Growing GOP Doubts Jeopardize Swift Obamacare Repeal in Senate

EghtesadOnline: A fourth Republican senator has voiced strong doubts about the party’s current strategy to repeal Obamacare without detailing a replacement, more than enough to scuttle efforts to deliver swiftly on a central promise from President-elect Donald Trump.

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07 January 2017

Bob Corker of Tennessee told reporters Friday morning that he wanted a different approach, according to Bloomberg.

"Repeal and replacement should take place simultaneously," he said.

Only one of the senators -- Rand Paul of Kentucky -- has so far said he plans to vote against the procedural gambit that sets up Obamacare repeal, citing unrelated budget concerns. Paul and three others are concerned that Republicans haven’t said yet how they would replace the health insurance scheme after repeal, with one of them also opposing the plan to defund Planned Parenthood as part of the repeal.

The skeptics could end up yielding to pressure from their colleagues to support the plan when it reaches the Senate floor, but Republicans can only afford to lose two senators. If they lose a third, the effort would stall, and they’d be forced to return to the drawing board. Such a delay would be an embarrassing setback for Republicans, given the intense pressure from conservatives and the Trump team to speed this through.

Republicans have been calling for repealing the health-care law for more than six years, but now that it’s in reach, jitters are emerging. Many Republicans worry that they could end up with the blame if millions of Americans lose coverage in the coming years.

Senator Tom Cotton of Arkansas was the latest to call for a replacement to accompany any repeal.

"I think when we repeal Obamacare we need to have the solution in place moving forward. Again, that solution may be implemented in a deliberate fashion. But I don’t think we can repeal Obamacare and say we’re going to get the answer two years from now. Look, this is a very complicated problem," Cotton said on MSNBC.

Paul said he met with Trump’s pick to lead the Health and Human Services Department, Representative Tom Price of Georgia, on Thursday and told him that "it’s absolutely imperative" that Congress votes on replacing Obamacare on the same day it repeals it.

"We’ve got about 100 bills to replace Obamacare, OK? We need to put together the best of them into one bill," he told reporters. "You can’t wait six months or a year and leave people floundering about without an alternative."

Susan Collins of Maine also said she was worried about scrapping the current law without clearly outlining the next steps.

The problem for Republicans is they have yet to coalesce on any one replacement plan -- many competing plans are swirling around and sorting them out could optimistically take months.

Expiration Date

So far, Republican leaders are sticking to their intention to push through a bill in the next few weeks that would set an expiration date for Obamacare without replacing it, but they have little margin for error.

Some of the objections being voiced could simply be the opening rounds of bargaining, as senators try to send messages to their colleagues in the House, as well as the nascent Trump administration. The actual repeal bill hasn’t been drafted yet in either chamber.

Senate Majority Leader Mitch McConnell defended the plan on the Senate floor from Democratic attacks that they were repealing a law that was working for millions without a replacement ready to go. McConnell insisted Republicans would act later in the year on several pieces of legislation that would result in better and less-expensive care.

“We plan to take on this challenge in manageable pieces,” he said Thursday, adding that there will be “bumps along the way.”

On Wednesday, McConnell said the bill Republicans intend to push through soon after Trump’s inauguration would be very similar to the repeal legislation sent to Obama for his veto a year ago, but his members have various worries about how acting to repeal now without a clear replacement in place could roil insurance markets.

Paul and Cotton both represent states that have seen significant drops in the rates of the uninsured. If Obamacare collapses after a standalone repeal, they could be faced with the prospect of explaining to constituents why they’re losing health care they obtained when a Democrat was in the White House.

In addition to Paul and Cotton, Collins also said Thursday she wants to make sure that a framework for replacement -- preferably in the form of legislation -- accompanies repeal so insurance markets have time to adjust. They can’t "turn on a dime," she told reporters.

Planned Parenthood

Collins on Wednesday also said that a plan to bar funds to Planned Parenthood as part of the repeal bill is “of concern to me as well,” although she added that she didn’t “want to prejudge” the bill. Lisa Murkowski of Alaska has also in the past expressed opposition to defunding the group, which delivers basic health-care services to millions of women and also performs abortions.

Collins voted against a similar repeal effort in 2015 after the Senate narrowly rejected her amendment -- cosponsored by Murkowski -- to restore Planned Parenthood funding on a 48-52 vote.

On Thursday, House Speaker Paul Ryan made clear that the House plans to block funding to Planned Parenthood in its repeal bill.

"Planned Parenthood legislation would be in our reconciliation bill," he told reporters.