Republicans are finally in a position to do what they’ve been promising for over six years: repeal Obamacare. But realizing the political obstacles to getting there, the GOP is gravitating to a new strategy of passing a repeal of the law that doesn’t actually go into effect for several years. This strategy is doomed to fail.
To start, let’s outline the challenges for Republican lawmakers.
One option for the GOP is to simply repeal the law outright. Though this would be difficult to do with just a bare Senate majority, they probably could get rid of much of the law through a parliamentary maneuver known as reconciliation, combined with administrative actions by the Department of Health and Human Services.
The difficulty of this is that Obamacare, though broadly unpopular as a whole, still is the source of health coverage for millions of people. Anything Republicans do to repeal it will disrupt those insurance arrangements, and trigger stories about all the Americans losing coverage — after Republicans spent years attacking President Obama for breaking his pledge that anybody who liked their plans could keep them.
Another option is to wait to repeal the law until Republicans have agreed on a replacement. In such a case, though there would be disruption, Republicans would be able to offer an alternative for those whose coverage was displaced by repeal. The problem with this option is that despite having nearly seven years to agree to an alternative, Republicans still have not resolved their differences on health policy and agreed on a single piece of legislation. Coming up with an agreement could take years, and in that time period, the momentum for repeal could evaporate and in the meantime, the skeptical GOP base would feel betrayed.
That’s where the strategy of “repeal and delay” comes in. On the surface, this would provide Republicans with the perfect solution. They could open Congress in 2017 and pass a bill that repeals Obamacare, allowing them to say that they met their commitment. But they could delay the implementation of that repeal for several years, meaning individuals who depend on Obamacare, in theory, could still receive coverage through the program while Republicans craft an alternative.
In practice, however, this is a horrible idea.
For one, there’s no guarantee that insurance companies will continue to participate in Obamacare over the next several years knowing that the law is going to be repealed.
Over the first few years of Obamacare’s implementation, insurers have lost billions of dollars trying to sell insurance through Obamacare. Many of them are willing to stick it out, for now, in hopes that they could establish a foothold in the young market and be in a position to profit if and when it stabilizes. But that calculation changes dramatically if they know that after several more years of racking up losses, the market is going to expire anyway. Many more insurers are likely to exit ahead of the 2018 year, disrupting people’s insurance arrangements.
Additionally, the political landscape could change dramatically between now, when Trump and congressional Republicans have just come off a huge election victory, and the 2018 midterms, when the party in power historically suffers setbacks. President Obama came into office with much stronger political standing in 2009 than President-elect Trump will, and within two years, he had completely lost his ability to achieve any of his domestic policy goals.
The idea that Republicans, in the second half of Trump’s first term, with the 2020 election heating up, will be in a better position to pass an Obamacare replacement than they are now, is inconceivable.
Republicans now find themselves in a difficult position of their own making. Had they done the hard work of hashing out their differences and coming up with an alternative to Obamacare while they had years to do so, they would be in a position to repeal and replace Obamacare within the first hundred days of the new presidency. But having procrastinated, they now find themselves with much worse options.
