PHILIP KLEIN: Republican Obamacare plan signals that liberalism has already won.

I’ve already shared my skepticism that the bill, which doesn’t actually start repealing the major spending provisions of Obamacare until the 2020 presidential election, would actually end up repealing much in practice. But for the sake of argument, let’s just assume the plan gets implemented exactly as written.

Supporters of the bill could argue that it does make changes to Obamacare – repealing taxes, reducing spending, and scaling back some mandates and regulations. There are even a few areas in which one could argue the bill moves health policy in a more conservative direction relative to the pre-Obamacare status quo. It provides for expanded health savings accounts and, though it would spend more money than otherwise would have been the case before Obamacare, it would overhaul Medicaid into a program in which states are given a per capita grant and provided the flexibility to run their own programs.

But at the same time, the GOP bill preserves much of the regulatory structure of Obamacare; leaves the bias in favor of employer healthcare largely intact; replaces Obamacare’s subsidies with a different subsidy scheme; and still supports higher spending for Medicaid relative to what was the case before Obamacare.

What we have here is the GOP negotiating with itself over the terms of its surrender.