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Obamacare Repeal: Back to Square One

Repeal-and-delay is back.

Early last month I outlined the problem that Republicans were facing when it came to repealing and replacing Obamacare:

Republicans’ biggest problem is that, unlike the Democrats in 2009 and early 2010, they don’t have a filibuster-proof majority in the Senate. Since Republicans don’t seem inclined to nuke the filibuster itself, they’ll need significant Democratic buy-in to enact a replacement. Specifically, they have just 52 of the needed 60 votes, and the extra votes will not come easily: Democrats are united in defense of the law.

The one workaround is the “reconciliation” process, which is filibuster-proof but can be used only for matters related to the budget. A bill passed through reconciliation can eliminate Obamacare’s taxes and subsidies, in other words, but it can’t touch the law’s mountain of other insurance regulations, including those that dictate plans’ pricing and coverage.

In response, the tactic Republicans have come up with is “repeal-and-delay”: kill the law’s funding through the reconciliation process immediately, but set the changes to take effect two to four years from now. This will force Democrats to the table and give Republicans time to craft a replacement based on the various blueprints that conservative groups have put together.

A month and a half later, they have a brand new plan, reports the Wall Street Journal (paywall). It involves a series of “precarious steps.” The first is to pass a reconciliation bill that repeals key chunks of the law and (possibly) creates part of a new system as well. This will “likely include a transition period designed to prevent people losing coverage abruptly.” Executive actions could help ease the transition as well. Further changes will be made a little at a time, through bills that will require 60 votes in the Senate, meaning eight Democrats in support.

So, it’s more or less repeal-and-delay again. As it turns out, there just aren’t that many ways to coerce Democrats to support Obamacare repeal.

The leadership is betting that Republicans won’t dare block the effort, despite being deeply divided on key issues including financial assistance and Medicaid, and that Democrats will get on board with further reforms once a reconciliation bill is enacted.

Those are big bets. It will be incredibly embarrassing if the GOP can’t get a reconciliation bill through, and disastrous for the country if a reconciliation bill destabilizes the market and Democrats and Republicans can’t work together to steady it.

Robert VerBruggen is managing editor of The American Conservative.



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