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Is the GOP Healthcare Plan Actually an April Fools' Prank?

It's the only way to explain what Republicans have been doing and saying on healthcare.

by Harry Cheadle
Apr 1 2019, 8:47pm

Florida Senator Rick Scott seems likely to become a leading GOP voice on healthcare. Photo by Joe Raedle/Getty

Someone who has been reading the news for the past few years would probably come to the conclusion that Republicans, for the most part, want to eliminate the Affordable Care Act. During Donald Trump's first year in office, the GOP tried to repeal Barack Obama's signature healthcare law, but had to settle for slowly stripping away elements of it and doing what it could to drive down enrollment in the plans it made accessible to consumers. Among other things, as part of their 2017 tax cut package, Republicans got rid of the tax penalty people without health insurance had to pay under the ACA. A coalition of conservative state attorneys general has since argued in a lawsuit that that means the whole law should be struck down—a controversial view that a federal judge and the Department of Justice now officially agree with.

That lawsuit is working its way through the appeals process. But even as Republicans remain very much at war with the ACA at every level of government, they are having more and more trouble admitting it.

When VICE News spoke to Republican senators about the latest legal attack on the ACA last week, they appeared somewhat at odds with the Trump administration's aggressive stance, with Lisa Murkowski (who voted against repeal in 2017) saying, “I thought, ‘Oh, OK, we’re starting all over again with the ACA. What’s the plan?’” Also last week, Trump declared that a group of GOP senators were going to come up with an Obamacare replacement, but it was unclear who was discussing what with whom. Compounding the confusion, one of those senators, Florida's Rick Scott—who made a bunch of the money he used to fund his campaigns at a company that massively defrauded Medicare and Medicare—said on Sunday that he was actually waiting to see what kind of plan the White House put out. Also on Sunday, White House Chief of Staff Mick Mulvaney popped up on TV to reassure people that Republicans would make sure no one lost coverage if the ACA disappeared and suggested the GOP had always been in favor of protecting people with pre-existing conditions—even though the repeal bill of 2017 would likely have driven up costs for those very people.

None of this really makes sense. The Trump administration wants to wipe out the ACA, but Republican politicians don't have a replacement ready, and don't seem too excited to wade back into a debate over healthcare. Even as they decry the ACA, when pressed on specifics, conservatives claim they would keep many elements of the law, ranging from protections for people with pre-existing conditions to maternity care, intact. Oh, and talking about healthcare in the first place seems like a bad idea for Republicans, who are far less trusted on the issue than Democrats, according to polls.

But there's an easy explanation for all of this, one that can be found by simply looking at the calendar: The whole thing—all of the GOP's actions and messaging on healthcare for the past several months—amounts to one giant April Fools' prank.

Like all good pranks, the GOP's new non-plan stems from a believable premise: Everyone knows the GOP wants to erase the ACA from the books. But then the prank takes this premise to an absurd conclusion: If Republicans got rid of the ACA, they would need some kind of replacement at the ready. According to a New York Times rundown, if the ruling striking down the ACA stands, 21 million people could lose insurance, tens of millions would have to pay more, and the medical industry would lose billions of dollars in revenue. That would be a disaster, but it would also create a political crisis for the GOP, which would naturally be blamed for it.

If Republicans were serious about supporting this ACA-ending lawsuit and believed it had a chance to succeed, they would be scrambling to prepare a bill that would soften these blows to the healthcare system. That would mean working with Democrats, who now control the House—and it would certainly mean having policies, or at least a message, that most conservative politicians could support. None of that appears to be happening—a dead giveaway this is a prank.

Another sign that this is a prank is that the timing is incredibly stupid. Trump started talking about being the "party of healthcare" while much of the media and DC were focused on the Mueller investigation ending without any new charges, widely regarded as a victory for the president. Republican strategists were reportedly aghast that Trump would pivot from the Mueller story so quickly. Why stop talking about the good news about Mueller to remind everyone of your unpopular healthcare ideas? It's a prank, that's why.

To be sure, all of those moves happened well before April 1. But the coup de grace hit on March 31—perfect timing for pranksters who don't want to be found out immediately. That's when Scott and Mulvaney appeared on television to say things that made no sense at all. Why would Mulvaney blithely guarantee that no one would lose coverage in a TV segment that could easily become fodder for future attack ads? Why would Scott say he was waiting on the White House when the White House said it was counting on him? Don't these mixed messages point toward an underlying lack of cohesion among Republicans on healthcare policy?

If Republicans were serious, these positions would be terrifying. After all, there remains the possibility—however slight—that the result of all this legislative and legal chicanery will be a sudden end to the healthcare law that leaves tens of millions unable to afford a doctor's visit. The good news is that it seems like there's no way Republicans could possibly be serious, and the timing basically lines up for an April Fools' prank. And people say conservatives don't have a good sense of humor.

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