Right after the election, there was a lot of tough talk among Republicans about getting rid of Obamacare once and for all as the first order of business in 2017. Then, as the political costs of throwing tens of millions of people out of health insurance became apparent, alongside the GOP’s total disarray over what to put in Obamacare’s place, the “repeal and delay” strategy emerged based on a plan of quick action to zap the legacy initiative followed by a lengthy hiatus before its effective date. The idea was to get the political gratification of bringing down the Great White Whale of Obamacare but then to give beneficiaries and insurers considerable time (two years? three years? four years?) to adjust, and give themselves the time (and political space) to get their act together on a replacement plan, which would probably require Democratic votes in any event.
But as January arrived, and the initial step of a budget resolution instructing the relevant committees to repeal Obamacare was unveiled, senatorial feet started dragging. Lamar Alexander, chairman of one of those committees, publicly complained that it might not be smart to repeal Obamacare without a replacement being ready. Rand Paul, coming at it from a different ideological perspective, said Republicans should have the guts to repeal Obamacare immediately and without a delayed effective date, whether or not a replacement was ready (Paul had separate but even more vociferous criticism of the budget blueprint that would enable Obamacare repeal, complaining that it would boost the national debt). Susan Collins and John McCain have been expressing concerns about leaping before looking ahead on health care. And now come two more dissenters, Tom Cotton, who says Republicans should not “kick the can down the road for a year or two years” in repealing and replacing Obamacare, and Bob Corker, who argues that “[r]epeal and replacement should take place simultaneously.”
That’s six senators who may not fully be onboard the repeal-and-delay train. There are 52 GOP senators, and it will take 51 votes to enact the budget resolution (due to hit the Senate floor next week) that gets the ball rolling (50 will suffice once Mike Pence is sworn in as vice-president, but that won’t happen for another two weeks). In other words, shockingly enough, Republicans may not have enough votes in the Senate to repeal Obamacare.
Now, it is possible some or all of the unhappy GOP senators can be convinced to vote for the budget resolution that makes the Obamacare repeal possible in a filibuster-proof budget-reconciliation bill, on grounds that the repeal won’t actually be put into place until the reconciliation bill itself is passed. And then GOP strategists can take their sweet time building support for a more specific repeal plan with effective dates and at least the glimmering idea of a replacement plan.
I suggested yesterday, somewhat whimsically, that Republicans could even put off the reconciliation bill indefinitely, telling their supporters they had more or less already “repealed Obamacare” in the budget resolution, even though the budget resolution has zero effect on real life (other than perhaps spooking insurance companies and providers who rely on Obamacare funds) until it is implemented in a reconciliation bill. That “delay and maybe repeal” scenario is beginning to look more realistic every day.