“Repeal and delay” is the sequel to “repeal and replace,” which isn’t viable because after seven years of opposing ObamaCare the congressional GOP still has yet to coalesce around a replacement plan. They can’t repeal and replace the law in January because there’s nothing to replace it with. If, however, they wait to repeal the law until they do have a replacement ready, things could go haywire — the Republican base could become angry and demoralized at having to wait, Democrats could come roaring back and take back Congress in 2018, and suddenly the votes aren’t there for repeal anymore. Solution: Repeal the law right away in January, but delay the effective date of repeal for at least three years while Republicans come up with a new system for health insurance. Repeal will be the law of the land and meanwhile the GOP can take its time in crafting a thoughtful alternative. Easy peasy.
Really, though, it’s not so easy. And Mark Meadows, the new head of the Freedom Caucus, knows it.
The proposal “will meet with major resistance from Freedom Caucus members,” the North Carolina Republican vowed in an interview, calling it “the first big fight I see coming for the Freedom Caucus.”
“It should be repealed and replaced, and all of that should be done in the 115th Congress” — the two-year period starting in January through 2018 — and “not left to a future Congress to deal with,” Meadows added…
[D]uring a retreat in Virginia’s Blue Ridge Mountains over the weekend, Freedom Caucus members fumed at [the three-year] idea. Most said they wouldn’t settle for anything longer than a two-year replacement process, the time frame both chambers approved last year in an Affordable Care Act repeal bill that President Barack Obama vetoed.
The Freedom Caucus includes something like 40 House Republicans. If — if — they vote as a bloc, knowing that Democrats will unanimously oppose repealing O-Care, they could easily deny Paul Ryan and Trump a majority for a three-year “repeal and delay” scheme. In fact, even if only half of the caucus voted to block the plan, they’d leave Ryan with very little margin for error. The Freedom Caucus could singlehandedly force the new administration and party leaders to get this done in two years instead of three. Is that good news or bad news for ObamaCare opponents?
I think “the sooner the better” is the right approach here, although whether you agree depends in part on how you think the politics of this issue specifically and national politics generally will shake out in 2018. The Senate map is favorable to Republicans, remember; on the other hand, the out-party usually picks up seats in midterm elections. On the other other hand, midterm elections have had lower Democratic turnout in recent years, a trend that would damage Democrats’ chance for a comeback if it continues two years from now. If you think the midterms will turn out well for Republicans, then a three-year delay makes sense: The GOP should have more Republicans in the Senate in 2019, which will make it harder for Democrats to filibuster whatever replacement plan Trump comes up with. Even if Democrats pick up seats in the House, they’re unlikely to get the 25 or so they’ll need to regain control, so Ryan will still be able to pass the replacement bill. Why not wait, hope and trust that Trump will be popular, and finish the replacement process in the next, even redder Congress?
The problem with that logic is that there’s likely to be chaos in the insurance industry once ObamaCare is repealed next year, even if implementation of repeal is delayed. Once insurers know that the exchanges are going away, be it in two years or three, they’ll have little incentive to keep offering plans on them. Even worse, it’s not clear how much of ObamaCare will be left after the Senate uses reconciliation to repeal it. Reconciliation requires only 51 votes and thus isn’t subject to a Democratic filibuster, but it also can only be used for budgetary measures. So Republicans can repeal the tax and budgetary provisions of O-Care, but it’s uncertain if they can also repeal the law’s many, many, many regulations that way. That’s why the GOP needs repeal and delay: If you suddenly canceled the funding mechanisms for ObamaCare but kept the regulations requiring coverage for preexisting conditions in place, say, the exchanges would go “kaboom.” But here’s the point — once repeal is on the books, insurers will know that the exchanges are going to go “kaboom” soon anyway. Uncertainty will rule. Why not pull out of the exchanges immediately, leaving millions without coverage and lots of political chaos for the GOP to manage? In order to prevent that and encourage insurers to stay put until a replacement plan is ready, Republicans may need to make it worth their while by subsidizing the exchanges. If they don’t and the exchanges end up collapsing as insurers flee, what will it mean for the 2018 elections if suddenly millions are without their ObamaCare insurance and Democrats and their media friends are screaming that it’s all because of repeal? If Republicans don’t have something in place by the time Americans vote that November, the GOP could face a backlash. That’s why the two-year timeline is preferable.
But there’s another complication. As noted, Republicans will need 60 votes in the Senate to pass their replacement plan. That might be easier in the next Congress, if the GOP picks up seats in 2018 — but it might also be harder, if they end up losing seats. If you repeal and delay until 2019 and Democrats end up taking back the Senate before then, you’ll be at Schumer’s mercy in passing a replacement plan. Schumer could, in theory, declare that he won’t settle for anything less than delaying the repeal of ObamaCare for another two years, until after the next presidential election. Would the GOP play chicken with him on that, knowing that insurance exchanges are about to be disappear with nothing to replace them, or would they cave? If you do this on a two-year timeline, as Meadows and the Freedom Caucus want to do, you’ll at least know how many votes you need in Congress to get it done and you might be able to forestall a backlash at the polls by putting a new system in place before Americans vote. The question, simply, is whether McConnell can get to 60 votes in the current Congress for a replacement to ObamaCare, with the Senate split 52/48. Are there eight Democratic votes to be found among the many red-state Dems who are up for reelection in 2018: McCaskill, Tester, Manchin, Heitkamp, Casey, Brown, etc? Would those Democrats be more likely to vote with the GOP knowing that repeal has already been passed and that something needs to replace the exchanges ASAP? Or would the lefty base intimidate them into voting no and demanding that McConnell simply delay the schedule for full repeal further? There are a lot of ways this can go politically. I’m not sure this ends without McConnell having to think seriously about getting rid of the filibuster altogether and passing the replacement bill with 51 votes. And I’m not sure he can find a majority of his own caucus that’s willing to do that.
And there’s yet another complication. Some Republicans don’t want to replace ObamaCare with anything:
Some Republicans just want to repeal Obamacare, with no replacement. Others say they would like a replacement, but don’t like the ideas leading Republicans have outlined.
Passage of a bill that mostly repeals Obamacare by 2019 would empower both groups of Republicans to block replacement legislation. The repeal-only bloc would already have gotten most of what it wants. The Republican congressmen who are lukewarm about a replacement would, judging from past form, decide that doing nothing is better than whatever flawed bill Republicans put forward.
McConnell and Ryan could find in two or three years’ time, once repeal is on the books, that they can’t get a simple majority from their own caucus for a replacement bill. (The Freedom Caucus, as the House’s resident fiscal conservatives, could factor in there too, blocking any bill that they deem is too exorbitant in spending.) What do they do then? And on top of all of this uncertainty, there’s the additional problem that a three-year timeline will complicate Trump’s reelection bid in 2020. If the replacement process hits a snag in 2019, with McConnell unable to find 60 votes for the GOP’s bill or (gulp) Chuck Schumer in charge in the Senate, Trump might be forced to call for a further delay in repeal or to consider backing a compromise plan with the left. He’d probably prefer to have this issue settled by 2018 — except that then you have the same potential “snag” problem except as regards the midterm elections. The only good solution to this conundrum was for the GOP to have a replacement bill ready to go in case it won this month’s election and found itself in a position next year to undo ObamaCare. Then they could have used Trump’s victory to pressure the red-state Dems to join them in building a new system. As it is, all we have now are gambles.