PETER SUDERMAN: Why Republicans Didn’t Repeal and Replace Obamacare.

Trump’s inexperience is a factor here. But the outsider president’s expectations were set in large part by seven years of Republican promises to repeal and replace the health care law. And throughout that time, Republicans were never really serious about developing a replacement plan that could pass.

Back in 2013, when Obamacare’s exchanges went online, and immediately crashed, it was clear that many Republicans were simply not interested in productive health policy improvements. Instead, they viewed the struggles of the health care law strictly as a political cudgel to wield against political opponents.

To be clear: I am not saying that there were literally zero Republican health care policy proposals. There were any number of white papers and policy frameworks and even a fully written piece of legislation or two. But there was very little effort to sell these plans to either the broader public or to Republican lawmakers, and to create the political conditions under which they were likely to both pass and be successful. What Republicans lacked was a shared vision—a theory of the case and how best to address it.

These efforts take significant time and energy. Democrats and their allies on the left spent nearly two decades working through ideas and building broad consensus after the failure of President Bill Clinton’s health care plan in the early 1990s. Republicans didn’t mount a similar effort. This was a widespread institutional failure driven by a combination of policy disinterest and political cynicism.

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