OPINION:
I feel like Republicans in Congress are about to blow it.
Since 2010, they’ve been promising the American people they would repeal and replace Obamacare if elected to office. We can bet a repeal will happen. It’s the replacement part that’s in question. GOP Congressmen had about seven years to figure out an alternative — and yet, none exists.
Yes, Rep. Tom Price, President-elect Donald Trump’s pick to head the Department of Health and Human Services, has a plan. So does Sen. Lamar Alexander and Rep. Pete Sessions. House Speaker Paul D. Ryan’s “Better Way” agenda laid out a foundation of what a replacement should look like. But none of the GOP plans agree on the details.
And that’s the problem.
In the Senate, Republicans are going to need a 60-vote majority to replace Obamacare, and the truth is, they don’t have the votes. Eight Democrats are going to need to be swayed to vote for a replacement, and right now, no plan has even been set before them.
Politically speaking, Senate Democrats also don’t have any incentive to work with the GOP. Once Republicans move to repeal, they own Obamacare, its failure and all the political fallouts for not having an alternative.
An argument has been made that 10 Democratic senators — all hailing from states that Mr. Trump won in 2016 and who are up for re-election in 2018 — can be swayed into voting for a replacement. Yet, not all of those senators reside in red states, and not all of their constituents want Obamacare to be gutted.
Yes, Sen. Joe Manchin from West Virginia has said he’d work with Republicans on a replacement. But Florida Sen. Bill Nelson and Sen. Dean Heller from Nevada, are going to be a tougher sell. Sen. Bob Casey from Pennsylvania has vowed to “fight like hell” on replacing President Obama’s signature health care policy.
So you have that.
Yet, the GOP can’t afford not to repeal Obamacare — it’s been their signature platform. There’s no way Senate Majority Leader Mitch McConnell can go home to Kentucky without getting this done this year.
GOP congressional leaders are already going to suffer a political blowback for not gutting the program by their artificial Jan. 27 deadline — when they said they wanted the reconciliation process to be done, with no chance of a replacement bill being ready.
Since Republicans have tied Obamacare’s repeal in the budgetary process, realistically they have until April 28 to actually repeal aspects of the health care law — that’s when funding for the government expires and new funding must be approved.
To do this, all they need is a 50-vote majority, and Obamacare items like Medicaid funds, the individual mandate,and subsidies for private health care coverage — the income-generating portions of Obamacare — would be erased.
Why a replacement is needed almost immediately is because other Obamacare aspects — such as covering those with preexisting conditions, and allowing adult-children to stay on their parent’s health care coverage (the most expensive aspects of Obamacare) — will still be in place, and will need a 60-vote supermajority to change.
Repeal without a replacement will blow the entire thing up, leading to higher government deficits and lack of individual health care coverage.
My worry is by April 28 (or sooner), congressional Republicans are just going to kick the can down the road, because a replacement bill, and the votes to pass it, still won’t be in order.
They’ll do this by repealing the law in the reconciliation process, but not really.
They’ll claim they’ll “repeal” Obamacare, but that repeal won’t actually go into effect until a two or three years’ time — enough so they can figure out a replacement. The devastating aspect of this is the entitlement will become that more entrenched in our society, and that much harder to replace.
This week, Mr. Trump said he wants repeal and replace to happen “essentially simultaneously” — within the same day, or perhaps the same hour as the vote to repeal. He also wants it done quickly, writing on Twitter Friday that “the unaffordable care act will soon be history!”
Mr. Ryan, has set a mid-February date to get a plan enacted, after Mr. Price is confirmed.
But if congressional Republicans don’t come through, you can bet Mr. Trump will turn on them, fast.
And he’ll have a point. GOP House and Senate members have had seven years to come up with a replacement and gather a consensus around it. If they fail to deliver, it won’t be because of a lack of ideas, but out of shear incompetence.
The wildcard is if GOP members do indeed enact a fake repeal, then will Mr. Trump cave and sign it into law, or veto it, daring the GOP to produce something better, with the midterm elections on the line.
I guess we’re just going to have to wait and see. It’s going to be an interesting ride.
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