Backed into a corner, Mitch McConnell (R-KY) decided to do what some have argued should have always been the first step: just repeal Obamacare outright. Or at least, he decided to call his colleague’s bluffs on the matter. After multiple failures to scrape together enough Republican Senators to pass any version of the Better Care Reconciliation Act, the Senate Majority Leader will accede to the president’s request to repeal Obamacare now and work on a replacement bill later.
The beauty of the repeal bill is that it calls out both the moderate and conservative extremists in the GOP. Thanks to the stance of conservative Senators who said that previous replacement bills did not go far enough to warrant their support, not a single version of McConnell’s prior bill could muster the votes to make it to the floor. Thanks to Senators Cruz (R-TX), Lee (R-UT), and Moran (R-KS), there will be no Republican Senate bill to “fix” Obamacare. However, on the other side of the conservative spectrum, basically within moderate Democrat territory, Senators Murkowski (R-AK), Collins (R-ME), and Capito (R-WV) are staunchly opposed to repeal without a replacement plan for Obamacare contained within the same text. While McConnell did not force the former group of ideological purists to put actions to their words, it looks increasingly likely that he will compel the centrists to back up their opposition with an actual vote against pure repeal.
Will the trio of moderates stick to their guns and deliver a blatant rejection of a simple repeal bill? Will they risk the ire of the Republican base, the vitriol from the president’s Twitter account, and possible primary challenges from the right? Is this even the correct story for our focus? Scratch the surface of any proposed repeal, and you will find that such a plan falls significantly short of eliminating every vestige of Obamacare from the law.
Thanks to the budget reconciliation tricks that the GOP has been relying on thus far to skirt the 60-vote requirement to overturn a filibuster, all the previous Republican health care bills (in both the House and the Senate) have been crippled. A simple repeal bill would be no different. In practice, the Senate could eliminate the subsidies, the taxes, and the Medicaid expansion (as these are all laws which impact the budget, providing the legislative loophole to use reconciliation rules). However, much of the regulatory framework will persist, including the requirement that covers pre-existing conditions, limits on how much more money older customers may be charged compared to younger, and bans on lifetime caps on benefits. While such regulations enjoy widespread support amongst voters, they are one of the many reasons why premiums have risen over the past several years. No one would be surprised if a new law requiring every car to have a sunroof resulted in higher prices, but people seem to be outraged that adding mandatory features to all health care plans has raised insurance costs.
If Republicans fail to pass a straight-up (or mostly-straight-up) repeal, there will be plenty of accusations of hypocrisy to go around. Collins, Murkowski, and Capito each voted on a pure repeal bill in 2015, according to Senate records. Those primary challenges can be rough for politicians who break the trust of the people who voted for them. Just ask Eric Cantor.