Tuesday, January 10, 2017

Obamacare repeal meets bipartisan opposition

The Republican promise to repeal Obamacare is meeting bipartisan opposition. Democrats are protesting the entire idea of repeal. Meanwhile, some Republicans are seeking to delay the repeal or protect some facets of the Affordable Care Act until a replacement can be written.

A core dispute among Republicans is whether Obamacare should be repealed before a replacement bill is ready. Obamacare can’t simply be repealed because it remade the American health care system. Not all of the healthcare eggs that Obamacare scrambled can be unbroken. Removing the law would not restore healthcare to its previous status quo, which was unpopular anyway.

The ultimate solution must take into consideration that an estimated 20 million people are insured under Obamacare. And, believe it or not, some of them even like it. To be politically viable, the Republican plan for repeal and replacement must find more coverage for these Americans.

Democrats contributed to the discussion about how to handle Obamacare with a five-hour talkathon on the Senate floor. The evening bull session among Democrats began at 6:45 p.m. on Monday and lasted into the wee hours of Tuesday morning. The Democrats boiled down their message to what The Hill calls “The Pottery Barn” rule: You break it, you buy it. Ironically, this is the same rule that gave Republicans control of Congress after Democrats passed Obamacare in 2010.

“Get real, [Republicans] don't have a clue what to do next," Sen. Elizabeth Warren (D-Mass.) said in The Hill. "Repeal and run. That's the Republican plan.”

Some Republicans agree that they don’t know what to do next. That is the essence of the debate among Republicans. One faction wants to pass a budget resolution to start the repeal and then follow up with a replacement later. The budget reconciliation is the same trick that Democrats used in passing the original Affordable Care Act to avoid a filibuster by Republicans. The resolution contains language that would direct House and Senate committees to write a bill to repeal and replace Obamacare by Jan. 27.

An amendment introduced by Sen. Bob Corker (R-Tenn.) would extend the deadline to craft a replacement law until March 3. Corker is joined by Rob Portman (R-Ohio), Lisa Murkowski (R-Alaska), Susan Collins (R-Maine) and Bill Cassidy (R-La.) in favoring more time to write the new law.

“This amendment will give the incoming administration more time to outline its priorities after its chief healthcare official assumes office and fully reviews the tools currently at his disposal,” Corker told the Washington Examiner. “By extending the deadline for budget reconciliation instructions until March, Congress and the incoming administration will each have additional time to get the policy right.

Republicans all favor a repeal of Obamacare, but they have not agreed on a replacement. The original bill allows only a few weeks to write a complex bill to restructure the health insurance industry. Corker’s amendment would extend that time to a few months.

In either case, Obamacare will probably not go away instantly. MarketWatch reports that Republicans may delay full repeal for two to four years while the replacement law is written and implemented. At the same time, they will also be working on reforming the tax code, another massive undertaking which will be passed by the same budget resolution tactic.

While the budget reconciliation to repeal Obamacare would be passed by a simple majority vote, subsequent bills to replace it would be subject to cloture votes that require 60 votes. This would allow the 48 Senate Democrats to block bills that Republicans try to pass separately from the budget resolution.

Republicans can’t count on the Democrats to pitch in. “I take (Senate Minority Leader Chuck) Schumer at his word that if we just go ahead and repeal, Democrats won't provide one vote for enacting the replacement," Sen. Ron Johnson (R-Wis.) told CNN. "So I think we need to actually have a game plan.

One sticking point among Republicans is whether Obamacare’s taxes should be repealed immediately. Bloomberg reports that some Republicans, among them Sen. Cassidy and Rep. Pete Sessions of Texas, believe that the Obamacare taxes should be repealed as part of the tax reform.

The problem, according to Cassidy, is that most Republicans have taken a pledge not to raise taxes. If the Obamacare taxes are repealed immediately, “then you’re in a hole” where Republicans politically cannot enact a new healthcare law because they can’t vote to pay for it.

“If we don’t like ’em, we can replace them,” Cassidy said. “But we can do it in a way where you overall are lowering tax rates and making the tax code more efficient. There will be enough there for people to win.”

Other Republicans say that the taxes must go immediately. “Repeal it, get rid of it, every single bit of it, don’t keep any of it,” said Rep. Jim Jordan (R-Ohio). “That’s all the taxes, all the mandates, all the things that are in this thing that the American people don’t like and that I think have driven up the cost of medicine, hurt economic growth. I think we’ve got to do what we told voters we were going to do.”

A second problem is defunding Planned Parenthood, which will also be part of the budget reconciliation. Pro-abortion Republicans Susan Collins and Lisa Murkowski may not vote for the budget bill if it defunds the abortion provider. The loss of their votes could derail the repeal effort.

Corker told CNN that it “doesn’t seem very intelligent” to repeal the law without knowing what is going to replace it. Rand Paul agreed, “I will do everything in my power to have a vote on it the day we repeal Obamacare.”

Nevertheless, the Republican leadership is still pressing for a quick repeal and eventual replacement. “We're not going to do a comprehensive bill,” said Sen. John Cornyn (R-Tex.). “We are going to do it in a step-by-step basis” with a series of smaller bills.

The direction that the GOP will take will soon be evident. The Senate plans to vote on the budget reconciliation authorizing the repeal of Obamacare this week. 

Originally published on The Resurgent

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