Michael Tanner of the Cato Institute devotes his latest National Review Online column to a critique of congressional Republicans’ proposed replacement for the Affordable Care Act.

If you want to see political malpractice in action, you don’t have to read Donald Trump’s latest tweet — just look at the mess Republicans have made of repealing and replacing Obamacare. Given seven years to come up with a replacement for one of the most poorly designed (and most scrutinized) laws in modern history, Republicans somehow managed to botch both the politics and policy.

Replacing Obamacare should have been a low bar. The health-care law did expand coverage, but by less than most accounts would lead one to believe. Of the roughly 20 million Americans who have gained coverage under Obamacare, nearly 11 million are on Medicaid, which provides little of actual value in terms of care. This small benefit came at the expense of virtually destroying the individual insurance market. Premiums for the benchmark silver plan have roughly doubled since the law was implemented, while out-of-pocket costs, including deductibles, co-payments, and co-insurance, have skyrocketed. Consumer choice has dwindled with insurance companies pulling out of the market — roughly a third of U.S. counties and five states have just one insurer offering Obamacare plans — and provider networks shrinking. Keeping your plan and your doctor has become a laugh line. The law’s taxes and regulations have slowed America’s economic recovery, and, according to some studies, reduced its job growth. …

… [H]ealth-care reform may be complex, as President Trump belatedly realized, but Republicans could have hardly asked for an easier target. Unfortunately, given every opportunity to hit it, they have missed.

First, rather than having a proposal ready to go on Day One of the Trump administration, they dallied, allowing Democrats to stir up protests at town halls and seize control of the media narrative. Then, they put their plan together in secret, keeping much of the Republican rank-and-file in the dark. While a handful of insiders designed the replacement bill, there was little or no input from groups such as the House Freedom Caucus. Rand Paul’s traveling copy machine may have been a stunt, but it effectively illustrated GOP leadership’s extreme secrecy and paranoia. It’s little wonder the plan that resulted is already facing opposition from both moderates and conservatives.