President Donald Trump lamented that an Obamacare repeal may take until 2018 in an interview with Bill O’Reilly on Super Bowl Sunday.
“I would like to say by the end of the year, at least the rudiments, but we should have something within the year and the following year,” the president explained.
Republican leaders originally set the Obamacare repeal deadline on January 27th. That deadline was quickly brushed away given increasing disunity regarding Obamacare’s repeal. Secret recordings of the Republican retreat in Philadelphia revealed a deluge of uncertainty from Republican leaders, the rank-and-file. Arguments included whether to repeal and replace Obamacare simultaneously or separately, to maintain Obamacare’s taxes to fund a replacement, and to keep the states Obamacare exchanges.
Since then, Republicans leaders such as House Energy and Commerce Committee Chairman Greg Walden (R.-Ore.) believe that the scope of healthcare reform needs to change from “replace” to “repair.” Speaker Ryan rebuked that rhetoric by called Obamacare a “collapsing law.” He noted, “Somewhere along the line there was confusion that we were going to take the Obamacare architecture and, you know, tinker at the margins and repair it.”
Despite the rhetoric, it is unclear how Republicans plan to repeal Obamacare beyond reconciliation, where any Obamacare repeal will require the support of Democrats. Senate Minority Leader Chuck Schumer promised no cooperation from Democrats unless there will be a repeal-and-replace package at the same time, and “So long as it covers as many people as the ACA, so long as it helps bring healthcare costs down, so long as it doesn’t move our healthcare system backward.”
The American Medical Association, the largest association of doctors, wrote a letter to Congress in January providing a roadmap for what “in reasonable detail what will replace current policies.” Vice President Mike Pence speaking with ABC’s George Stephanopoulos said that there will be a smooth transition between repeal and replace, noting, “He’s also made it very clear that at the same time that we repeal Obamacare, we’re going through both executive action and through legislation, set into motion a replacement of Obamacare that will be orderly and will lead the American people.”
Senator Lamar Alexander (R.-Tenn.), Chairman of the Senate Health Committee said argued that Obamacare’s repeal will only take place when there is a practical alternative, saying:
I think of Obamacare like a collapsing bridge. If your local bridge were “very near collapse,” the first thing you would do is send in a rescue crew to repair it temporarily so no one else is hurt. Then you would build a better bridge, or more accurately, many bridges, as states develop their own plans for providing access to truly affordable health care to replace the old bridge. Finally, as the new bridges are finished and safe to drive across, you would close the old bridge.
While Congress will vote to repeal and replace Obamacare this year, the repeal of Obamacare finally will become effective when our reforms are implemented and we have concrete, practical alternatives.
I believe this is what the President means when he says we will repeal and replace Obamacare simultaneously and what Speaker Ryan means when he says we will repeal and replace Obamacare concurrently.
Sen. Alexander is a proponent of repealing and replacing at the same time, an idea that President Donald Trump has signed onto in the past. Any form of repeal would only be effective after there is a practical alternative that includes several of the popular republican reforms to Obamacare, such as shopping insurance plans across state lines, and expansion of health savings accounts.
There are number of plans to replace Obamacare, including from Sens. Susan Collins (R-ME) and Bill Cassidy (R-LA), a separate plan from Senator Rand Paul (R-KY), as well as from Speaker Ryan. However, there is little consensus from Congress, or the White House on which plan will be implemented to replace Obamacare. There is also little agreement on when the plan will take place, Speaker Ryan has mentioned March or April, but with President Trump’s remarks it seems that Obamacare may stay until even 2018.
President Trump said that Obamacare repeal is “very complicated” but reminds everyone that “Obamacare is a disaster.”