Wheels Coming Off the Obamacare Repeal Train

January 9, 2017 11:48 p.m.

David has posts below pulling together the evening’s rapid fire developments in the Senate, where Republican defections now appear to have at least delayed Obamacare repeal. This isn’t out of nowhere. A growing number of Senate Republicans have been expressing skepticism about “repeal and delay” for some time now – even though it’s been largely ignored in much of the press. There was an initial flurry of calls for delay just after the election. They were were batted down by the leadership in the House and Senate. But they’ve been bubbling up over the last week.

There was Susan Collins, Rand Paul and even Tom Cotton, who we mentioned on Friday. Then today Lamar Alexander again expressed his opposition (he did so in November too). Alexander is the Chair of the key health care committee in the Senate. Then came Bob Corker saying not to repeal the Obamacare taxes before there was a replacement (a key point we’ll get to below). And then late this evening five senators – Portman, Corker, Collins, Cassidy and Murkowski – introduced an amendment that that would force at least a one month delay before Obamacare can be repealed.

This is, to be clear, hardly the end of repeal. The delay the five Senators are proposing is only more than a month. Just a brief delay in the grand scheme of things. And given the internal dynamics of the congressional GOP, I would not rule out the possibility that the leadership will bully the hold-outs into abandoning their postponement and falling into line. But the GOP only has a 52 seat majority in the Senate. They can only lose three votes. And well over three seem opposed to immediate repeal without a replacement.

But there’s a bigger story here. Early this afternoon I noted that Republicans, through numerous public statements, have already made a huge strategic concession: that no one should lose their coverage or be worse off once Obamacare is repealed. In other words, they now agree – or to put it more crisply, are unwilling to publicly disagree – with the proposition that the more than 20 million people who’ve gained health care coverage under Obamacare should continue to have affordable access to coverage.

The problem is, none of the proposals Republicans are considering come close to accomplishing that. And there’s the added problem that Obamacare just isn’t that unpopular. Only a quarter of voters want to see it repealed. This is the fundamental issue: Republicans say they want to replace Obamacare with something ‘better’. But they’ve adopted the metric of coverage with real health insurance as the standard of ‘better’. And none of their plans come close.

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This is the importance of immediate repeal. Once Obamacare was or is repealed, it’s entire funding base goes too. That means that any replacement that provided anything like the expanded coverage of Obamacare would require a very sizable tax increase – something almost unimaginable under a GOP Congress. The point was to move fast and create a fait accompli.

If repeal is delayed – and more importantly, if it is delayed to have a debate over replacement – Republicans may have missed their best chance to get rid of the law. Don’t get me wrong. I’m not saying it won’t happen. But without creating a fate accompli early it will be much harder – both in terms of the politics and in terms of the perverse desire to kick tens of millions off their health care coverage.

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