June 29, 2015

As Paul Ryan demonstrated during his appearance on CBS' Face the Nation Sunday, conservatives are just about out of ACA talking points now. We've gone from death panels, to "government-run healthcare," to "it's illegal because a word is out of place," to....nothing.

We begin with the tired and false "repeal and replace" call:

I'm as motivated as ever before to repeal and replace this law, and that's what we're working on. What I really worry about, John, with this ruling is the grave injustice it does to the rule of law. I mean, so much for calling balls and strikes. I think Justice Roberts is now counting foul balls as home runs.

And, look, I think that they have done a great disservice to the country, because they're rewriting laws at the bench. We had three constructionists on the court, when we should have had five. And, so, yes, I'm very shocked at this ruling, but it does not deter us from actually delivering on what we really want, which is affordable care for everybody, and let people choose what they want to buy. And that's not what this law does.

Just because the chorus must be sung, please let's remember there is no "replace" in their lexicon. Only "repeal."

Conservatives do not believe everyone should have access to health care. Period. Therefore, they have no intention of changing anything.

That doesn't play well in the 2016 context, though, so Ryan is instead dancing to Frank Luntz' focus group-tested message.

So, yes, that's what we're going to go with now, is go back to working on coming up with a comprehensive replacement bill, showing the country what that looks like, how we can fix this mess, and then implement the fix in 2017.

Dear Nation, I have already told you what their 2017 alternative is, and it's nothing that comes near "replacing" the Affordable Care Act.

Right after Ryan claims they came up with a replacement plan already he admits there is no plan.

I think we will see more of those now. We were working on responding to King-Burwell, should the court stick with the Constitution and the rule of law as written. Since the ruling didn't go the right way, from our perspective, I think we're now going to work on a comprehensive replacement plan.

Oh, after 50+ repeal votes suddenly they're going to work? Stop the presses!

And now we get to the new talking point.

Look, I just don't think this law is fixable. It's born on such a fundamentally flawed premise.

It makes people buy what the government lets you -- only lets you buy. It's going to lead to massive consolidation, virtual monopolies of insurance companies, government-run corporations, effectively. And it denies people choice. It gives the states no rights to craft markets for themselves that work for them.

So, I just think it's so fundamentally flawed. I think the law is going to collapse under its own weight. The rationing it will do to Medicare, the denial of choice, the double-digit increases in premiums we seem to see every year is something that I just don't think the country's going to stand for.

Everything old is new again, isn't it?

Point #1: It makes people buy what the government lets you is just patently false. You can go out and buy other policies with other companies that offer required coverage. It's just that if they're not on the exchange no subsidies are available.

Point #2: Medicare, like all health care, is already rationed and had been by insurers. That Medicare point is intended only to create generational divides.

Point #3: Double-digit increases in premiums have slowed under the Affordable Care Act. Before the ACA passed, they were the norm, not the exception. And now they actually have to justify those increases. Transparently.

The logical next step here in our healthcare journey is to fight to add a public option or Medicare buy-in to this system. It's time, now that this case is behind us, to stop letting Republicans define healthcare in terms of repealing and replacing, but for all of us who understand what the pathway forward should be to start being as strategic and vocal as they have been.

Paul Ryan and all the rest of them will keep whining about the ACA, but that's all it is. This battle is done for them and they know it. So now it's time for us to start talking about how to make it better.

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