A man holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare in Miami, Fla in 2015.
Photo by Joe Raedle/Getty

The Republican ‘Obamacare’ crusade is off to a very shaky start

Since Election Day, Republicans have coalesced around a health care idea called “repeal and delay.” Roughly speaking, the strategy involves GOP lawmakers using their majority status to quickly pass legislation that repeals the Affordable Care Act, while also leaving the law – or at least most of it – intact for years while Republicans work on their alternative.

The original GOP idea, of course, was “repeal and replace,” but that fell out of favor when it dawned on Republicans that replacing an effective reform system is extremely difficult, and they had no idea how to achieve their goals.

But as the new Congress gets underway, even “repeal and delay” is running into trouble. Bloomberg Politics reported today:
A fourth Republican senator has voiced strong doubts about the party’s current strategy to repeal Obamacare without detailing a replacement, more than enough to scuttle efforts to deliver swiftly on a central promise from President-elect Donald Trump.

Bob Corker of Tennessee told reporters Friday morning that he wanted a different approach.

“Repeal and replacement should take place simultaneously,” he said.
I suspect for most people, this sounds like common sense. If you’re a public official opposed to one policy, and you’d prefer a different approach, you try to replace one with the other.

Most Republican leaders, however, reject that model – because they have political goals in mind, not policy goals. GOP officials want to pass an “Obamacare” repeal bill so that they can say, “Hey look, we repealed ‘Obamacare.’” They do not, however, want to deal with the sweeping, potentially life-or-death consequences of such an approach, so Republicans insist on pushing legislation that looks like repeal, while buying the party some time to come up with an ACA alternative – which they’ve been working on since June 2009.

Bob Corker said this morning that this approach doesn’t work for him, and in a development that should matter a great deal to his party’s leadership, he’s not the only one.

New York magazine’s Ed Kilgore put together a helpful list:
Lamar Alexander, chairman of one of those committees, publicly complained that it might not be smart to repeal Obamacare without a replacement being ready. Rand Paul, coming at it from a different ideological perspective, said Republicans should have the guts to repeal Obamacare immediately and without a delayed effective date, whether or not a replacement was ready (Paul had separate but even more vociferous criticism of the budget blueprint that would enable Obamacare repeal, complaining that it would boost the national debt).

Susan Collins and John McCain have been expressing concerns about leaping before looking ahead on health care. And now come two more dissenters, Tom Cotton, who says Republicans should not “kick the can down the road for a year or two years” in repealing and replacing Obamacare, and Bob Corker, who argues that “[r]epeal and replacement should take place simultaneously.”
For those keeping score, that’s six Republican senators who, at a minimum, are skeptical of their party’s existing health care strategy. In a 52-48 Senate, if three of those six end up voting against the GOP’s budget blueprint, “repeal and delay” dies and Republican leaders will have to go back to the drawing board.

To be sure, it’s a fluid dynamic. Maybe each of these six senators will end up following partisan orders when push comes to shove; maybe none of them will. There’s time for a variety of scenarios to play out, and no one on either side should get too excited just yet.

But we talked yesterday about the importance of congressional vote counts and the latest evidence suggests the Republican plan to gut the Affordable Care Act is already more difficult than GOP leaders anticipated.


Affordable Care Act, Health Care, Obamacare and Senate Republicans

The Republican 'Obamacare' crusade is off to a very shaky start