EDITORIAL: Neither repeal, replace nor repair

July 19--Insurance companies currently are evaluating whether to participate next year in the federal health exchange. That is where more than 200,000 Ohioans purchase health coverage on their own. The marketplace already faces turmoil, largely due to the uncertainty about what the Republican Congress will do with its pledge to repeal and replace the Affordable Care Act.

It did not help when President Trump tweeted on Tuesday morning: "As I have always said, let ObamaCare fail then come together and do a great healthcare plan. Stay tuned." Put aside that the president and allies have had ample time to advance something "great" as a substitute. To invite the failure of the exchange tells insurers to flee, the president denying funding for subsidies and otherwise weakening essential elements of the marketplace.

The president tweeted in the wake of the Republican repeal and replace effort suffering multiple blows. Mitch McConnell suddenly lacked the votes for the legislation he has been pushing the past month. When the Senate majority leader then advanced the option of a repeal now with a replacement in two years, he quickly lost Susan Collins of Maine, Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia.

Capito was particularly emphatic: "I did not come to Washington to hurt people."

The proposal to repeal and delay that McConnell has in mind already cleared the Senate two years ago. The Congressional Budget Office projected 32 million people would lose their insurance. The bill would end subsidies for private coverage, along with halting the Medicaid expansion and the individual mandate. The outcome would be more cruel than the legislation Republicans recently have had in play.

No doubt, McConnell has a tough task, stitching together a majority when the divisions are deep among Republicans, arch conservatives tugging in one direction, Rob Portman of Ohio and those closer to the center pulling toward the opposite. Yet this moment is about more than differences among senators.

For example, Portman has been quick to highlight flaws (and they are real) in the Affordable Care Act. He has all but promised relief from high deductibles, co-pays and rising premiums. Yet, as things stand, the senator and his colleagues have not come close to a credible policy replacement.

Perhaps that is because the Affordable Care Act draws on many Republican ideas, including the exchange and the individual mandate, and now the party's concept cupboard is bare.

If anything, that reinforces the responsible course from here, one Gov. John Kasich emphasized over the weekend -- Democrats and Republicans working together. This editorial page argued not long ago that Sherrod Brown and Rob Portman surely could find a way to repair the Affordable Care Act. Brown later suggested the same. Why not test the proposition? And in the meantime? Stick with the Medicaid expansion and support the federal health exchange as designed, bringing the necessary certainty to insurers, helping Ohioans and others across the country gain access to affordable health coverage.

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