How Republicans should have dealt with ObamaCare

The Week
Maybe a fake filibuster wasn't such a good idea after all...

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Maybe a fake filibuster wasn't such a good idea after all...

Republicans' "defund ObamaCare" plan is going about as far as their "Repeal ObamaCare" plan, which is to say nowhere.

Senate Democrats are not about to throw away President Obama's signature achievement, nor is the president about to sign it away. Republicans threatening to shut down the government or default on the national debt are no threat to Democrats, politically speaking. All they are doing is giving Democrats fresh hope for keeping the Senate and taking back the House in 2014.

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Does this mean Republicans must surrender and accept their new socialistic doctor overlords? Not quite.

Republicans interested in winning the health care debate have other tactical options that carry far less political risk than taking the government hostage. Here are three others things a more rational Republican Party still can do:

1. Nothing
If conservatives are so convinced that ObamaCare will be a disaster, then let it be a disaster. If premiums go through the roof, if consumer choice is greatly diminished, and if businesses lay off workers en masse, Republicans will easily take control of Congress and the White House by 2016. Then they can tear apart ObamaCare from the roots and start from scratch.

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The one problem with this gambit is there is always a chance that every nightmarish Marxist scenario predicted by Republicans won't come to pass. If it turns out that ObamaCare's implementation goes smoothly, people might end up liking it and voting to keep in power those that gave it to them.

So Republicans might want to cover their bases…

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2. Take charge of the exchanges
Republicans may regularly slam ObamaCare as a one-size-fits-all big government monstrosity. But those who have actually read the law know that the states are the ones who take the lead in implementing the program. States run their own "exchange," or marketplace, and have great latitude to decide the criteria by which health insurers will be allowed to sell coverage in that marketplace.

However, most Republican governors opted against setting up the exchanges as a snub to Obama. But refusing to create the exchange does not stop ObamaCare. Under the law, the federal government simply comes into your state and sets one up for you.

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So instead of taking the opportunity to show that Republicans can do a better job managing health reform, these governors have ceded that opportunity to Obama.

Except for three brave Republicans: Nevada Gov. Brian Sandoval, New Mexico Gov. Susana Martinez, and Idaho Gov. Butch Otter.

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Those three now have to chance to show they know best — better than a federal government now stuck juggling 27 different state exchanges and sharing responsibility with seven other states — how to expand coverage, reduce cost, foster healthy competition, and strengthen customer choice.

If they prove Republican governors can survive and thrive implementing health care reform, others might consider taking their ObamaCare exchanges back from Obama. And if all goes well, Republicans could make the case they can be better trusted with health care and gain a mandate to enact their own reforms.

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3. Get ObamaCare waivers
Okay, maybe getting Republicans to actually run more ObamaCare exchanges is too much to expect.

But inside the law is an even bigger gift to conservatives: a state waiver program to bypass ObamaCare completely, so long as the state has an alternative plan that will expand health care coverage and cuts the federal budget deficit at least as much as ObamaCare would.

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In other words, if Republican governors think they have a better idea than ObamaCare, they can get a waiver and prove it.

Congressional Republicans can help accelerate this process. The current law doesn't allow waivers to be issued until 2017, effectively requiring states to give ObamaCare a chance first before trying something else. But President Obama previously expressed support for legislation that would allow waivers to be issued starting next year. Congress could pass such a law immediately if Republicans were interested in trying out their own ideas.

The only catch: They need to actually have those ideas.

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Congressional Republicans who used to insist their position on ObamaCare was "repeal and replace" haven't bothered much with the replace part. Sen. Ted Cruz just spent 21 hours railing against ObamaCare on the Senate floor, but couldn't manage to find the time to propose what he would do differently.

Also, Republicans would need to accept that ObamaCare would remain on the books, resigning themselves to strategy of reforming and refining Obamacare instead of abolishing it. But that isn't a concession to anything but reality. In fact, it isn't all that different than their approach toward Medicare and Social Security. Republicans routinely argue those programs need to be radically transformed, but not flatly repealed.

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After Sen. Cruz left the Senate floor Wednesday, Rush Limbaugh defended him by saying, "If you don't fight, you can't possibly win." True enough. But there are many ways to fight. Right now, Republicans are not fighting the policy battle. And they are not winning it.

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