When it comes to replacing Obamacare, just what do Republicans want?

In 2010, President Obama signed the Patient Protection and Affordable Care Act into law. Since then, conservatives and Republicans have attacked the bill.

Rightly so: It’s based on a penalty that Chief Justice Roberts called a “tax.” It greatly expands federal reach into health care and into the economy at large. It has made millions of Americans dependent on the federal government instead of offering them cost-effective, market-based options. And it just plain doesn’t work well.

Americans want good, affordable and accessible medical insurance. Obamacare isn’t the way to deliver or pay for it.

So, what’s the Republican alternative?

Yes, both House and Senate have advanced their own plans. Yes, the media have not given them a fair hearing. But why during the seven years they had to craft a consensus plan with which to replace Obamacare did Republicans leaders not do so?

What is the GOP Doing?

“Every Republican running for office promised immediate relief from this disastrous law,” said President Trump this week. They have been talking about repeal and replace “for the last seven years,” he said.

Mr. Trump is right to be frustrated. Seven years, no agreed-upon Obamacare alternative.

I worked for many years on Capitol Hill. I grasp how hard these things can be. Politicians come and go. Leadership changes, as do policy priorities and fiscal realities.Members of Congress usually have strongly held views, which is why they were elected in the first place. These views often conflict. That makes finding common ground hard.

But it’s the job of leadership to get people of common cause to work together and agree on the basics. Surely, the GOP could have coalesced around a measure all but a few outliers could have accepted. It could have been ready to go shortly after the new Congress began.

Instead, they were long on Obamacare attacks and short on figuring out exactly how they wanted to replace it. They then banged together bills that were not well-vetted and whose provisions they did not explain.

And in one of the more bumbling moves in recent political memory, not a single woman Republican was on the team assembled by Senate Majority Leader McConnell to draft the GOP bill.

Working Towards a Consensus

This is all maddening. In the early 1990s, I served on the staff of then-U.S. Senator Dan Coats of Indiana. He became frustrated by the lack of leadership on health reform, so he had staffers compile legislation he had offered and sponsored into a comprehensive package of bills.

This old collection of bills is no longer relevant. What’s relevant is that for more than a quarter-century, the GOP has had every opportunity to come together around a common plan. The kind of plan Sen. Coats offered and the other GOP innovators have tried to advance.

Over the years, Republicans have put forward a number of creative plans to bring needed change to the way Americans get the care they need. Four of the most significant and recent were detailed here at The Stream in January of this year.

For example, in the previous Congress (2015-16), there were two comprehensive GOP reform plans offered. Congressman Phil Roe, R-Tenn., himself a physician, introduced his comprehensive American Health Care Reform Act, after first introducing it in 2013. Then there was a far-reaching measure by Congressman Pete Sessions, R-Texas.

None of the Republican plans offered over the years have satisfied everyone in the House or Senate GOP. But they provided blueprints that, taken together and sorted out, could have been the basis of a single plan that the great majority of congressional Republicans could have supported.

Instead, we’re stuck in political neutral, barely scraping by in the Senate and with great dissatisfaction among Members in the House.

Similarly, Republicans are all for tax reduction and simplification. So are most Americans. But do they have a consensus bill ready to go? Did they present President Trump, early after his inauguration, with a consensus draft he and his team could have worked with them on enacting out of the box? To my knowledge, no.

And so it goes.

Patience is Wearing Thin

Conservatives have every right, even duty, to draw attention to the faults in the Democratic Party’s ill-conceived policies. But if that’s all we do, if we run against the left without preparing to govern, we do a disservice to the American people.

There is still time to find ways at least to undo some of Obamacare’s worst provisions. And replace them with measures that reduce government’s role and let people have real health care choices.

But the patience of the American people is wearing thin. As is their confidence in the capacity of the party with which they have entrusted Congress to do what it promised.