Republicans make more health care promises they can’t keep

Kellyanne Conway, who’ll soon serve as a senior advisor to the president in Donald Trump’s White House, was asked on MSNBC this morning about the Americans who’ve gained health security under the Affordable Care Act, and whether they can expect to keep their coverage going forward. Conway may not have intended to make news with her answer, but it’s worth keeping these comments in mind as the “repeal” crusade advances:

In an interview with NBC’s “Today,” Conway added that Trump “is committed to retaining those pieces [of the Affordable Care Act] that his advisers will say are working.”Just on the surface, it’s striking when a Republican acknowledges — out loud and in public — that there are elements of the ACA that have “merit” and “are working.” These truths generally go ignored by the right.But let’s not brush past the details. According to one of his top aides, the Trump White House will not take away any American’s current coverage and doesn’t intend to drop protections for those with pre-existing conditions.About a month ago, House Speaker Paul Ryan (R-Wis.) made similar commitments, telling CBS News, “We will give everyone access to affordable health-care coverage,” and adding that protections for consumers with pre-existing conditions is “a very important feature of any health-care system.”The Speaker added, in an interview with the Milwaukee Journal Sentinel, that the Republican approach will make sure that “no one is left out in the cold” and “no one is worse off.”Once again, it appears Republicans are writing checks their party can’t cash.First, if GOP policymakers are going to create a system that guarantees coverage for pre-existing conditions, they’re going to need to make sure everyone is brought into the system to help manage costs. And if they’re going to bring everyone into the system, they’ll need to offer subsidies to help consumers buy insurance.If this blueprint sounds familiar, it’s because I just described “Obamacare.”Second, if Republicans intend to keep their promises about a new reform law that doesn’t take coverage from anyone, gives “everyone” access to affordable insurance, and protects those with pre-existing conditions, all while repealing the Affordable Care Act, we will literally never see the GOP plan because it will never exist.Indeed, it can’t exist because there is no way to keep all of these promises. As we discussed  a month ago, if such a policy could exist, GOP officials would’ve come up with it a long time ago.As Bloomberg’s Jonathan Bernstein joked a while back, the Republicans’ best bet is probably to take the Affordable Care Act, slap a new GOP-friendly name on it, and “pretend they’ve ‘replaced’ Obamacare with a new, market-based solution.”Here’s my best guess: Republicans will move forward with their “repeal and delay” gambit, scrapping the ACA while keeping the status quo in place for years while they work on a GOP alternative. The “delay” will be indefinite, however, because the search for an alternative is destined to fail.