The GOP Just Took Another Small Step Toward Repealing Obamacare. But It Gets Much Harder From Here.

By
Ready for the rough road ahead? Photo: Chip Somodevilla/Getty Images

To no one’s surprise, the House today passed the Senate-drafted version of a budget resolution for fiscal year 2017, a bare-bones measure designed to authorize the repeal of Obamacare (and probably a few other health-related items, like defunding of Planned Parenthood).

There were nine Republican defectors who voted with all the Democrats against the resolution; by my rough count five hard-core conservatives who either wanted a balanced budget or a more immediate repeal of Obamacare, and four sorta kinda moderates concerned about yanking the rug from beneath constituents without a replacement plan being developed. House GOPers had a margin of error of 23 votes, so it wasn’t close.

But this vote really ends the easiest part of the Obamacare repeal effort.

From now on, anything Republicans in Congress do to the Affordable Care Act will involve actual changes in law and budgeting, not vague and non-binding spending targets and abstract instructions to look for savings. It must also come to grips with all the huge problems associated with ending one massive health-care program and creating another. These range from what to do about purchasing exchanges, purchasing subsidies, provider subsidies, and the problems of people with preexisting health conditions, to sorting out the interests of states that did and did not accept the ACA Medicaid expansion, to deciding how to cope with the taxes and fees that paid for the whole thing and might be useful in paying for a replacement.

Sure, Paul Ryan and Mitch McConnell could get around some of their “Obamacare replacement” problems by taking other must-pass legislation hostage, such as reauthorization of the Children’s Health Insurance Program (CHIP). But that would involve trading one set of headaches for another.

Republicans can no longer paper over divisions by punting decisions on down the road. In part, that’s because Congress now has to deal with Donald J. Trump in direct and concrete negotiations aimed at securing his signature on the final product, with, it is assumed, his warring staffers and cabinet in concurrence since this could be the most important thing the administration does this or any year.

So there probably should not be a lot of celebrating at this first step being completed without bloodshed. The path ahead for Republicans is enough of a minefield that they may privately wish they had lost the election and could go back to casting votes without consequences.

The Easy Part for Congress in Repealing Obamacare Is Over