A thoughtful article by a Senator

Ben Sasse is a Senator from Nebraska, but not one of the Senators one hears a lot about; I had barely heard of him. But a column he wrote on the online Web site of the National Review, entitled “The Three Republican Camps after King v. Burwell,” is so good that I need to display it.

In the wake of the Supreme Court’s disappointing King v. Burwell decision, many are asking what comes next for those of us who have opposed Obamacare as a disastrous federalization of American health care.

I predict that the Republican party will quickly divide into three camps on health-care politics:

1. There are those who will want to throw in the towel. They will say it is time to move beyond the fight for repeal and admit that Obamacare is here to stay. They will condescendingly shake their heads at us unsophisticated conservatives, claiming that the only constructive path forward now is to make our peace with Obamacare, and to try to make it 12 percent less bad.

2. At the other extreme, there will be those who remind the first camp that no voter sent us to Washington to be slightly more efficient central planners than the Democrats. We are not here to sweep the floor of the Titanic by modestly adjusting Democrats’ unaffordable entitlement expansions. They will insist that we should invest 100 percent of our efforts in repealing Obamacare, and stop there. Even though the president would veto all repeal attempts (presuming such efforts could even clear the Senate), forcing such vetoes is necessary to remind voters where each party stands and thus why the 2016 presidential election is so crucial to America’s future.

3. Finally, there are those who — while remaining committed to full repeal — believe that there is no viable political pathway to repeal without simultaneously outlining our replacement plan. And then actually winning voters to support that vision. This group recognizes that it has a harder messaging job than the other two camps but believes that actually getting rid of Obamacare — rather than just romantically fighting lost causes — requires admitting that you cannot beat something with nothing. I propose that we name these three camps: the Fix-It Caucus; the Repeal-Only Caucus; and the Replacement Caucus.

Actually, I do not know of many Republicans that will join Sen. Sasse's “Fix-It Caucus.” But this is, of course, the direction that the Democrats are trying to push the Republicans to go.

To the Fix-It Caucus, I say: There is no way to sufficiently improve the command-and-control foundations of Obamacare, because it starts with the flawed (and unconstitutional) demand that Americans buy only the full-service insurance-and-redistribution products that Washington’s empowered bureaucrats compel us to buy. If the Beltway class’s Greek-style overspending is ever to be restrained, it will be accomplished only by giving the central planners even more power over rationing access and setting prices for drugs, devices, and procedures. The central planners’ answer to imperfect central planning is always more power for the central planners. Their answer is never more freedom. We ought not go down this road with the Washington-always-knows-best authors of Obamacare.

To the Repeal-Only Caucus, I agree that we should indeed use every available means — including reconciliation — to fully repeal Obamacare. But we must admit something else as well: American health care wasn’t healthy before Obamacare. And thus that even though the public disapproves of Obamacare (by an average of eight percentage points, according to Real Clear Politics), large portions even of Obamacare’s opponents are not persuaded by a repeal-only message. A family’s desire to be able to keep its health insurance when changing jobs or geography (a problem that Obamacare doesn’t make any better, by the way) is perfectly reasonable. We should acknowledge it and advance that cause.

So count me in the third camp.

And I would say the same for myself: “count me in the third camp.”

We must make the 2016 election a referendum on Obamacare vs. an understandable, common-sense, patient-centric alternative. We need a 2016 presidential nominee who can not only prosecute the case against Obamacare, but who will also enthusiastically champion the conservative cause of putting families in control of their own health futures. An exclusively negative set of talking points is a path to a dead end, both on Obamacare and in the 2016 presidential election.

Democrats have long held an advantage over Republicans on health care, mostly due to a perceived empathy problem in my party. But Obamacare has been such a train wreck that this Democratic advantage is mostly gone today. Obamacare is not popular. It’s going to be less popular than ever by Election Day 2016.

So here is the good news: The American people might finally be ready to listen to Republican ideas on health care. But they’re not looking for us to only say no to Obamacare — although that remains part of our task. They want us also to be for actual health-care reform that empowers families, expands choices, and comes with an honest budget.

We owe them that much this time.

Let’s remember how we got here: It was not simply that President Obama had a bad idea on health care and Democratic majorities in Congress. Obamacare arrived also because Republicans failed to persuade the public that we could address the avalanche of problems government had already created by decades of interfering with the health-care market. As a result, Obama filled the vacuum while Republicans appeared not to care. We cannot make that mistake again.

Beginning now, presidential contenders must present a constructive vision for health-care reform. It should be a minimum requirement that any candidate worthy of consideration must have a coherent plan for the voters. The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017. If Republicans fail to offer compelling alternatives to Obamacare in the 2016 campaign, we will lose — and we will deserve it.

The only point where I might differ from Sen. Sasse is that he says “The primary election for Republicans is partly about what vision of a replacement for Obamacare we think our nominee can sell to voters in the general election — and then successfully implement in 2017,” and I might say that “The primary election for Republicans is mostly about what vision of a replacement for Obamacare …” Obamacare is, I think, the #1 issue on which we need to fight the 2016 campaign.

The danger for Republicans over the next year is that the circular firing squad so dominates the conversation that the media latches on to a “There they go again, Republicans infighting” narrative, and then the third group — the Replacement Caucus — is never heard.

There’s an election here to be won, but there are no shortcuts. We have to do the hard work of making the case one voter at a time. Fixing Obamacare certainly is not the solution. And neither is being the “Party of No.” That will simply turn off the swing voters we need in order to put a conservative in the White House who can repeal and replace Obamacare.

We have an opportunity here, but let there be no more talk of waiting until some future date to produce the Republican health-care alternative. Now is the time.

Your move, 2016’ers.

I like what Sen. Sasse says. I would nearly totally agree with his points. And in particular, the Republicans need to come up with ideas for a better way to do health care.