December 8, 2016

Politico tells me that Republican Obamacare opponents in Congress have a tough road ahead:

After meeting with Vice President-elect Mike Pence on Tuesday to hash out plans to repeal Obamacare, top Senate Republicans are no closer to resolving an issue that’s splintering the GOP heading into the start of Donald Trump’s presidency: how long to give themselves to replace the law....

The only firm plans are for the Senate to kick off the repeal effort as soon as Jan. 3 by passing a budget resolution -- Senate Majority Leader Mitch McConnell is calling it the “Obamacare repeal resolution” -- that sets the table to repeal the Affordable Care Act on a simple majority vote. Then, shortly after Trump is sworn in, Republicans aim to have a repeal bill on his desk to sign.

It’s what comes after that moment of catharsis that Republicans are struggling with.

Lawmakers have proposed putting off the effective date of repeal from as little as six months to as long as three years to come up with a replacement -- and give insurance markets a chance to prepare. Several senators suggested at the meeting with Pence that additional measures from Congress or the administration may be needed to address rising insurance premiums and avoid roiling the insurance markets in the period between repeal and replace, attendees said.

But we're told that none of these concerns are preventing Mitch McConnell from proclaiming that Obamacare repeal will be the first order of business for the Senate, which will be sworn in two and a half weeks before Donald Trump's inauguration. If there's a painful struggle in their future, he doesn't seem particularly concerned about it, and the warnings from the Democrats -- regarding repeal-and-replace, Chuck Schumer says, "bring it on" -- don't seem to worry him.

Repeal is a huge brand-building exercise for the GOP. (Watch the party-approval polling numbers after it happens -- the GOP's will skyrocket, as conservatives who regularly vote GOP but grumble about the party stop grumbling.) After that? ¯\_(ツ)_/¯? According to Politico, folks like Ted Cruz and the House Freedom Caucus want a quick replacement, just as a matter of principle. Some Republicans don't want the replacement process stretching into 2019, when the next presidential campaign will be under way. And, oh yeah, there's concern about a possible "death spiral," in which insurers, knowing the law is on its deathbed, pull out of the marketplaces and leave a lot of people uninsured.

But if McConnell thought any of this was a reason to tread carefully, repeal wouldn't be at the top of his agenda. He clearly believes Republicans will be fine under any of these scenarios.

I predict a replacement period that extends past the 2018 midterms, for reasons Zandar laid out a few days ago:

Yes, Republicans will blame what they do to Obamacare on Obamacare. Now, that won't work if Democrats out-message them. But when has that ever happened? (Maybe the last time was during George W. Bush's drive to privatize Social Security. So: not in a decade.)

But what about the death spiral? Zandar again:

It will also be rumored that Those People are still getting coverage under the really good Obamacare, while Real Americans (i.e., white people) are caught in the death spiral.

So, yeah, they'll get away with this. And the replacement plan will be woefully inadequate. But it will seem shiny and promising through at least ... oh, 2020, when it will gradually become obvious that the new policies are full of holes and universal coverage is more of a theory than a fact. But by that time, Trump and the GOP Congress will be safely reelected.

(Crossposted at No More Mr. Nice Blog)

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