‘ Repeal and replace’ collapses. So now what?

Tellingly, the latest and perhaps last Republican strategy on health care is a measure that would repeal the Affordable Care Act in two years with no replacement in sight.

So much for repeal- and- replace. Republicans did not have a viable alternative to the ACA when they staged their first repeal vote seven years ago. They don’t now, and in all probability would not in two years even if the repeal measure were to pass.

They don’t have a plan because meaningful reform ideas are few and far between and involve tough political choices. And they don’t because the ACA, in many respects, grew out of Republican plans from the 1990s and early 2000s.

By trying to kill the law, first with the specious argument that they had something better and now without any such pretense, Republicans have left themselves in a bind. They’ve moved the goal posts so far that they have run out of playing field.

Just hours after Senate Majority Leader Mitch McConnell announced the repeal- only plan, it was in critical condition. Three GOP senators, sufficient to kill the deal, came out against it. Several others, seeing how devastating it would be to their states, would stop it if necessary but would rather not buck their party unless they have to.

The repeal- only approach has more problems even than the repeal- and- replace proposals. Rather than stripping 23 million or 24 million people of their health care coverage, it would do so for 32 million people, according to the Congressional Budget Office. That’s one in 10 people in America.

Repeal- only would slash the Medicaid that pays for nearly half of all newborn deliveries and most nursing home care. It would force the closure of many rural hospitals, clinics and drug- treatment programs that rely on Medicaid and cost- sharing subsidies. And the uncertainty would foment chaos in the health care world.

Insurers, highly skeptical that Congress could agree on a replacement, would respond by fleeing health care exchanges, leaving no option for buying individual coverage.

These shortcomings have been known for a while. As recently as a few short weeks ago, McConnell himself insisted that lawmakers have an alternative in place before passing any kind of repeal.

The question now is: What next?

President Trump responded with a typical Twitter- snit. “Let Obamacare fail and then come together and do a great health care plan.”

A more fruitful approach came from Sen. Lisa Murkowski, RAlaska, one of the no votes on the repeal- only plan. “Republicans have to admit that some of the things in the ACA we actually liked,” she said, “and the Democrats have to admit that some of the things they voted for in the ACA are broken and need to be fixed.”

Repeal- and- replace is dead. Repeal- only appears dead. Now’s the time for a bipartisan effort to retain and repair.

Parties should work together to retain and repair 2010 health law