How Republicans Intend to Kill Obamacare

There are standard dictionary definitions of the word reconciliation – “the restoration of friendly relations” and “the action of making one view or belief compatible with another” among them – and then there is the Congressional process called Reconciliation. The former suggest comity, the latter is the process by which debate is closed down and a budget bill can be passed through the Senate. With Republicans holding a 52 to 48 advantage over Democrats (including two Independents), Reconciliation is how Republicans intend to overturn the Affordable Care Act, aka Obamacare.

“House and Senate budget leaders, along with conservative lawmakers, are beginning to unite around a proposal that would avoid a filibuster from Senate Democrats and put a bill repealing key provisions of Obamacare on President-elect Donald Trump’s desk not long after his inauguration—a bill that is likely to earn his signature,” Melissa Quinn, a senior news reporter for The Heritage Foundation’s The Daily Signal, pointed out in a piece headlined “Republicans Begin to Unite Around Obamacare Repeal Plan.”

According to Quinn, the process for repealing Obamacare, an effort that was an epic fail for the GOP over the past few years, is now being honed for immediate action as soon as Trump takes office. And while Republicans are not quite ready to come up with their own health care plan, the process to dismantle is taking on a life of its own.

Under ordinary circumstances, Republicans would need 60 votes to actually pass a bill in the Senate to repeal Obamacare. However, as Quinn reported the day after Election Day, “GOP lawmakers are likely to use a budget tool called reconciliation—a procedure used in the Senate that allows a bill to pass with 51 votes—to roll back key provisions of Obamacare and avoid a Democratic filibuster.”

According to Quinn, last year, The GOP-led House and Senate “passed a budget resolution … that included instructions to use reconciliation to repeal Obamacare and were ultimately successful in getting it to Obama’s desk, where it was vetoed. The bill called for the repeal of the individual and employer mandates, Medicaid expansion, tax credits, medical device tax, and Cadillac tax. It also stripped the government of its authority to run the exchanges set up under the law and lessened the fine for failing to comply with the mandates to $0, which was needed to abide by Senate rules.”

“Because Congress failed to pass a budget resolution for 2017—a proposal stalled in the House—budget experts say Republicans could pass a revamped fiscal roadmap for next year, one that includes reconciliation instructions for Obamacare’s repeal,” Quinn pointed out.

Millions of people will be affected by whatever the Republican do. Thus far thy have failed to unite over a single replacement plan. As New York magazine’s Jonathan Chait recently reported, “The Republican approach involves endless rhetoric about “choice,” “competition,” “markets,” “patient-centric” care, and so on. But none of these concepts has the magic power to conjure resources out of thin air. So when Republicans design alternative plans, and they have sketched out quite a few, inevitably they just provide fewer resources.”

Since GOP lawmakers are not yet prepared to come up with its own comprehensive health care bill, “that reconciliation bill would likely have a delayed enactment date to give congressional Republicans time to craft and pass a replacement plan”:

After passing a budget resolution for 2017, GOP lawmakers could then craft a second budget resolution for 2018, which could also include reconciliation instructions to tackle another legislative priority, such as an overhaul of the tax system.

Using this two-budget approach to repeal Obamacare would give Republicans the chance to put a bill dismantling the health care law on Trump’s desk soon after his Jan. 20 inauguration, lawmakers said.

“I think having the opportunity to have two reconciliation bills as opposed to one, two reconciliation processes as opposed to one, is wise,” House Budget Committee Chairman Tom Price, R-Ga., told Congressional Quarterly.

Politico’s Dan Diamond reported that Senate Budget Chairman Mike Enzi has basically endorsed the “novel plan.” “Enzi said the strategy would allow the GOP to repeal the Affordable Care Act and pass tax reform without fear of filibusters from Senate Democrats.”

President-elect Trump recently said that there are two items he would like to keep: allowing young people to stay on their parents’ insurance until age 26, and continuing the ban on the exclusion of pre-existing conditions by insurers.” In a recent op-ed in The New York Times, Jonathan Gruber pointed out that “Maintaining this popular provision while scrapping the rest of the health care law would be worse for people with pre-existing conditions than repealing the law in its entirety.”

Gruber, an economics professor at the Massachusetts Institute of Technology, was a health care consultant for the Obama administration, explained: Before the “major provisions” of the Affordable Care Act went into effect on January 1, 2014, “the primary source of profit for insurers was not providing better care so that patients stayed healthy, or negotiating better prices with hospitals and drug companies; it was their ability to avoid the sick and insure only the healthy. And insurers had three tools for doing so: denying coverage to the insured for any costs associated with pre-existing conditions; denying insurance entirely to sick people; and charging the sick much higher prices than the healthy, a practice called health underwriting.

“If Mr. Trump preserves just the ban on the first of these tools, and allows insurers to reintroduce the other two, he has effectively done nothing. That’s because any insurer can simply use the other tools to accomplish the same goal as it could with all three.”

Repeal of Obamacare "would cause massive disruption and chaos in the individual market for health insurance," a Center for American Progress release stated.

These are heady days over at The Heritage Foundation, the premier right-wing think tank/public policy institute in the country, that has been slashing away at Obamacare since debate started over it seven years ago. While institution scholars are floating ideas and proposals about numerous issues, the repeal of Obamacare appears to its number one priority, with tax reform not very far behind.


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