Policy Lock

Jon Chait notes the latest nail in the coffin of the drive to repeal the Affordable Care Act, apparently right-wing hero Marco Rubio likes two parts of the Act, one of which is “the ban on insurance companies denying coverage based on preexisting conditions.” As Ramesh Ponnuru notes, this provision is one of the tentpoles on which the whole structure hangs, and you can’t keep it without keeping the whole structure.

So even if Rubio won’t repeal health reform, who will? The answer is that nobody who has to stand in a remotely competitive election is going to vote for a “sick people lose their health insurance” bill and therefore there will be no repeal. Not in 2011, not in the Jeb Bush administration, not ever.

From where I sit, that’s all to the good. What I find more distressing, however, is that it’s actually unlikely that the bill will be modified at all in any substantial way. Conservatives are going to find that acquiring 60 Senate votes for legislation that’s backed by a majority of House members and the President of the United States is really hard to do. It takes a major effort, and you generally don’t want to organize a major effort over something minor. So realistically, it’ll be pretty impractical to tweak the bill—even though there’s substantial bipartisan consensus among wonks that the bill should be tweaked in a number of ways to improve cost control mechanisms and do other things. At which point I hope conservatives will begin to rethink their opportunistic embrace of America’s dysfunctional legislative procedures. I understand that the existence of massive dysfunction has been situationally advantageous to people who think it’s really important to let poor people go without adequate health insurance or to let coal companies inflict massive negative externalities on the world for free, but it’s not actually a good thing to make it so difficult to change the laws.