Real health care reform means more than just adding a letter to “ACA”

House Speaker Paul Ryan, R-Wis., announces that he is abruptly pulling the troubled Republican health care overhaul bill off the House floor, short of votes and eager to avoid a humiliating defeat for President Donald Trump and GOP leaders, at the Capitol in Washington, Friday, March 24, 2017. (AP Photo/J. Scott Applewhite)

After weeks of extensive whipping by Republican leadership and the White House, including personally by President Donald Trump and Vice President Mike Pence, the GOP replacement for Obamacare, called the American Health Care Act (AHCA) and nicknamed “Obamacare 2.0” by disenchanted conservatives, failed spectacularly today when Speaker Ryan canceled a vote in the House of Representatives.

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This can mean only one thing – the bill was headed for an embarrassing defeat on the House floor. Republicans could only afford 21 defections, and evidently, they failed to stop the bleeding.

When you believe in the ideas and policies put forward in legislation, the best moment – the culmination of all that hard work – is when you see the people’s elected representatives vote on that bill. I would know – I used to work on Capitol Hill.

Yet, despite all the promotion, the whipping and threats, GOP leadership ultimately refused to submit their bill for the ultimate test. Speaker Ryan, supposedly at the direction of the White House, pulled it at the last moment.

“We are going to be living with Obamacare for the foreseeable future,” Ryan told the press in the wake of the news that he had canceled the vote. “I spoke to the president a little while ago, and I told him the best thing I think to do was to pull this bill, and he agreed with that. I will not sugarcoat this, this is a disappointing day for us. Doing big things is hard.”

But did the AHCA really do “big things”?

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The bill, which Speaker Paul Ryan and the executive branch aggressively promoted, replaced the tax penalty of Obamacare with a permanent 30 percent surcharge for anyone who had a lapse in health care coverage, kept the tax credits (restructured somewhat), continued favoritism of employee-based health insurance and, most disastrously of all, kept in place regulations and mandatory programs that Republicans have previously claimed are causing insurance markets to collapse.

Remarkably, all the free-market ideas, all the reforms that Republicans had publicly committed to for years before the election of President Trump, somehow ended up on the cutting room floor of Ryan’s AHCA.

By standing for what the Republican Party repeatedly promised constituents – a full repeal of Obamacare – and by offering a legitimate replacement plan from Senator Rand Paul, the House Freedom Caucus was able to effectively point to an alternative that actually did what Republicans had promised for seven years that they would do.

With Paul’s bill, which would lower the cost of insurance, give Americans the freedom to purchase insurance across state lines, join voluntary larger insurance pools, and implement other free-market reforms, conservatives wielded an effective counterweight to threats from GOP leadership: it’s the AHCA or Obamacare.

RELATED: Hey Republican leadership: Health care reform isn’t just something you “do”

Ryan, Trump and Pence aggressively lobbied House members to support the AHCA. Indeed, in the days leading up to Friday’s canceled vote, Trump and House Majority Whip Steve Scalise even spoke of supporting primary challengers against upstart conservatives who blockaded their health care bill.

But when offered the choice of a carrot or stick, conservative lawmakers and even more moderate members of the Republican conference held strong against the pressure. The House Freedom Caucus had finally come into its own.

The Republican Party subjected us to seven years of votes to repeal Obamacare. Indeed, only 15 months ago, they sent a bill to President Obama’s desk to do just that.

It may be an over-simplification to say that the AHCA only changed the ACA by one letter, but it certainly failed to do what Republicans had promised the American public. And, in the truest test of ideas in our constitutional republic, it could not even make it to the House floor for a vote. That’s an indictment on Trump, on Ryan and on the entire weak-kneed Republican effort.

What do you think?

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