The Obamacare Repeal Movement Is Dead. Long Live Obamacare Repeal.

“It’s probably gonna happen after the midterms.”

(Composite by Hannah Yoest / Shutterstock)

To hear Republicans tell it, the current health care system is an abject mess that they—not Democrats—are keen on fixing.

“Let me look right into the camera and tell you clearly: Republicans are the ones concerned about health care,” House Speaker Mike Johnson told reporters on Monday. “Republicans are the party working around the clock to fix health care.”

Johnson’s remarks provided a rhetorical strategy for other Republicans to use as they push back on Democrats’ demands to extend enhanced Obamacare subsidies, the concession they are insisting upon in exchange for helping reopen the government. They want to create the impression that Republicans intend to push broader health care legislation once the government actually reopens.

But there’s a problem. If you ask those same Republicans the logical follow-up question—will they move to repeal and replace Obamacare to fix health care?—they get a little shy. In conversations I had with several of them this week, Johnson’s GOP colleagues danced around whether they intend to pursue a comprehensive health policy overhaul. Obamacare is definitely bad, they still insisted, but their remarks often cease there, with no word on how they think it should be fixed, or if it should even be repealed.

“We need to take a look at the whole ecosystem of health care,” Sen. Bernie Moreno (R-Ohio) told me. “The ironic part of the Affordable Care Act is it made care less affordable, so we actually have to pass something to make care more affordable, to make sure Americans have access to good, high quality care—which is what they expect—and dramatically lower costs. The system is just too expensive.”

But when asked whether Republicans would take up the cause of repeal-and-replace again, Moreno said any GOP plan would likely not come until the next Congress, and then, only so long as Republicans defend their majorities. His reasoning is that Democrats would be more likely to negotiate on a conservative health care bill if they continued to lose elections.¹

“My personal preference would be let’s do it holistically, but it’s probably gonna happen after the midterms, because right now Democrats just want to obstruct everything,” he said. “So if we can beat them pretty soundly in the midterms, we break the fever—meaning they reject the extremists in their base and they come to their senses—where you have Democrats like Joe Manchin that are here. Then you can actually make a deal with the Democrats. And I think we can make that happen. We need to. It’s a big problem.”

For years, the campaign to repeal and replace Obamacare was a Republican rally mainstay, held up as the party’s central policy offer to voters in election after election. But they never actually acted on the pledge, even when they were in a position to do so. The GOP got so used to repeatedly assuring reporters and the public that their new health care initiative was just around the corner that the claim turned into a running joke among health care reporters on the Hill.

The closest Republicans came to successfully repealing the law was in the 2017 legislation that Sen. John McCain torpedoed with his dramatic thumbs-down vote on the Senate floor. After that, it seemed that the party had resigned itself to simply moving on.

But health care broadly, and Obamacare specifically, is back in the news. Enhanced subsidies that help reduce the cost of purchasing insurance on the ACA marketplaces for around 22 million people are set to expire at the end of the year, which could more than double the cost of insurance for those affected. Senate Republicans and their counterparts in the House have expressed no interest in negotiating with Democrats to address the matter—at least not right now, in the context of a government shutdown fight.

That was the state of play until Monday afternoon, when Rep. Marjorie Taylor Greene (R-Ga.) broke with her party. In a long, somewhat rambling post on X, Greene signaled that while she doesn’t want any illegal immigrants getting any government benefits, she is eager to address the issue of the expiring subsidies now, before her kids’ premiums jump up in the new year. (Who knows what kind of solution she has in mind? Near the end of her post, she added that “all insurance is a scam, just to be clear!”²)

I was not in Congress when all this Obamacare, “Affordable Care Act” bullshit started. I got here in 2021. As a matter of fact, the ACA made health insurance UNAFFORDABLE for my family after it was passed, with skyrocketing premiums higher than our house payment.

Let’s just say as nicely as possible, I’m not a fan.

But I’m going to go against everyone on this issue because when the tax credits expire this year my own adult children’s insurance premiums for 2026 are going to DOUBLE, along with all the wonderful families and hard-working people in my district. . . .

Not a single Republican in leadership talked to us about this or has given us a plan to help Americans deal with their health insurance premiums DOUBLING!!!

What’s notable about the Republican intraparty health care debate is the divide that exists between those who lived and worked through the repeated failures of repeal-and-replace in the late 2010s and those who were not yet in Congress during those earlier fights.

Those with the scar tissue are keen on avoiding getting thrown back into the ring for another Obamacare battle royale. Sen. John Barrasso (R-Wyo.) avoided giving a direct answer to the question in the disciplined manner of a lawmaker climbing the rungs of Senate leadership.

“All the talk is the government shutdown, which is what I’m gonna go talk about on the floor,” Barrasso said. “And I’ll mention health care in the speech. So you can listen to that if you’d like.”

In his floor speech, Barrasso said, “Obamacare is a failure, Obamacare is broken, and now Democrats are holding the American people hostage to prop it up.” But rather than going on to expand on America’s health care problems—or explicitly call for the ACA to be repealed and replaced, as he once did—Barrasso spent the remainder of his ten-ish minutes of floor time accusing Democrats of prioritizing the well-being of undocumented immigrants over that of their fellow Americans.

Sen. Chuck Grassley (R-Iowa), the oldest and longest-serving member of the Senate, responded to my inquiry about a potential GOP health care initiative with a flat “No.”

“Fifteen years,” Grassley added, indicating that perhaps the ACA has become too ingrained in American society to be done away with. “Well it’s—we’ve always had a—I guess fifteen years is the answer to your question of why you wouldn’t repeal it.”

“There’s a lot of work to improve it, that’s for sure,” chimed in one of his staffers before they disappeared into an elevator.

The one Republican who both lived through the repeal-and-replace flubs of yesteryear and has expressed support for scrapping the law is, apparently, Sen. Mike Lee. The Utah Republican posted on X that the ACA is in dire need of repeal because it “doesn’t work” and “never will.”

But what exactly Lee imagines the alternative might be, or how he’d want to approach replacing the ACA—these are anyone’s guess. Lee eschews the walk-and-talk interviews Capitol Hill reporters rely on to obtain candid answers on various topics, and his X posts don’t typically provide much in the way of actual insight into his deeper policy preferences.

The conversation among Democrats is, naturally, quite different. The party has centered its shutdown strategy on their demand that the enhanced Obamacare subsidies be extended. At the same time, many Democrats have come around to acknowledging that the ACA fell short of their goals for how health care should operate in the United States.

Sen. Bernie Sanders (I-Vt.), who voted to pass the ACA in 2010 and has at times attempted to salvage the harder-wearing parts of it since, believes the law doesn’t go far enough in providing care for every American.

“We cannot simply defend the status quo in healthcare and the Affordable Care Act—legislation that has provided massive amounts of corporate welfare to the big insurance companies and big drug companies—while premiums, deductibles, co-payments and the price of medicine has soared,” Sanders wrote in an April op-ed.

Sanders is more representative of how Democrats want to approach health care policy. If they manage to take back control of the House, Senate, and presidency, it would once again become a top agenda item.³

If a deal is to be made on the ACA to get us past the government funding impasse, it will be a narrow one on the issue of subsidies. But even that is more than most Republicans want to think about right now. They couldn’t cobble together a single palatable health care law in the first Trump presidency, and they don’t have any desire to try again.

Constructive criticism

People on the internet love to discuss dying art forms, often in the context of artificial intelligence applications taking away occasions for real humans to show creativity and effort. But one art form that has diminished because of other factors, too, is criticism.

Audience capture, the online attention economy, alarming fandoms, and bad financial incentives are some of the reasons that editors and writers increasingly shy away from offering substantial, necessary criticism of books, films, fashion, and music. Those who keep their critical focus end up standing out in a crowd of peddlers of weak and unnecessary praise. (Not to blow our own horns too loudly, but my colleague Sonny Bunch writes and discusses movies honestly, which is why I think so many of my apolitical friends and family who I turned onto The Bulwark now also religiously read Bulwark Goes to Hollywood. And our other culture writing—especially our books coverage—is, like Sonny’s, both entertaining and uncompromising.)

Given my low expectations, I was pleasantly surprised by this recent review of Taylor Swift’s new album in Defector. It’s by Kelsey McKinney, who writes:

Despite my hopes, The Life of a Showgirl is the weakest and least interesting album Swift has ever made. It has no heart, no purpose, no emotional core. And it is transparently clear why that is: because Swift clearly cared more about producing something—anything—that could be sold for profit than about making an album worth buying. It’s not an album. It’s a product for sale, and it sounds like one. . . .

To create something, anything, good, takes time and desire. “A project that takes five years will accumulate those years’ inventions and richnesses. Much of those years’ reading will feed the work,” Annie Dillard wrote in The Writing Life. Good creative work draws on the well of your experience, on everything that you consumed and felt and saw over a period of time. If you dip into the well constantly without giving it time to refill, you end up with nothing but pieces of mud, nothing that will satiate a thirst for art.

Swift hasn’t given herself time to write anything good in years. Since October 2022, Swift has released three full-length albums: Midnights, The Tortured Poets Department, and now Life of a Showgirl. Each of them was weaker than the last. In addition, she has also re-recorded four of her previous albums and released them (with new bonus tracks) as Taylor’s Version editions. During that same time period, she also spent 18 months on the road performing 149 shows on the Eras Tour.

I’ll be the first to admit that I’m not in Swift’s target demographic and didn’t feel compelled to seek out reviews of her latest album,⁴ but even without seeking them out, I found my social feeds full of sycophantic, uncritical reviews. McKinney’s review is a welcome corrective, and it offers a reminder that reading solid criticism is good for your brain.

Read the whole review.

1. Don’t bet your paycheck on this one.

2. “Medicare for all?” Maybe a more palatable name is “Medicare for y’all.”

3. Anything is possible, I guess.

4. My musical tastes are on a spectrum ranging from Slayer to Rick Ross.