Obamacare repeal? More like Obamacare reform
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By Caitlin Owens
In Summary: Republicans in the US Congress and Senate are still shocked that their wildest Obamacare repeal dreams just came true. But there’s a very real possibility the entire law may not be possible to repeal. Rather, the law may become significantly changed. Or, in the words of the President elect Donald Trump, be reformed or simply amended! Out of all the rallying cries of the conservative base that helped Trump cruse to victory, nothing is giving the forthcoming political order in Washington such migraine headache as Obamacare. They have no choice but to do something about Obamacare to keep their base on board. Failure to act is neither optional nor acceptable. The Republicans, ironically, must now own Obamacare!
Washington, USA--Capitol Hill Republicans are still shocked that their wildest Obamacare repeal dreams just came true. But there’s a very real possibility the entire law isn’t repealed; it just gets significantly changed.
{Or, in the words of the President elect Donald Trump, be reformed or simply amended! Out of all the rallying cries of the conservative base that helped Trump cruse to victory, nothing is giving the forthcoming political order in Washington such migraine headache as Obamacare. They have no choice but to do something about Obamacare to keep their base on board. Failure to act is neither optional nor acceptable. The Republicans, ironically, must now own Obamacare!} (emphasis added).
How 2 senior GOP aides we talked to described it:
• "It’s going to be more massive reform”
• Healthcare in the U.S. will be improved “through a rewrite of Obamacare”
To be clear: Republicans will likely call whatever they end up doing Obamacare repeal, especially publicly. And when you end up with something vastly different, what’s the difference?
What they say they won’t get rid of:
•Pre-existing condition coverage
•Letting children stay on their parents’ plan until age 26
•Lifetime caps on coverage
•Medicaid expansion (but it will look different)
What they say they will go after:
•Essential health benefits (insurers won’t have to cover as many things)
•Age rating bands (bigger range of premiums will be allowed)
There’s no step-by-step plan yet -- because they had never planned for a President Trump. “We’re in rapid detox of holy crap, we have to actually do this,” the first aide told me.
A few political realities:
Despite what House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell and Trump himself are saying, throwing 20 million people off their health plans might be political suicide, and Republicans know it. And no one really knows how to come up with a health reform plan that expands coverage while lowering costs – just ask the Democrats.
Congress tested its repeal strategy last year using “reconciliation,” a procedural tool that prevents legislation from being filibustered in the Senate. Even this repeal bill didn’t get rid of the whole law. But one of the aides said this version of the bill was mostly about “messaging,” and that this time, “We’re not going to use that package. We’re not dumb.”
One big reason why? Medicaid expansion. Repealing it would certainly cause tension with governors – some who are Republicans – in expansion states. Senator John McCain last year, on Arizona’s decision to expand Medicaid: “I am very reluctant to take positions counter to the decision made by the governor.”
So what’s the solution? Work with Democrats to find an actual bipartisan compromise. Republicans are eyeing senators like Patty Murray, Ron Wyden, Michael Bennet, Tim Kaine, and everyone up for reelection in 2018. This may seem ridiculous on its face, but Republicans think Democrats will be compelled to come to the bargaining table when they realize the alternative is to let Trump do whatever he wants. The bottom line: Republicans need to be able to tell their constituents they repealed Obamacare, even if this is a little bit of a stretch. The key question here is what political risks the party is willing to take, not whether there are any risks at all.
Source: Linkedin