ByFiguring out how Republicans plan to approach health care this year isn’t easy. A little more than a week ago, just before Christmas, Senate Majority Leader Mitch McConnell (R-Ky.) said that his party would “probably move on” from full repeal of the Affordable Care Act now that Republicans have eliminated the individual mandate, which is a key piece of the law’s architecture. But just a few days later, some conservative House Republicans said they aren’t ready to back off: Repeal is “still on the table,” insisted Rep. Mark Meadows (R-N.C.).
Of course, this back-and-forth should feel pretty familiar by now. In March, after an initial effort to pass repeal legislation in the House failed, GOP leaders indicated they were ready to focus on other priorities. But some determined members of the Republican caucus kept at it. Within a few weeks the full House was voting on, and approving, new legislation.
In July, after Sen. John McCain (R-Ariz.) cast a dramatic and decisive third vote to kill Obamacare repeal in the Senate, McConnell said “it’s time to move on” ― yes, the same phrase he used last week. But two Republican senators, Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, had other ideas. They got to work on their own bill, rallying support among colleagues and eventually persuading McConnell to try again ― although that proposal, like the Senate’s previous effort, never got the votes it needed to pass.
This time could be different. By eliminating the mandate, which requires those who opt out of coverage to pay a penalty, Republicans have finally notched a significant legislative victory in their years-long crusade against Obamacare. President Donald Trump has taken to saying that Republicans have “essentially repealed” the 2010 health care law and polls show 44 percent of Republicans believe him. Plenty of progressives seem happy to encourage that notion, if only because it might keep Trump’s gaze focused elsewhere.
But progressives also know that, substantively speaking, Trump happens to be wrong. The law’s Medicaid expansion remains in place, as do its health insurance tax credits and protections for pre-existing conditions. That means there’s still plenty of Obamacare for Republicans to repeal. And if it’s easy to construct a coherent theory for why Republicans won’t seriously take up their campaign again this year, it’s just as easy to construct a coherent theory for why they will.
Why Republicans Might Move On From Repeal In 2018
Probably the single biggest impediment to another run at full repeal is the vote count in the Senate ― and how it’s
Figuring out how Republicans plan to approach health care this year isn’t easy. A little more than a week ago, just before Christmas, Senate Majority Leader Mitch McConnell (R-Ky.) said that his party would “probably move on” from full repeal of the Affordable Care Act now that Republicans have eliminated the individual mandate, which is a key piece of the law’s architecture. But just a few days later, some conservative House Republicans said they aren’t ready to back off: Repeal is “still on the table,” insisted Rep. Mark Meadows (R-N.C.).
Of course, this back-and-forth should feel pretty familiar by now. In March, after an initial effort to pass repeal legislation in the House failed, GOP leaders indicated they were ready to focus on other priorities. But some determined members of the Republican caucus kept at it. Within a few weeks the full House was voting on, and approving, new legislation.
In July, after Sen. John McCain (R-Ariz.) cast a dramatic and decisive third vote to kill Obamacare repeal in the Senate, McConnell said “it’s time to move on” ― yes, the same phrase he used last week. But two Republican senators, Bill Cassidy of Louisiana and Lindsey Graham of South Carolina, had other ideas. They got to work on their own bill, rallying support among colleagues and eventually persuading McConnell to try again ― although that proposal, like the Senate’s previous effort, never got the votes it needed to pass.
This time could be different. By eliminating the mandate, which requires those who opt out of coverage to pay a penalty, Republicans have finally notched a significant legislative victory in their years-long crusade against Obamacare. President Donald Trump has taken to saying that Republicans have “essentially repealed” the 2010 health care law and polls show 44 percent of Republicans believe him. Plenty of progressives seem happy to encourage that notion, if only because it might keep Trump’s gaze focused elsewhere.
But progressives also know that, substantively speaking, Trump happens to be wrong. The law’s Medicaid expansion remains in place, as do its health insurance tax credits and protections for pre-existing conditions. That means there’s still plenty of Obamacare for Republicans to repeal. And if it’s easy to construct a coherent theory for why Republicans won’t seriously take up their campaign again this year, it’s just as easy to construct a coherent theory for why they will.
Why Republicans Might Move On From Repeal In 2018
Probably the single biggest impediment to another run at full repeal is the vote count in the Senate ― and how it’s about to change.
The closest Republicans came to passing one of their bills was that late July vote, when McConnell and his lieutenants brought several measures to the floor in a desperate attempt to pass anything that could lead to negotiations with the House. The final attempt was on a “skinny repeal” bill that would have eliminated the individual mandate and done little else. It failed because, with Sens. Susan Collins of Maine and Lisa Murkowski of Alaska joining McCain in voting no, Republicans were one short of the 50 votes they needed for a bill to pass. (Vice President Mike Pence would have broken the tie.)
Now, in theory, Republicans are two votes short because they lost one of Alabama’s Senate seats in the recent special election. With Democrat Doug Jones in the seat that Luther Strange had occupied, passing repeal would require flipping two votes (among Collins, McCain and Murkowski) to yes. Flipping just one of them was going to be hard enough.
That’s especially true now that the individual mandate will be disappearing. The mandate has played an important role in the newly reformed health insurance system by giving healthy people more incentive to get coverage. Without that penalty in place, insurers will have to raise premiums. But the mandate has also been among the least popular features of the Affordable Care Act, creating a serious political liability for the program as a whole.
Now that liability is gone, leaving only the law’s more popular provisions. There’s the Medicaid expansion, through which millions have gotten coverage and on which states have to come to rely in their fight against the opioid epidemic. There are the guarantees of insurance for people with pre-existing medical conditions. And there are tax credits worth hundreds or even thousands of dollars a year to people who use them.
Voting to undermine these provisions was difficult for many Republicans the first time around. Voting to undermine them now, with Republicans down in the polls and midterm elections much closer, is bound to be harder.
Reviewed by Unknown
on
January 01, 2018
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