, 10:05pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/61 "2017-03-13T22:05:29Z")
> [@Little\_Nemo](#): > > The Republicans have backed themselves into a corner by essentially promising to deliver a program that will: > > 1. Provide cheap adequate health care to everyone > 2. Allow everyone complete choice on how they participate > 3. Generate high profits for everyone involved in providing health care > 4. Have minimal government involvement > 5. Cost significantly less than past or present programs > > Sure, those features sound great. But they’re impossible. But by promising them, the Republicans have set themselves up so that anything they deliver will look like a failure. You’re absolutely right that the Republicans have promised a plan that will do all of the above. You’re right that this is impossible. However, you misunderestimate them. When the failure occurs, it will not be their fault. They will find someone to blame. Obama or Democrats or Immigrants. Whatever. The important thing is to find someone to blame. And you can bet they’re working on that part of the plan right now. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 9:04am UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/62 "2017-03-14T09:04:48Z")
If they want that, then the best strategy is to lose on this vote and then watch as ACA goes into a death spiral. The individual mandate is not working and the companies are not making money on the exchanges. Without fixes, ACA will fail. ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [March 14, 2017, 11:28am UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/63 "2017-03-14T11:28:37Z")
I think the Republicans want to do enough to say they ‘repealed’ it, and not so much that they actually make things noticeably worse for millions of Americans who are going to be pissed off and vote for Democrats next time. The Liberal Media is falling for it, of course, saying that they accomplished their ‘repeal and replace’ strategy, when they actually did almost nothing but change the way the ACA is funded. As though changing the way your subsidy (or penalty) is calculated is the same thing as eliminating a huge government program and replacing it with something entirely new. The Repubs are keeping an enormous amount of the structure and benefits created by the ACA, which is why their bill is so svelte, it spends most of its text referencing documents created by Democrats. ---
**Author:** ![Celidin](https://avatars.discourse-cdn.com/v4/letter/c/cc9497/32.png) [@Celidin](https://boards.straightdope.com/u/Celidin)\ **Post date:** [March 14, 2017, 12:38pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/64 "2017-03-14T12:38:26Z")
> [@adaher](#): > > At this point I almost wonder if they shouldn’t just repeal it totally, stick their middle fingers in the air, lose Congress and the Presidency, and dare Democrats to try to pass something again. The fear here, I would imagine, in the Republican leadership is that if they blow it that badly (e.g. no replacement), at some point, the voters might get pissed off enough to elect enough Democrats into office (probably over a couple cycles given how 2018 looks now) to give them a filibuster-proof majority in the Senate and enough seats in the House to pass genuine single-payer. ---
**Author:** ![CandidGamera](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/candidgamera/32/2878_2.png) [@CandidGamera](https://boards.straightdope.com/u/CandidGamera)\ **Post date:** [March 14, 2017, 12:39pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/65 "2017-03-14T12:39:39Z")
> [@Cheesesteak](#): > > The Liberal Media is falling for it, of course, saying that they accomplished their ‘repeal and replace’ strategy, … Cite? ---
**Author:** ![carnivorousplant](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnivorousplant/32/3563_2.png) [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)\ **Post date:** [March 14, 2017, 1:36pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/66 "2017-03-14T13:36:51Z")
Did I see Ryan on the news with a binder titled “American Care Act”? ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [March 14, 2017, 2:25pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/67 "2017-03-14T14:25:54Z")
> [@Little\_Nemo](#): > > I suspect a lot of Republican lawmakers are secretly hoping for something like a natural disaster or a terrorist attack; something that will divert public attention. Yes. Though I’d rewrite “secretly hoping for” to be “actively fomenting”; change “natural disaster” to “false felony accusations against Obama or Clinton”; and make the object of the verb plural in number. This week it’s the wiretapping allegation Trump found on a looney blog. Fasten your seat belts; we’re going to have new calumnies every week. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [March 14, 2017, 2:31pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/68 "2017-03-14T14:31:52Z")
> [@adaher](#): > > This is the problem with not just the party, but the right as a whole. Not enough people really thinking about policy in any deep way. Even the think tanks have been absent on major issues like health care. They are fine on tax policy and education, but if a policy problem leads to an unconservative solution they just wave their hands and say, “private sector”. Right-wing think tanks are excellent when thinking is irrelevant or very little of it is required. _ **Taxes?** _ Cut them, especially on the rich. _ **Taxes are already too low?** _ Cut them some more. Regretfully raise taxes on the underclass if you need to brag about fiscal prudence. _ **Public schools?** _ Divert their funding to private education for the elite, especially religious schools. _ **Public schools are underfunded and getting poor results?** _ Good, an educated underclass is in America’s interest. Our leader even said “I love the poorly educated!” _ **But healthcare?** _ The trade-offs are more subtle. Of course we want the working class under severe emotional stress, and without power in the employment market because they’re dependent on employer-provided health insurance. And picking their pockets to enrich Big Pharma and Big Insura is good. _ **But a balance needs to be struck** _. Emotional stress and overwork are good for the economy, but employees _too_ crippled to work and consumers _too_ sick to shop are _not_ good for the plutocrats. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [March 14, 2017, 2:35pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/69 "2017-03-14T14:35:04Z")
> [@Celidin](#): > > The fear here, I would imagine, in the Republican leadership is that if they blow it that badly (e.g. no replacement), at some point, the voters might get pissed off enough to elect enough Democrats into office (probably over a couple cycles given how 2018 looks now) to give them a filibuster-proof majority in the Senate and enough seats in the House to pass genuine single-payer. The Democrats could pass genuine single-payer using the barest majority (i.e., 51 Senate votes) in all three branches of the federal government. The GOP’s plans now vis-a-vis reconciliation have rewritten the rules & show what’s possible. The Dems could get there either by (a) increasing Medicaid eligibility to infinity percent of the FPL, or (b) decreasing the Medicare eligibility age to 0. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [March 14, 2017, 2:43pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/70 "2017-03-14T14:43:19Z")
> [@adaher](#): > > If they want that, then the best strategy is to lose on this vote and then watch as ACA goes into a death spiral. The individual mandate is not working and the companies are not making money on the exchanges. Without fixes, ACA will fail. The problem, for the Republicans, is they’ll go down in that death spiral. It’s pretty clear the voters want them to fix the ACA not merely abolish it. ---
**Author:** ![TruCelt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/trucelt/32/523_2.png) [@TruCelt](https://boards.straightdope.com/u/TruCelt)\ **Post date:** [March 14, 2017, 2:52pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/71 "2017-03-14T14:52:09Z")
> [@ThelmaLou](#): > > I think it’s crystal clear that their endgame is for the rich to get as rich as they possibly can, and for old, sick, poor, and disabled people to stop being so much trouble and die already. Preferably BEFORE they have any expensive medical procedures or nursing home care. This goes for sick babies, too. Unwanted babies who are born because of no affordable birth control or abortions-- well, they’re no problem, as long as they die AFTER they’re born. Dying before they’re born-- BIG no-no. That must be prevented no matter what! Honestly, when I first saw this thing I just thought it was an enormous tax cut for the rich. The more I see of it though, the more it scares me. The hardest hot people are the “poor and elderly”, and the “poor, young and sick” demographics. In functional reality, this bill would cause poor elderly folks to die younger, and sick babies and youngsters to suffer more, and also die sooner. I A lot of people have called it evil. But I think it’s less emotional than that. The cold, sinister, term that comes to mind is “culling.” ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 3:07pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/72 "2017-03-14T15:07:12Z")
> [@Little\_Nemo](#): > > The problem, for the Republicans, is they’ll go down in that death spiral. It’s pretty clear the voters want them to fix the ACA not merely abolish it. Perhaps, a lot will depend on messaging and media coverage in that event. Republicans are in power, but Democrats created the program and as of 2016, insurance companies were leaving, large premium hikes were the norm, and insurance companies weren’t making money due to their customer pool being older and sicker than expected. The Republicans are ALREADY highlighting these facts, while Democrats are just saying, “Republicans own it now.” If we’re going by today’s messaging, Republicans are going to win. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 3:09pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/73 "2017-03-14T15:09:36Z")
> [@2ManyTacos](#): > > The Democrats could pass genuine single-payer using the barest majority (i.e., 51 Senate votes) in all three branches of the federal government. The GOP’s plans now vis-a-vis reconciliation have rewritten the rules & show what’s possible. > > . The Democrats can, but it’s very, very difficult due to the cost. Budget reconciliation has to reduce the deficit or at least be deficit neutral. Which means there’s no path to single payer without a very steep middle class tax hike. Now I know the standard Democratic argument: “The new taxes just replace your premiums!” Which is true for many, but not those who would rather keep their insurance, especially those in organized labor. Organized labor will of course shill for the Democrats, but union members and their families will not be happy losing their gold plated plans in favor of Medicaid. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [March 14, 2017, 4:12pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/74 "2017-03-14T16:12:34Z")
> [@adaher](#): > > Perhaps, a lot will depend on messaging and media coverage in that event. Republicans are in power, but Democrats created the program and as of 2016, insurance companies were leaving, large premium hikes were the norm, and insurance companies weren’t making money due to their customer pool being older and sicker than expected. The Republicans are ALREADY highlighting these facts, while Democrats are just saying, “Republicans own it now.” If we’re going by today’s messaging, Republicans are going to win. This. Many Republican voters already believe that Trump has reduced the unemployment rate from 40% to 4%. All the Republicans in Congress have to do is lie and lie and lie about how great the new TrumpCare is, even when it costs people more, leaves millions uninsured, and cuts Medicare, leading to an increased mortality rate. They’ll just straight up lie about it, and their base will believe it unquestioningly. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 4:37pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/75 "2017-03-14T16:37:38Z")
I think you’re right, but making a mistake a lot of people make about the context. Lying to the base and the base happily accepting it is fairly normal in this day and age. President Obama just had to say, “I didn’t know, I read it in the paper just like the rest of you” was a good enough defense for most Obama supporters, even as the media and Jon Stewart raked Obama over the coals for such an obviously stupid and buck-passing statement. But that doesn’t mean he got away with it. His approval rating always dropped significantly in the wake of such behavior. He’d be getting close to 50% again and then some story would break and he’d claim ignorance and BAM! back down to 41%. The types of voters who do not unconditionally approve or disapprove of a President are the ones who decide elections. Republicans approach their political messaging with the intent to both mobilize their base and make their case to that 10% or so. Democrats just haven’t been as good at it. And furthermore, as long as Trump doesn’t actively do anything to mess up ACA, the Democrats still own the death spiral, should it come. They designed it and have not attempted to bring any useful fixes up for a vote, and only a few Democrats even proposed any fixes to begin with. I can write this messaging and I’m not a professional. Republicans will win that fight. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [March 14, 2017, 5:20pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/76 "2017-03-14T17:20:55Z")
Far be it from me to suggest that Republican voters aren’t as dumb as a sack of hammers. But if this Wealthcare goes through and the average Joe personally knows people who lose their insurance because of it, that’s going to start to impact some of the base. And if they get offered a white male Democratic nominee in 2020, they may find no reason to vote Republican anymore, even down ballot. They were told that everybody would be covered for less and they’re going to love it. If that bit of magic does not materialize, then woe to the Republicans. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 14, 2017, 5:27pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/77 "2017-03-14T17:27:11Z")
Except the base mostly benefits from this bill. Republicans aren’t THAT stupid. They made sure their most loyal voters(middle class voters making between $50-100K) make out like bandits. It’s primarily the poor who get screwed, and they already vote mostly Democrat. ---
**Author:** ![BobLibDem](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/boblibdem/32/3149_2.png) [@BobLibDem](https://boards.straightdope.com/u/BobLibDem)\ **Post date:** [March 14, 2017, 5:34pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/78 "2017-03-14T17:34:17Z")
> [@adaher](#): > > Except the base mostly benefits from this bill. Republicans aren’t THAT stupid. They made sure their most loyal voters(middle class voters making between $50-100K) make out like bandits. It’s primarily the poor who get screwed, and they already vote mostly Democrat. I question both assumptions. I don’t think those between $50-$100K are the most loyal Republican voters. I think the most Republican voters are the \>$100K crowd. Those from say $30-$50K are the blue collar no college voters that vote based on race and social issues. They’ll abandon the GOP in a heartbeat if it costs them money. ---
**Author:** ![carnivorousplant](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnivorousplant/32/3563_2.png) [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)\ **Post date:** [March 14, 2017, 7:10pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/79 "2017-03-14T19:10:02Z")
> [@BobLibDem](#): > > Those from say $30-$50K are the blue collar no college voters that vote based on race and social issues. They’ll abandon the GOP in a heartbeat if it costs them money. They also favor the Republican position on gun control and abortion. ---
**Author:** ![TruCelt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/trucelt/32/523_2.png) [@TruCelt](https://boards.straightdope.com/u/TruCelt)\ **Post date:** [March 14, 2017, 7:23pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/80 "2017-03-14T19:23:06Z")
The initial problem all of this was meant to solve will be worsened by the Republican plan. That was the conflict between doctors and hospitals being unable to refuse help to acutely ill ER patients, and their inability to pay after the fact. It’s a tough slog getting through this thing, but I haven’t found anything which addresses hospital bill defaults. So if nothing else, we’ll get the reality check two years in when the hospitals all go belly up. [Previous page](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904.md?page=3) [Next page](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904.md?page=5)