Last night, Senators Mike Lee (R-UT) and Jerry Moran (R-KS) announced they would oppose a motion to proceed on the latest healthcare bill, joining a host of other Senators who were vowing to do the same. With nowhere left to go, Senate Majority Leader Mitch McConnell immediately pulled the legislation. It’s back to the drawing board on healthcare reform.
McConnell released a statement late Monday night admitting that, “Regretfully, it is now apparent that the effort to repeal and immediately replace the failure of Obamacare will not be successful." This means there are basically four options left on the healthcare table, a situation which looks a lot like what we predicted last year:
- Vote immediately to repeal Obamacare (and come up with alternative plan later).
This is McConnell’s plan: vote on Obamacare repeal, and set it to detonate in two years.
“So, in the coming days, the Senate will vote to take up the House bill with the first amendment in order being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Obama: a repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.” Mitch McConnell, 7/17/17
The presumption here is that this would push Republicans to come up with an alternative healthcare plan while getting them safely past the mid-term elections -- though admittedly putting the crunch on President Trump for 2020. However, as we’ve discussed, the only way to repeal Obamacare is with 60 votes in the Senate, and Republicans hold just 51. Barring elimination of the filibuster, which is extremely doubtful, all-out repeal of Obamacare with a simple Senate vote is not going to happen. Proponents of this approach are likely just trying to put on record which Senators once again voted for repeal.
- Come up with yet another bill.
Whether Republican led or via a bipartisan effort, which Senator John McCain recently called for, it is possible we’ll see another iteration of a national health plan. How far it would go depends on how much it pleases both moderate Republicans, hardline conservatives, and Democrats.
- Proceed to unravel Obamacare through the reconciliation process.
The budget reconciliation process would allow Republicans to pass certain legislation with a simple majority rather than a supermajority. Republicans could undo Obamacare's budget-related provisions -- its subsidies, taxes, and penalties -- but not its regulations about what insurers must cover. This presents significant challenges though. Obliterating Obamacare’s spending but maintaining its numerous regulations would all but destroy the individual insurance market.
- Phase out Obamacare over time, piece by piece.
Taking down Obamacare in its entirety may prove to be too difficult. Republicans may have better success proposing and passing bills that eliminate or at least restructure some its provisions. That will be a long and difficult process, but it’s starting to look more and more like the only possibility.
Bottom line? Obamacare is very much still the law of the land. Stay abreast of the discussion, but maintain compliance with individual and corporate mandates to avoid financial penalty.
