It was hardly risky for President Barack Obama and Democrats to create the Affordable Care Act (ACA) without Republicans in 2010 because they had a veto-proof majority in both houses of Congress. It was equally without risk for Republicans to vote again and again to repeal the measure when Obama was in office to veto it. Today, it carries no risk for Democrats to oppose replacement bills by House and Senate Republicans because they don't want it replaced.
If, as appears to be the case, the Republicans' Senate bill doesn't pass and the ACA federal market keeps collapsing, it will be incumbent upon both parties to work together on a replacement. We have thought this was the best way forward since a Republican president was surprisingly elected in November to go along with the Republican Senate and House elected in 2014 and 2010, respectively, at least in part to get rid of the ACA.
A Republican plan that would repeal most of the ACA and give Congress two years to figure out a replacement could be resurrected - it got all but two GOP votes a year ago - but several senators already have put the kibosh on that. So it's looking more and more like a bipartisan plan is the best idea.
The cracks are even beginning to form in Democrats, who have vowed to have nothing to do with any Republican-led attempts to repeal and replace the health care measure.
"To my Democratic colleagues," said Sen. Richard Durbin, D-Ill., "this is no time for high-fives. We have work to do."
"Republicans should start from scratch and work with Democrats on a bill that lowers premiums, provides long-term stability to the markets and improves our health care system," Senate Minority Leader Chuck Schumer, D-N.Y., said.
While that is movement, the minority leader's idea of "start[ing] from scratch" indicates he believes the way forward is to tinker at the margins of the ACA, which is what some conservative Republicans believe their House and Senate plans already were.
No, Schumer and his fellow Democrats need to understand that a health care bill created from scratch by both parties is a law that actually starts at the beginning. As in, goodbye mandates, goodbye fines, goodbye unneeded coverages.
Both sides will have to give something to get what they want. Republicans, for instance, in both House and Senate plans, wrote in ACA mandates on allowing children to stay on their parents' plans until age 26 and not punishing clients for pre-existing illnesses.
What will Democrats give up? They're not saying. But they'll have to.
The sooner the parties come together and start anew, the better.