Op-Ed

Repeal, repair, rebuild — and rampaging goats: the rhetoric of Obamacare

A lawmaker recently compared Obamacare to a goat destroying his house.
A lawmaker recently compared Obamacare to a goat destroying his house. Associated Press

The Obamacare repeal effort is just getting under way, and already the political wordplay is dizzying. On the GOP side, the rhetoric has gone from “repeal and replace” to “insurance for everybody” to “repair and rebuild.” Meanwhile, Democrats continually warn that the Republicans are trying to “rip apart our healthcare system.”

To help you keep pace with the debate, we’ve assembled this handy glossary of buzzwords and talking points. Enjoy.

From Republicans

‘Repair and rebuild’

This is the GOP’s attempt to describe its legislative strategy for Obamacare, and an evolution of the phrase “repeal and replace.” As Politico reported Thursday, it is the mantra of Oregon Rep. Greg Walden, who is leading the offensive against Obamacare in the House. It is meant to soften the GOP’s tone and suggest the replacement effort will be carefully staged and surgical. It also opens the door to delay tactics if things don’t quickly shape up in the GOP’s favor.

‘We won’t pull the rug out’

This is the GOP’s favorite metaphor. Congressman Tom Price, Donald Trump’s pick to lead the U.S. Department of Health and Human Services, trotted it out last week at a courtesy hearing to offer assurance that Republicans will preserve access to healthcare. It’s a rhetorical bulwark against efforts by Democrats to portray the Republican plans as callous and catastrophic.

‘Insurance for everybody’

That’s how Trump described his plan to replace Obamacare to the Washington Post. Other Republicans have deliberately avoided making such a sweeping promise, and Trump himself has already walked it back. It stands as an example of how quickly rhetoric gets floated, seized upon and then just as quickly jettisoned.

‘Universal access’

This is the GOP term that emerged in mid-December to describe lawmakers’ ultimate destination for insurance coverage. Republicans are essentially promising to elevate the use of catastrophic coverage and other products to provide access to varying levels of coverage and different price points. But whether these plans will be affordable remains to be seen.

‘Obamacare only affects 7 percent of the market’

GOP lawmakers use this talking point to downplay the consequences of repealing the health law. Most people get insurance through their employers, Medicare or Medicaid, they point out. Individual coverage only represents a small fraction of the market.

However, that 7 percent accounts for more than 15 million people, and many provisions of the Affordable Care Act apply to employer-sponsored plans as well.

‘We must eject the rampaging goat’

In describing the negative impact of Obamacare, Rep. Drew Ferguson, a Republican from Georgia, went where no one expected: a goat metaphor. Ferguson said the goat (Obamacare) “has been messin’ in and destroying my house” for six years. His conclusion? Well, he wants the goat out so he can clean up and renovate. The metaphor carries no special relevance, other than displaying the lengths to which lawmakers will go to make their point.

From Democrats

‘Make America Sick Again’

A play on Donald Trump’s campaign slogan, this phrase emerged in early January as Democrats held rallies to generate support for Obamacare. Judging by the nation’s $3.2 trillion tab for healthcare costs in 2015, a number expected to jump as high as $3.6 trillion this year, it seems clear a lot of us are pretty sick already. But you get the point.

‘You break it, you own it’

It’s an enduring mantra for Democrats. It is meant to back Republicans into a political corner and make clear the GOP will take the blame for any bad fallout from tinkering with Obamacare.

‘Trumpcare’

This portmanteau, an obvious take on Obamacare, was suggested by President Obama himself. It turns the tables on what has often been a pejorative way of describing the Affordable Care Act. It also suggests that, for good or for bad, Donald Trump will own whatever replacement plan emerges.

‘They want to rip apart our healthcare system’

Democrats use this talking point as a rhetorical sword against GOP repeal plans. It is meant to stoke fear that Republicans will dismantle Obamacare without a clear plan to replace it, leaving millions in the lurch.

‘I can’t buy a $10 million house’

Bernie Sanders deployed this metaphor to make the point that promising universal access to healthcare doesn’t mean everyone will, in fact, get healthcare: “I have access to buying a $10 million home. I don’t have the money to do that.” Its intent is to portray the GOP as out of step with the needs of average citizens.

#savemyhealthcare

This is the Democrats’ favorite health-related Twitter hashtag, featuring testimonials of those who say the law has benefited them. There’s also #The27Percent, a group of Americans under 65 with preexisting conditions who are worried about losing coverage.

‘Eliminating healthcare coverage for 32 million people’

It is the Democratic statistic of the week and comes from a Congressional Budget Office report requested by Senate Minority Leader Charles Schumer. The CBO indeed estimated that the number of uninsured would rise to 32 million by 2026 if the ACA is repealed. Republicans say that’s meaningless because it doesn’t take into account a GOP replacement plan.

This piece was originally published by STAT, statnews.com, a national publication reporting on health and medicine.

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