The GOP is abandoning its base on the ACA, and it’s putting the health care law in jeopardy by allowing Republicans to roll back key parts of the law, according to a new analysis by a top GOP health policy analyst.
The analysis, released Monday, shows that the party has been willing to embrace some of President Donald Trump’s most controversial policies without the support of the party’s core members and leaders, including House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell.
It also highlights the political realities facing the GOP as it tries to enact major changes to the health law as the GOP faces a growing Democratic rebellion over how it would replace the Affordable Care Act.
For decades, the party had an important role to play in advancing the country’s health care agenda, said Mark Mazur, a senior fellow at the centrist Brookings Institution.
But with the GOP’s failure to coalesce around a single vision for the ACA after the 2010 election, he said, the Republican base no longer considers it a priority.
“The GOP is now in the position of trying to move in an agenda that is more pragmatic, and less ideologically driven, with less political capital invested,” Mazur said.
The conservative, pro-market wing of the GOP has been more reluctant to embrace its vision of an overhaul than other factions within the party, said the analysis by Mark Rozell, a professor at the University of Pennsylvania’s Wharton School of Finance and Economics.
The GOP has become increasingly pragmatic, but it’s become more focused on how to get the right results than on the right goals, Rozell said.
For instance, it’s now less concerned about how to reform Medicaid, which would require changing Medicaid rules and cutting the number of Americans eligible for subsidies.
Instead, the GOP wants to find ways to reduce the cost of insurance and expand access to health coverage for low- and moderate-income Americans.
This is particularly important in states that expanded Medicaid under the ACA.
Republicans are now working with governors and state legislatures to craft legislation that would repeal parts of Obamacare and replace it with new coverage options, but the political pressure to find compromise has led to the GOP abandoning its original vision for health care reform, Rozel said.
This has led many of the Republican Party’s conservative members to back off of the ACA’s most radical elements, such as the requirement that Americans purchase coverage and limit the amount of subsidies they can get, Rozill said.
But the health insurance overhaul is only one of a number of changes that Republicans are trying to make to the law.
The House and Senate are working on a bipartisan replacement plan to repeal much of the Affordable Health Care Act and replace the law with a new, more robust version.
The bill will likely have major changes, and Republican lawmakers are pushing for more flexibility to get it through the House and the Senate.
But it will likely take a longer time for Republicans to get to the finish line, Rozelsaid.
Republicans have been pushing the law’s most contentious provisions as part of their effort to repeal and replace.
These include the Medicaid expansion and the so-called individual mandate, which mandates that individuals purchase health insurance or face a penalty.
For many Republicans, the Medicaid expansions are central to their vision for their party.
But they also face pressure from the left and from the business community, who argue that these provisions are necessary to ensure coverage for millions of Americans who lack it, and to prevent insurance companies from charging too much for coverage.
The nonpartisan Congressional Budget Office estimates that the ACA would reduce the federal deficit by $1.2 trillion over the next decade.
But that figure does not take into account the impact of the Medicaid reforms and other changes Republicans are proposing.