But it left the Republicans with no leverage on policy: they had nothing to offer wavering Congressional Democrats (from Ben Nelson to Bart Stupak) who had problems with the legislation but wanted to vote for some kind of reform, and they had nothing substantial to put forward when Scott Brown’s victory seemed as if it might force the White House back to the negotiating table.
As a result, now that the bill has been passed and the Supreme Court has declined to do their work for them, the Republicans are left to thread a very narrow needle. First they need to take the Senate as well as the White House, and then they need to find a way to pass a party-line repeal bill while lacking any clear consensus on a replacement. Otherwise they will have combined a political victory with a once-in-a-generation policy defeat.
As I've written at length before, my view is that the Republicans actually had very limited leverage and that some version of Romneycare was always the only realistic final outcome, bipartisanship or no bipartisanship. But I do think the Republicans' failure to come up with an alternative health care policy led to Obamacare in this respect: by never uniting around their own health care reform ideas after the defeat of Hillarycare, Republicans virtually ensured the issue would next be dealt with on Democratic terms. And so it has been.
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