Yeah, it’s hard to disagree. If you missed this post from a few days ago and haven’t followed the “repeal and delay” saga, try to force yourself through it to prepare for the long three-year slog ahead. It’s boring vote-counting stuff for the most part but it’s high high high stakes. Here’s the simplest possible version: What happens if the GOP sets a time bomb to blow up ObamaCare in 2019? Can they “defuse” the bomb by replacing O-Care with a new Republican-made insurance system before it goes off? And if they can’t and it does go off, which side is likely to suffer more political casualties? Trump and the GOP or Schumer and the Democrats?
“We’re not going to do a replacement,” Schumer said of the Senate Democratic caucus. “If they repeal without a replacement, they will own it. Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It’s all theirs.”…
Asked directly if Democrats would refuse to support anything that falls significantly short of the ACA in terms of expanding social welfare, Schumer said: “The odds, after they repeal without any replacement, of us sitting at the table to do something that will chop one arm off instead of two is very small.”…
As Jonathan Cohn reports today, health experts are predicting that repeal-and-delay could cause insurance markets to unravel very quickly. Insurance companies may exit the markets due to the uncertainty of seeing any replacement materialize. They may also pull out because Republicans look likely to repeal the individual mandate while trying to keep the protections for preexisting conditions (which cannot be repealed by a simple majority), which will make the risk pools older and sicker. The overall result could be millions losing coverage and all around chaos.
Schumer said that in this scenario, Democrats would not toss Republicans a lifeline. “They broke it, they own it,” Schumer said.
Once the repeal time bomb is set next month, with Republicans voting to eliminate ObamaCare on a two-year or three-year deadline (the party’s still bickering over which is better), the race will be on to build a new system before time expires. The challenge isn’t just to build a system, though, it’s to build a system that can attract 60 votes in the Senate. Next month the GOP should have 52; if, as expected, they pick up a bunch more seats in 2018, they could be close to 60. That’s the argument for preferring a three-year timeline for repeal rather than a two-year timeline. By 2019, if the midterms go well, it could be much easier for the GOP to pass its ObamaCare replacement.
But … it could also be harder. A recession could strike next year. Trump could turn out to be incompetent as president. If you gamble on repeal after the midterms and the GOP ends up not picking up many seats — or even losing control of the Senate in a blue wave — suddenly you’ve got a big problem. How do you get 60 votes for a replacement for ObamaCare if Schumer is vowing that Dems won’t lift a finger to help Republicans? Now, it could be that he’s bluffing or that he won’t have as much control over his caucus as he thinks. Joe Manchin, for instance, should be safely reelected in West Virginia in 2018 and might then vote for the GOP’s ObamaCare replacement the next year no matter how mad it makes Schumer. But the Democratic base will put tremendous pressure on red-state Dems to hang together with the party and block a replacement bill. It would be their ultimate revenge on Trump for wrecking, or trying to wreck, Obama’s legacy. They’ll fight tooth and nail to deny him and the GOP its great victory.
If they succeed, and McConnell can’t find 60 votes for a replacement, suddenly both parties will be staring at a bomb that’s about to go off with no way to defuse it. If there’s no new system in place as the ObamaCare exchanges expire, millions will lose their insurance. That brings us back to my question up top: In that scenario, which side will suffer greater casualties in terms of being blamed by voters? Will it be the GOP, who set the bomb by voting for repeal, or will it be Democrats, for standing by and letting the bomb go off instead of working with McConnell on a compromise replacement system? Normally you’d bet heavily that Republicans would suffer more since the media would spin for the Democrats, but the fact that Trump has such a gigantic megaphone is an X factor. If he spent months beforehand attacking Schumer for obstructing a replacement bill, what would do that to public opinion? What would it do to public opinion if Barack Obama suddenly came off the sidelines and started attacking McConnell and the GOP for repealing his signature program in the first place?
If Schumer and the Democrats are in control of the Senate in 2019, the terrible solution seems obvious. In order to stop the bomb, he, Ryan, and Trump would have to agree to further delay the repeal of ObamaCare. The exchanges would get a reprieve and would remain in effect through the next presidential election. If instead McConnell and the GOP are still in control of the Senate in 2019 (which is likely), it could go several ways. McConnell could convince Senate traditionalists like Hatch and McCain to vote to end the filibuster for legislation, a radical move but one that would allow the GOP to pass its ObamaCare replacement with 51 votes. Alternately, there might be enough red-state Democrats left in the Senate who are willing to defy the Democratic base that they’ll cross the aisle and give the GOP 60 votes for a replacement bill. The catch there, though, is that there are many Dems from states Trump won who are up for reelection in 2018; if they survive, they’ll be able to vote for or against a GOP O-Care replacement in 2019 knowing that they won’t have to face voters again for six years. It’ll be much harder to pressure them in that case, especially with Schumer squawking that Democrats are prepared to make the GOP “own” whatever system comes next. Don’t expect Democratic votes, he’s telling you.
And there’s another complication to all of this. No one’s entirely sure when the bomb will go off. You can say that the ObamaCare exchanges will remain intact until 2019, but that doesn’t mean insurers will wait around until then and continue to offer plans on the exchanges. They could bail as soon as the repeal vote comes down next year, fearing that without the individual mandate in effect there won’t be enough revenue coming in to make the new risk pool sustainable. Republicans may need to offer insurers some sweet, sweet taxpayer sugar to entice them to stay in the exchanges until a replacement is ready. How do you suppose that’ll play politically on the right?
You can play with the timelines on all of this if you like, preferring a two-year deadline (as the Freedom Caucus does) to a three-year one. In that case you’re under more pressure to come up with a replacement plan ASAP but at least you’ll know how many Democratic votes you need in the Senate to pass the plan — eight. It’s also possible that trying to do all of this before the midterms rather than after will frighten those red-state Democrats whom Schumer is counting on. You might not get Montana’s Jon Tester to vote for a GOP insurance overhaul in 2019, right after he’s won reelection, but force him to vote on that overhaul in 2018, before the election, knowing that voters back home might end up with no insurance if he and his caucus block the Republican bill, and he might cave. I think the two-year timeline is better than the three-year one for that reason, but Schumer’s still going to have “tremendous leverage” here unless and until the filibuster is abolished. Whatever the timeframe, we’ll be dealing with a live bomb soon.
Oh, one other thing. It should go without saying that once the ObamaCare dragon has been slain, the left will happily move on from that as their template for what American health coverage should look like and proceed directly to pushing single-payer as their new model for the U.S. Unless the GOP’s replacement system is highly efficient and popular, making it politically difficult for liberals to uproot it, that’s the next big insurance war we’re headed for once Democrats are back in power.