Republicans are playing with the future of the entire health insurance industry

Victoria Fleischer/Think Progress

Since President Obama first signed the Affordable Care Act into law, Republicans have been itching to dismantle it. And come January 20 — the day Trump takes the oath of office and Republicans have a majority in the House and the Senate — they will actually have the capacity to do so.

In other to expedite the process, Senate Republicans have one strategy in mind: repeal and delay. They want to repeal Obamacare quickly and give themselves a two to three year grace period to create an alternative policy.

But experts caution that repealing the ACA without having another plan in its place is dangerous. On January 3, in a piece for Health Affairs, Joe Antos and James Capretta of the right-leaning American Enterprise Institutewarned that this strategy would leave many people without insurance.

“The most likely end result of ‘repeal and delay’ would be less secure insurance for many Americans, procrastination by political leaders who will delay taking any proactive steps as long as possible, and ultimately no discernible movement toward a real marketplace for either insurance or medical services,” they wrote.

Some Senate Republicans agree. Sen. Rand Paul (R-KY) told MSNBC that “it’s a huge mistake for Republicans if they do not vote for replacement on the same day we vote for repeal.” And he’s not alone. Sen. John McCain (R-AZ), Sen, Bob Corker (R-TN), and Sen. Tom Cotton (R-AR) have also cautioned against this strategy.

Transcript:

VICTORIA FLEISCHER, ThinkProgress: Since the day it was signed into law, Obamacare has been on the defense. And in a Trump administration, it could actually be left in tatters. Only the Republicans don’t exactly have a health care plan to enact in its place.

Their strategy: repeal and delay. They want to repeal Obamacare as quickly as possible, while giving themselves a two to three year grace period to come up with an alternative plan.

In order to expedite the vote, House Republicans are taking advantage of the budget process, which eliminates the Democrats ability to filibuster.

So what does that mean for health care?

The GOP plans are scarce on information, but there are two major issues with the Republican approach.

1) Fewer people will buy insurance.

Obamacare created the individual mandate, which requires everyone — healthy and sick — to buy insurance. Remember: healthy people balance out costs and keep premiums low. Republicans want to abolish the mandate. That means healthy people are less likely to buy coverage and sick people would get stuck with higher and higher premiums.

2) Fewer insurance companies will offer plans.

Insurance companies have adjusted their plans to Obamacare, but without a replacement, they don’t know how to prepare for the future. This uncertainty would likely lead companies to pull out of Obamacare’s state-level marketplaces. With fewer companies in the marketplace, premiums will rise.

And so begins the spiral: competition decreases, premiums rise, more healthy people leave, and on and on and on…until the whole system collapses.

Repeal and delay isn’t final yet, and there are some Republicans who don’t want it to be. But in the meantime, at least 20 million people’s access to health care hangs in the balance.

The Republican plan to repeal Obamacare may be on the brink of collapse

Tara Culp-Ressler/Think Progress

Dismantling Obamacare is at the top of Congress’ agenda. With a GOP-controlled Congress and an incoming president both eager to scrap health care reform, moving forward with Obamacare repeal this month may seem like a foregone conclusion. But that’s not necessarily the case.

A small handful of GOP senators are starting to express reservations about Congress’ current Obamacare repeal effort — raising questions about whether it will actually have enough support in the Senate.

Because Democrats are expected to present a united front against attacking the health law, Republicans can only afford to lose support from two senators in order to advance the measure being used to repeal Obamacare.

Rand Paul (R-KY), Bob Corker (R-TN), Tom Cotton (R-AR), and Susan Collins (R-ME) are all signaling a potential break from the rest of their party. Though it’s not yet clear whether these senators will cast a vote against Obamacare repeal, the growing unease in the Senate puts the GOP on shaky ground.

Working through a budget process known as “reconciliation” to sidestep a Democratic filibuster in the Senate, Republican lawmakers are trying to pass a resolution that will instruct several congressional committees to come up with legislation to repeal key parts of the health law by January 27.

Without a viable plan to replace Obamacare — a policy goal that the GOP has failed to deliver on for six years — Republican leaders are rallying behind a dubious tactic known as “repeal and delay.” They want to use the budget reconciliation bill to officially repeal Obamacare now, before figuring out what kind of new health care legislation to enact in its place. This strategy threatens to throw the insurance industry into chaos by creating widespread uncertainty among major insurers.

Even traditionally right-leaning players are worried that “repeal and delay,” which could jeopardize the coverage of at least 20 million people who gained insurance under Obamacare, is much too risky. Prominent libertarian think tanks like the American Enterprise Institute, lobbying groups like the American Medical Association, and leading conservative outlets like the Washington Examiner have all raised concerns that repealing Obamacare needs to wait until Congress has a real plan for what’s going to come next.

And a handful of Republican senators — particularly those representing states where large numbers of people have benefited from the reforms under Obamacare — appear to agree.

So far, Paul is the most forceful opponent of the GOP’s current budget resolution, arguing that his fellow conservative lawmakers should not support it because it will add too much to the national debt and because it doesn’t include an Obamacare replacement plan. “We need to think through how we do this, and it’s a huge mistake for Republicans if they do not vote for replacement on the same day as we vote for repeal,” Paul said this week.

Cotton, Corker, and Collins have been less definitive about whether they plan to withdraw their support from the resolution. But they have all expressed some doubts about rushing to repeal Obamacare before having a replacement plan ready to go, saying the GOP needs a different strategy.

“I don’t think we can repeal Obamacare and say we’re going to get the answer two years from now,” Cotton told MSNBC on Thursday.

“Repeal and replacement should take place simultaneously,” Corker told reporters on Friday morning.

If the people who don’t want Congress to pursue “repeal and delay” decided to flood their representatives’ offices with calls urging them to oppose the current budget resolution, it’s possible that could influence some of the moderate lawmakers who are teetering on the edge.

Just earlier this week, House Republicans reversed course on a deeply unpopular plan to gut the independent Office of Congressional Ethics after being overwhelmed with calls from angry constituents.