Anyone getting way down in the weeds of the Obamacare-repeal situation needs to keep constantly in mind how insanely complex repeal is both substantively and procedurally — so complex that those promoting repeal might try to pull a fast one. This occurs to distinguished congressional expert Sarah Binder deep in an interview with Vox’s Sarah Kliff about how the whole deal might go down.
[Senate] Majority Leader Mitch McConnell (R-KY) is labeling the resolution as repeal, so that buys them some time. The whole process is complicated, so you start wondering, if they don’t do the reconciliation bill, will anyone know?
What Binder is referring to is the first vote in the congressional budget process, the budget resolution, which is necessary but not sufficient for an Obamacare repeal. It’s an internal congressional device (which is why it does not require the president’s signature) that sets out broad and vague budget targets. It also instructs the relevant committees to draft “reconciliation” legislation — the second and legally binding step in the budget process that implements the resolution — in this case, by actually repealing the portions of the Affordable Care Act that can pass the test of being germane to the federal budget (such as purchasing subsidies, Medicaid super-matches to finance the expansion in states that pursued it, tax penalties to enforce the purchasing mandate, subsidies to insurers and providers so they don’t go broke, tax provisions to pay for it all, etc.).
But with both sides describing the votes on the budget resolution as about “Obamacare repeal,” and with a necessary time lapse as committees prepare the reconciliation bill, which is where a lot of the really tough decisions will have to be made (most especially the effective date for the various “repeal” measures that will affect real people in a terrible way), you have to figure there will be a strong temptation to just delay, delay, delay taking up the reconciliation bill. Mitch McConnell said just yesterday, “We’re going to move forward with the Obamacare repeal resolution first and we’ll take the second step a little bit later.” How much later is “later?”
Once other issues have grabbed the limelight and the attention of Congress, as they well may (there’s a debt-limit crisis looming in the spring), who’s going to rush back into an Obamacare crisis? Indeed, if Republicans decide they prefer not to actually change anything, at least until they have an Obamacare replacement plan, who’s going to call them out? Probably not Democrats, who would be fine, if a bit chagrined, by an “Obamacare repeal” that does not actually repeal Obamacare.
What would happen next if congressional Republicans actually did just indefinitely put off the moment of decision on repealing Obamacare? Quite literally nothing from a legal point of view, though the problems everyone has been anticipating about insurance companies bailing from Obamacare’s insurance exchanges once “repeal” had been signaled might emerge even without an actual policy change. Beyond that possibility, nobody would lose their coverage right away. The key question is whether conservative activists would be at least momentarily satisfied with symbolism, and whether the big guy in the White House goes along with the ruse.
The fact remains that the “repeal and delay” strategy Republicans have been pursuing is a nest of hornets, and as my colleague Jonathan Chait points out, not one that Republicans may ever escape. So why not “repeal and delay” even as Republicans high-five each other in an imaginary end zone for their imaginary touchdown in “voting to repeal Obamacare”?
Crazier things have happened, and probably will continue to happen in the post-factual Trump Era.