Republicans' next attempt to repeal and replace Obamacare will likely be pushed well into 2018, an election year.
The reason for the delay is both political and procedural with the GOP pivoting to tax reform, another major legislative priority. House Republicans are already saying that the process for considering a repeal again needs to change after the Senate failed multiple times to pass legislation.
Congress is expected to take up a fiscal 2018 budget resolution next week that would give Republicans the power to pass tax reform with only 51 votes in the Senate, bypassing the need for 60 to break a filibuster. This process, known as "reconciliation," is incumbent on such things as how the bill would reduce the deficit and on what the bill would set its focus. Any reconciliation bill must focus on spending and budget issues, constraining what can be included.
Republicans tried to use reconciliation to kill Obamacare, but the budget authority to use it expires Sept. 30, the end of the fiscal year. All Senate Democrats have opposed efforts to repeal and replace Obamacare, making the use of reconciliation the only way Republicans can repeal the law.
Republicans don't appear to be planning on adding an Obamacare repeal to the budget resolution for fiscal 2018. A source familiar with the matter told the Washington Examiner that the budget would be "tax reform specific."
Most Republicans have been skeptical about adding healthcare to the budget resolution used for tax reform, worried that it may interfere with the GOP's next major legislative priority.
"I think that is going to be pretty challenging," Sen. John Thune, R-S.D., said this week. Thune is the third-ranking GOP senator.
Since the budget resolution for fiscal 2018 won't include instructions on how to pass Obamacare repeal with 51 votes, the next opportunity would be for the fiscal 2019 budget resolution.
However, since the fiscal 2019 budget resolution would replace and nullify the reconciliation instructions in the fiscal 2018 budget, Republicans need to finish tax reform before coming back to repeal.
Under the Budget Control Act, the earliest a budget resolution for fiscal 2019 could be passed would be in the calendar year for Oct. 1, 2018, the start of the federal fiscal year. However, Republicans could get permission from the Senate parliamentarian to pass a budget resolution earlier, as they did for Obamacare repeal this year.
Thune previously hinted that the 2019 budget resolution could be the vehicle for Obamacare repeal.
For now Republicans have not set a deadline to finish tax reform, but Rep. Mark Meadows, R-N.C., said Thursday that there is talk of finishing it as early as November.
"I think everybody is pushing to have it done before Thanksgiving," said Meadows, leader of the conservative House Freedom Caucus. He added that the House could mark up the bill next month.
But Republicans haven't publicly committed to a timeline.
Congress first has to pass the budget, a House aide told the Washington Examiner. However, they are moving "forward as quickly as possible."
Other suggested timelines include finishing tax reform by the end of the year.
The tax reform effort likely will push the beginning of the next Obamacare repeal effort into early 2018, and longer if the move to overhaul the tax code falters or is delayed. That means Republicans would have to take another tough vote during the midterm election year.
Some House Republicans want things to be different if and when they do try repeal again.
A reconciliation bill first must pass the House before being considered in the Senate, which was why the House passed an Obamacare repeal bill in May.
But the Senate decided to craft and insert its own legislation. Senate leadership wrote the repeal and replace bill called the Better Care Reconciliation Act, but it failed in late July.
The Senate also failed to pass a "skinny" repeal bill that was seen as a legislative vehicle to start conference talks with the House on a new repeal bill.
Senate GOP leaders then tried to generate momentum in September for a bill led by Sens. Bill Cassidy of Louisiana and Lindsey Graham of South Carolina. However, lawmakers' concerns about the Senate's speed in taking up the bill and major disagreements over policy doomed the legislation.
The bill's collapse occurred right before the authority to use reconciliation to pass Obamacare repeal expires by the end of the week.
Some House Republicans were perturbed that the Senate discarded the lower chamber's work on healthcare.
"They didn't even consider what we put all the work in going forward," said Rep. Barry Loudermilk, R-Ga.
He called for the Senate to consider repealing the legislative filibuster, which President Trump also favors but Senate Majority Leader Mitch McConnell has resisted.
"We wouldn't be constrained by holding together the tight grouping that you have to do through reconciliation," Loudermilk said.
That critique was common from House Republicans during the repeal debate. Several Republicans chafed at not being able to include all of Obamacare in the repeal bill because it needed to be able to pass the Senate through reconciliation.
For instance, conservatives were miffed that reconciliation severely limited which Obamacare insurer mandates and regulations could be eliminated, which conservatives see as the key driver in premium increases.
Several House Republicans want to have an agreement with the Senate before drafting an Obamacare repeal bill next time so there are no surprises.
Meadows praised the GOP leadership's efforts on tax reform, which has started with collaboration between Senate and House negotiators.
"They made a much better start than healthcare," Meadows said after the framework for tax reform was released Wednesday. "It is a learning process, and more details earlier without a deadline looming of less than 40 legislative days away was something we can learn from."
The House released its first attempt at Obamacare repeal called the American Health Care Act on March 6. The legislation, which was drafted behind closed doors, drew condemnations from the Freedom Caucus and other conservatives for not fully repealing Obamacare and concern from centrists about the impact of cuts to Medicaid.
House leadership aimed to hold a vote on the bill March 24, but leadership had to pull it after support collapsed from conservative and centrist lawmakers.
Republicans went back to the drawing board and made tweaks to the legislation to lure conservatives. The bill passed on May 4 by a 217-213 margin.
Meadows said he wasn't afraid of taking another tough vote on Obamacare repeal. He then took a dig at the Senate, highlighting the animosity over the upper chamber's inability to pass one of the GOP's biggest legislative priorities.
"They take more naps than they do votes," he said.