Republicans, seven years after blasting Democrats for passing Obamacare in the dead of the night, are poised to pass a bill in the dead of the night that would tweak a few parts of the law rather than come close to delivering on their seven-year promise to fully repeal it.
The so-called "skinny repeal" bill, unveiled roughly two hours before the vote, wouldn't repeal much of anything. The only thing that's repealed are the penalties for the individual mandate (the mandate itself could not be repealed due to the restrictions imposed by the reconciliation process). Though news reports had suggested that they would also be repealing the employer mandate and the medical device tax, in reality, the tax would only be suspended for three years, and the employer mandate penalties would go to zero at first, but would come back in 2025.
Although there are some tweaks that could give Secretary of Health and Human Services Tom Price more leeway to grant waivers to states to experiment with free-market ideas, the bill ultimately keeps in place Obamacare's heavy restrictions that stifle state innovation.
Taken together, as conservative health policy analyst Chris Jacobs has illustrated, the bill would keep 411 of Obamacare's 419 sections of legislative text intact.
Significantly, it leaves Obamacare's regulatory framework in place, forcing insurers to cover those with pre-existing conditions without charging more on the basis of health status. But by ditching the individual mandate that was supposed to compel younger and healthier individuals from purchasing insurance, it's created a recipe for higher premiums and an exodus of insurers from the market.
Of course, we're not supposed to focus too much on the demerits of this bill. In fact, even Sen. Lindsey Graham, R-S.C., who is going to vote for it, attacked the bill earlier Thursday as "half-assed" and as a "fraud" and "disaster." The idea is that this bill is supposed to be the vehicle for senators to hash out a better bill in a conference with the House. But it's totally bonkers for senators to vote in favor of a bill that they don't want to become law, in the hopes that adding an additional legislative body to the negotiations will achieve what Senate Majority Leader Mitch McConnell could not in the past several months: get 50 senators to agree on a plan to repeal and replace Obamacare.
From the beginning, the entire Republican healthcare push has been a farce -- bypassing the relevant committees, writing it in secret, withholding details from the public, not allowing time for expert opinion and analysis, creating artificial deadlines, and patching together a bunch of policies in a piecemeal manner that were not governed by any coherent policy vision. And now, here we are, in the dead of the night, with Republicans poised to vote for a bill that they don't want to actually become law.