President Trump recently tweeted, “Unless the Republican senators are total quitters, Repeal & Replace is not dead!” He’s completely right that free-marketeers shouldn’t give up on health reform.
But if we’re being honest, none of the bills that the Senate considered last week would have come close to fulfilling the GOP’s 7-year-old promise to replace Obamacare with free-market healthcare. First, on July 25, the Senate defeated 43-57 a version of the Better Care Reconciliation Act.
That bill certainly had some positive features — for instance, it would have phased out Obamacare’s Medicaid expansion over three years while providing $100 billion to help those who lost Medicaid coverage buy private insurance.
The BCRA also offered a great deal of flexibility. Sen. Ted Cruz’s amendment, for example, would have allowed insurers to offer non-Obamacare-compliant plans so long as they also offered at least one Obamacare-compliant plan.
And the bill would have permitted people to pay insurance premiums with money they had stored away in their tax-free health savings accounts.
But it would have kept in place the law’s premium-inflating insurance regulations. It was nobody’s idea of a genuine repeal. It’s alarming that even this watered-down legislation was still viewed by many Republicans as too aggressive.
Then, on July 26, Sen. Majority Leader Mitch McConnell tried his luck with an even less ambitious proposal that would have repealed parts of Obamacare while delaying replacement for two years.
This ill-advised approach was destined to accelerate the collapse of the Obamacare exchanges — a disaster for which Republicans would certainly have taken the blame. The Senate came up short once again, voting 45-55 to defeat the legislation.
Finally came the “skinny” repeal bill, which, as its name suggests, didn’t amount to much. This bare-bones bill would have ended only a handful of Obamacare’s main provisions. The “repeal” of the employer mandate would have only lasted until January 2025. And the medical device tax would have returned on Jan. 1, 2021.
Not one of these options would have made good on the GOP’s promise to repeal and replace Obamacare — a promise that earned Republicans control of both Congress and the White House.
Fortunately, Senate Republicans aren’t completely abandoning their repeal efforts. Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., are drumming up support for their own bill. The measure has serious shortcomings, but anything that brings senators back to the negotiating table is a positive development.
People simply can’t afford for Republicans in Congress to give up on repealing and replacing Obamacare after promising that for more than seven years.