The fever dream is real. Congress can slaughter the Affordable Care Act and, in so doing, rob former President Barack Obama of perhaps his most significant domestic legacy.
But scuttling ACA without concurrent replacement would be bad policy, bad politics and devastating for insurers and the insured, alike.
Please, slow down.
Congressional Republicans have their president now in Donald Trump. Parliamentary maneuvers mean they have the votes to gut the health care law, commonly known as Obamacare.
But go ahead, ask House or Senate leadership about what replaces it. We'll wait. It's a question they've fielded for years, often after symbolic votes to kill the admittedly imperfect health insurance mandate.
You'll hear about tort reform, allowing the purchase of insurance across state lines. You'll hear about tax credits and health savings accounts. You'll hear about the "power of the free market."
What you won't hear is any semblance of a plan that protects the 18 million Americans who, according to the Congressional Budget Office, would lose coverage should Obamacare shrivel up and die. You won't hear any ideas about how, throughout the lengthy process to unwind Obamacare, the health care market doesn't enter a free fall for those insured by employers and those covered within the ACA's exchanges alike. You won't hear any ideas to keep insurers from fleeing the exchanges once it's sitting on death row or a legitimate proposal to fend off the spiking insurance premiums and skyrocketing national debt, described by CBO.
None of that grapples with protections for pre-existing conditions or the ACA's other widely popular pieces.
Fact is, congressional Republicans haven't cared about that for the past six years. ACA was little but a political device. It was a tool to whip up already festering disdain for Obama's presidency. Most Republican leaders didn't expect Trump to win. Rank-and-file Republicans are now running to reporters describing their panic over the situation they now find themselves.
Now Republican leaders must govern, while their right-flank clamors for immediate action. They're backed into a corner, pressured to kill a massive program that touches on the budget, health care delivery, insurance and countless other aspects of society that affect peoples' lives every day. And they're doing it while Democrats, waiting for failure, are ready to pounce.
Even Trump, just recently, boxed congressional Republicans in. "Everyone" will be covered, he said. Trump's handlers quickly "clarified," as usual, noting that the president isn't some single-payer lefty. Universal coverage isn't the goal under GOP rule. They call it "universal access." The two are not one and the same.
Trump wants Obamacare sent to death row in a matter of weeks. Right-wing House Republicans want it dead even sooner. Congressional leadership promises a viable replacement. It's the same thing they've said for seven years. The result never changes.
Trump swears his somehow-ethereal plan will be "great." But everything's "great" in the president's world, so that doesn't carry any weight.
It's up to Speaker Paul Ryan, Majority Leader Mitch McConnell and their lieutenants. They're the ones burdened with fulfilling their mandate without burning the very people who gave it to them. They're the ones who must ditch the posture of an obstructionist opposition and craft a replacement that assures market stability. They're the ones who should reach out to centrist Democrats, who also have a responsibility to work for the country and not simply raise the flag of obstruction.
Orchestrating ACA's death is easy. But doing so without a known legitimate replacement would prove a national tragedy.