After trying and failing to repeal the Affordable Care Act, most congressional Republicans grudgingly agreed a few years ago to simply move on to other issues. GOP officials didn’t have a plan of their own to replace Obamacare, public support for the ACA had turned repeal efforts into a political loser, and the calculus for Republicans became simple.
In 2025, however, the health care debate has regressed to familiar ground. GOP officials haven’t just started condemning the Affordable Care Act in ways that echo the rhetoric from 2010, they also have brought back their “repeal and replace” posturing while offering vague assurances about a Republican alternative to the existing health care system.
To be sure, Republicans do not have a health care plan. They have spent 16 years trying to come up with one, and at this point, it’s a safe bet that no such plan will ever exist.
Occasionally, however, GOP officials claim that they have some ideas about health care policy that they want to be taken seriously. Take Sen. John Kennedy of Louisiana, for example.
“I think a lot of people, I’ve certainly been thinking about what we could do to try to fix the Affordable Care Act,” the senator told CNN. “There are a number of ideas being batted around association health plans.” Kennedy specifically endorsed “bringing back high-risk pools, which have been outlawed under the Affordable Care Act.”
For those who might benefit from a refresher, the idea behind high-risk pools might sound appealing at first glance. Kennedy was describing an insurance model in which older consumers and those with preexisting conditions, and younger consumers who are healthy, are kept in separate risk pools. As a result, the latter group can spend far less on coverage, since insurers expect they’ll need less (and less expensive) care.
The GOP senator made this point explicitly during his on-air appearance, saying this approach would be appealing to “a lot of young people.”
Perhaps. But what Kennedy either didn’t know or didn’t say was that this model allows insurers to charge the young and healthy far less, while charging those who are neither young nor healthy vastly more.
Indeed, Americans have some experience with this model: It’s the one that existed before the Affordable Care Act became law.
States created high-risk pools to cover people with expensive health care needs — those with preexisting conditions, for example — keeping them out of the patient pools with younger and healthier people. The high-risk pools, however, created dramatic problems for those who needed the most help: Americans with preexisting conditions were stuck with plans they couldn’t afford and benefits that didn’t meet their needs.
Kennedy complained to CNN that the ACA scrapped these high-risk pools. That’s true. But it’s also true that this is a feature, not a bug, of the Affordable Care Act: Obamacare fixed this problem to the benefit of millions, with shared risk and guaranteed protections for those with preexisting conditions.
If the junior senator from Louisiana wants to have a big debate about turning back the clock, that sounds great, though Kennedy might not like where the discussion ends up.
This post updates our related earlier coverage.
This article was originally published on MSNBC.com
