Notice to Republicans: One of the primary reasons you are the majority in the House and Senate and have a Republican in the White House is the promise you made to repeal Obamacare. Know this, Republicans, failure to keep this promise places you at politically mortal risk.
It wasn’t a maybe, it wasn’t a might, and it wasn’t a we’ll try. It was a promise and we expect you to keep that promise. Repeal Obamacare. Repeal all of it.
Just because it’s difficult and will make some people mad is no excuse. Don’t replace it with Obamacare light and don’t keep it for some because of your perception of political risk. You are at risk from your base far more than you are from the Democrats and fellow travelers. Nothing you do will get anything like support from Democrats.
So do what you said you would do. Repeal Obamacare.
The High Stakes of Repeal-and-Replace
How Republicans proceed on Obamacare will have huge political implications, so they should take the time to get it right.
From National Review: By JIM GERAGHTY, February 2, 2017
The Affordable Care Act failed to live up to expectations in part because of the way the Obama administration and the Democratic Congress chose to tackle the complicated, multifaceted issue of health-care reform.
In the minds of the Democrats, all of the problems in health care had to be addressed in one massive bill. The sales pitch for Obamacare set up unrealistic expectations: Families could expect their premiums would go down by $2,500 per year, and if they liked their plans and doctors, they could keep their plans and doctors. It had to be passed quickly, before the president’s political capital had dwindled; some Democrats admitted they didn’t even have the time or patience to read every one of the bill’s thousand-plus pages before voting on it.
In January, President-elect Trump offered a similarly grandiose promise that everyone would be pleased with the replacement legislation:
- “We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”
What’s more, Trump said before his inauguration that he expected Congress to repeal Obamacare and then “very quickly or simultaneously” pass legislation to replace it.
But replacing such a massive law is much easier said than done, and even repealing it will prove more complicated than it sounded on the campaign trail. At least 40 Democrats will be strongly inclined to filibuster any repeal, so Republicans will have one of two options: They could nuke the filibuster entirely, which would leave them with no real power to block legislation if and when Democrats regain control over the chamber someday, or they could attempt to gut the law through the budget-reconciliation process, which is filibuster-proof. But not all of Obamacare can be repealed through reconciliation.
“There are no Democrats signing up to help us with this,” Senator Pat Toomey (R., Pa.) warned while discussing Obamacare at the Koch winter summit in Indian Wells, Calif., this past weekend. At the same event, Senator James Lankford (R., Okla.) said he was wary of replacing Obamacare with a similarly gargantuan and complicated bill: “We can’t replace a 2,700-page bill with another 2,700-page bill. This is going to be a series of bills.”
Lankford predicts that the end of Obamacare will take around six months. First there will be a series of decisions by Health and Human Services Secretary Tom Price once he is confirmed and situated in office. The original language of Obamacare left enormous power in the hands of the HHS secretary; the bill language listed more than 1,000 actions “the Secretary shall” take. Under one of Trump’s first executive orders, Price will have the authority to conclude that the tax penalty for not having insurance under the individual mandate represents a “serious burden” on violators and exempt them from paying it.
At the Koch meeting, Lankford said he envisioned Price’s actions as secretary being supplemented with a partial repeal though reconciliation legislation. Then there would be a series of replacement bills, which would take three years to fully implement.
One replacement option that seems to be gaining some momentum on Capitol Hill is the “Patient Freedom Act,” introduced by Republican senators Bill Cassidy (La.) and Susan Collins (Maine). The primary strength of this bill is a federalist approach that leaves states a lot of leeway to set health-care policy, including the option to keep Obamacare as it is. Cassidy and Collins think this could defuse some of the opposition to repeal in deep-blue states.