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GOP debate: What happened to healthcare?

I didn't really expect to see the medical device tax come up during the Republican presidential candidate debate on Wednesday night, but I thought healthcare policy would be put through the wringer at some point and that—you never know—one or two of the more-informed candidates might rail against the excise tax to score some points with the business community. That was my line of thinking before the debate got underway on CNBC. Then the train wreck started, and substance—never mind something as parochial as the device tax—was the first casualty.

I have to wonder how you avoid talking about healthcare, which represents approximately 17% of the national gross domestic product, during a debate titled, "Your Money, Your Vote?" But, with the exception of a largely predictable give-and-take on Big Pharma and greed, some legitimate questions about Ben Carson's ties to a dubious dietary supplement company and Mike Huckabee's baffling idea that finding cures for heart disease, diabetes, cancer and Alzheimer's somehow would "fix Medicare," healthcare issues were a no-show.

And that is downright bizarre, as noted in a blog post in Salon today, when you consider that the Affordable Care Act (ACA) has been red meat for Republicans ever since it became law.

"I've been a little bit surprised that the Republican debates so far this cycle haven't featured more Obamacare bashing," writes Heather Digby Parton on salon.com. "There was a time, not too long ago, when repealing the hated program was the animating issue of the party and, in the case of many of those who won in 2010 and 2012, their raison d'etre. As recently as 2014, this was the GOP's top agenda item, the rallying cry sure to bring the crowd to their feet. Now we barely hear about it from the Republican candidates for president," writes Parton. We continue to hear about it from Congress, however.

Last week, House Republicans voted to repeal core parts of the Affordable Care Act (ACA), including the device tax, and that measure is now with the Senate. Using so-called "reconciliation" to expedite the process, the Senate could bypass Democratic opposition and prohibit a filibuster, sending the bill directly to the president. The bill would also strip federal funds from Planned Parenthood. It is hard to imagine a scenario under which President Obama would not veto this bill.

Many in the medical device industry claim that the tax has caused companies to scuttle expansion plans and reduce investment in research and development. The administration, however, has vowed to veto any attempt to repeal the device tax, which it sees as a financial pillar of the ACA, unless an offset is found. (The tax is projected to raise $20 billion between 2013 and 2019, according to the administration, but it has fallen well short of its goal thus far.)

Republicans have held more than 50 votes trying to repeal the ACA, without success. Is that an example of principled determination, or Einstein's definition of insanity—doing the same thing over and over and expecting a different outcome?

TAGS: Medical
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