President-elect Trump, Majority Leader McConnell and Speaker Ryan are all publicly committed to repealing and replacing the Affordable Care Act on day 1 of Trump’s presidency. If they are serious about doing so, this is how it will work: In an article by Paul Winfree and Brian Blase, written earlier this month at Politico, they explain how a two-budget reconciliation process can be used to first secure repeal, then secure a replacement.
Last year, Congress failed to pass a budget for fiscal year 2017, creating an opportunity for Congress to pass two budgets next year, rather than just one. This gives Republicans two shots at getting filibuster-proof reconciliation bills to Trump.
Remember, “reconciliation” only requires 51 votes in the Senate, which Republicans have.
The first budget is simple. The spending and tax levels include one assumption: The ACA is repealed. That ACA repeal budget should also include instructions to the relevant committees in Congress. Congress should be able to easily pass a budget resolution with these criteria with simple majorities in each chamber and begin the process of work on the reconciliation bill before Inauguration Day. This will set up the ability for Congress to pass a reconciliation bill repealing all the budgetary components of the ACA immediately after Trump is sworn into office.
This process is how the ACA was passed in the first place, so there is no ethical harm in killing it in the manner in which it was born. Democrats practically ensured its doom in the manner in which they passed it, with zero Republican votes in the House or Senate. This leaves us with a great many question marks regarding a replacement plan. President Trump has indicated that he intends to keep adults on their parents’ plan through age 26 and preventing insurance companies from denying coverage to people with pre-existing conditions. Speaker Ryan and ranking committee members in the House have said the same.
This means that many of the new “costs” added to the system by the ACA will remain in place and that Republicans will have to find a way to pay for them. I imagine that much of the 2017 news cycle will be consumed with talk about the ACA’s replacement.
If, however, Republicans do not use this “two-budget” process, ensuring that then President Trump can sign the repeal on his first day in office, it will be clear that repeal and replace will probably never happen and that the ACA is here to stay. If, for whatever reason, we begin hearing talk of repealing and replacing at the same time, it will be safe to assume that this is a process intended to fail. There will simply be too much debate amongst Republicans to get everyone on board, simultaneously for both the repeal and the replace scenarios.
If the ACA is going to be repealed, it will likely be on Trump’s first day in office, or not at all.
11 comments
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Are you as dumb as the shit you write? You must be.
Listen carefully . . . I’ll tell you what I told a republican idjit neighbor of mine last week when he started this crap about how much better off we will be when “Obamacare” is repealed.
An uninsured person goes to the ER . . . which is what they do. Runs up a bill of $10,000. Can’t pay. What does the hospital do? The hospital DIVIDES THE $10,000 AMONG THE PATIENTS WHO HAVE INSURANCE AND THEY — THAT IS THOSE OF US WITH INSURANCE — PAY FOR THE UNINSURED PERSON.
Along comes the ACA. ACA establishes several small taxes and fees that all added together form a pool of $$$ from which subsidies come. Uninsured people then go to insurance companies and get medical insurance, paid for largely by the subsidies. Now, the cost of treating uninsured people is no longer spread among the rest of us because THERE ARE NO UNINSURED PEOPLE.
It is cheaper for everyone for each of us to pay a bit of tax or fee rather than have the medical cost for uninsured rolled into our insurance costs.
Since the institution of the ACA, the rate of increase for both medical care costs and medical insurance has dropped dramatically.
Repeal the ACA and suddenly something like 10 to 20 million people no longer have medical insurance and we are back where we started.
No wonder that CEO’s of major medical insurance companies are telling the GOP and Trump they best not repeal until they have a replacement THAT IS AT LEAST AS GOOD AS THE ACA.
http://www.modernhealthcare.com/article/20161119/MAGAZINE/311199952?utm_campaign=KHN:%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=37966741&_hsenc=p2ANqtz-_LwrkZ8zCTfATpvM_GWMhtZj2vEqIDbEyvVq7Q6m8uD3CdUOYuBX3TTA8Aph7aPJq89AvrKsjQNHRurLn2wXNrjT0C8Q&_hsmi=37966741
You dumbass republicans remind me of a dog chasing a car: You caught it. Now, WTF are you going to do with it?
Big Business republicans and their politicians like obamacare. They pump a couple hundred bucks a month into the pot, and leave the employee with the rest of the tab. Then they still have the gall to call it a company benefit. Kind of like those 401k matching funds they hold off paying only to December 31st employees, or those promotions in name only that just happen to put you into exempt status at the same pay.
Obamacare, going away? Don’t bet on it. More like a new bailout to wall street crook controlled insurance companies. Trump will find draining the swamp is a full time job.
We will see as soon as Trump becomes president.
Yes we shall. Try not to be disappointed if the obamacare version of Clinton’s “no credible evidence” is announced by congressional leaders.
No facts or figures, just get rid of it. The hell with everybody else.
You should compare the rise in the cost of healthcare for the 8 years of Bush 43′ vs. the 8 years Obama.
I don’t gain either way, if it stays or goes. The Party lug heads, the ones who are weeping tonight because Trump won’t throw Hillary in the slammer, would rather pay annual 15% increases without Obamacare, rather than 5% increases with it.
Oh, and Tucker, you ain’t no elitist. How you can lie yourself into believing that you are any better than John Doe populist is beyond reasonable comprehension. Trump probably pays his shoeshine boy more money than you make. Baron’s allowance probably tops your pay.
I stand by what I told you years ago Tucker. You should ask your college for a full refund, cause they robbed you.
You didn’t by any chance get your degree from Trump University did you?
ROTFLMAO!!!
I heard this clown (Tucker) speak at the Montross Tea Party. After listening to him, I went outside and checked the road signs to be certain I was still in Virginia and had not been transported to The Twilight Zone.
Of course, the rubes ate it up.
Reinhardt, I’d be much more impressed if you argued the details, and refrained from vicious personal attacks. What prompted such comments?
Constant attacks on populists.
Another label. Not sure I would know one if I passed him on the street.
Yeah you would, common man, backbone of America; drive over counties. Ongoing blindspot of SBT.