Senate Leadership Considers ‘Skinny Repeal’ of Obamacare

Senate REUTERSJonathan Ernst
REUTERS/Jonathan Ernst

Senate Republicans might try to pass a bare-bones repeal of Obamacare that would only cut the basic tenets of the law.

Compared to the Senate leadership’s Better Care Reconciliation Act (BCRA) and Senator Rand Paul’s clean Obamacare repeal bill, the new skinny repeal bill might pass through the Senate. Both bills failed to gain enough Republican votes in the Senate this week.

The thin repeal of Obamacare would repeal Obamacare’s individual and employer mandate, repeal the Affordable Care Act’s medical device tax, defund Planned Parenthood for one year, and increase funds for community health centers.

The new repeal bill would expand waivers for Obamacare regulations such as essential health benefits, although, it remains unclear whether those exemptions originally included in the BCRA complied with the Senate’s budget rules.

The bare bones plans would leave Obamacare’s Medicaid expansion, subsidies, and Obamacare insurance regulations such as pre-existing conditions intact.

Senate Republicans argue that a skinny repeal of Obamacare would make it easier for the many disparate wings to coalesce around a simple bill that would pass through the upper chamber. If the Senate were to pass a skinny repeal of Obamacare, the House and the Senate could reconcile the differences between the House-passed AHCA and whatever bill that goes through the Senate. After which, the unified congressional healthcare plan would have to pass through both chambers of Congress, and then President Donald Trump could sign the bill.

The Senate healthcare reform process already traversed a rocky path. The Senate’s motion to start debating healthcare legislation barely passed through the upper chamber at 51-50; Vice President Mike Pence had to break the tie after Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK) voted against starting the debate in Congress.

The Senate leadership failed to pass its healthcare bill and Senator Rand Paul’s (R-KY) clean repeal bill failed in the Senate after moderate Republicans shot down the legislation.

Senate Majority Whip John Cornyn (R-TX) suggested that a skinny repeal of Obamacare can get the 50 votes necessary to pass through the chamber. Cornyn said, “Sure. There’s plenty we agree on.” Cornyn explained that one obstacle is “trying to explain the concept that we need to do it this way, as opposed to solving all the problems in a Senate bill now.”

The Texas senator revealed that Congress could hash out the future of Obamacare’s Medicaid expansion, Obamacare’s subsidies to purchase health insurance, and protections for pre-existing conditions between the House and the Senate in the unified conference committee.

Conservative Sen. Mike Lee (R-UT) could back a skinny repeal of Obamacare, although a spokesman said that it “depends on how skinny it is.”

Fellow conservative Sen. Paul said that a bare bones repeal of Obamacare could create some positive results. Paul suggested, “I’ve always said I will vote for any permutation of repeal. Obviously, I want as much as I can get, but I’ll vote for whatever the consensus can be. It’s what I’ve been saying for months: Start on what you can agree on. Starting small and getting bigger is a good strategy.”

Sen. Roy Blunt (R-MO) explained that GOP senators just need to find the bare necessities that all senators can agree upon. Bunt said, “I can’t imagine at the end of the process that we haven’t agreed on something. And all we have to do is agree on something that keeps this going.”

Paul signaled that he would support a bare bones repeal, although he cautioned that establishment Republicans could try to slip more Obamacare subsidies and insurance bailouts into the unified congressional bill.

Sen. Paul said, “I would [be in] favor if we have a skinny repeal, just sending it over to the House and seeing if they can pass it rather than going to conference. Conference committee to me means Big Government Republicans are going to start sticking in those spending proposals.”


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