Buckle Up: Obamacare Repeal Is Going to Be a Long, Stupid Ride

I am still not convinced Donald Trump knows what Obamacare does. Someone should really ask him.

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Some mental health advice: Try, over the next couple of months, to not get too wrapped up in the day-to-day machinations of Obamacare repeal. It’s going to be a tedious, often pointless, and drawn-out slog, sort of like watching regular season baseball. Eventually, the GOP may settle on a strategy to repeal and replace the Affordable Care Act, at which point it will be worth paying attention. For now, it has not. Nor does it seem to have a real timeline for crafting one.

Republicans did make their first, tentative move toward slaying Obamacare on Wednesday night by kick-starting the budget reconciliation process, which theoretically will let them eliminate the health law’s tax and spending provisions with just 50 votes in the Senate. Specifically, the Senate passed a budget resolution telling congressional committees to draft some repeal legislation. But how soon will they get that job done? Nobody really knows. The resolution set a Jan. 27 deadline. But thanks to Tennessee Sen. Bob Corker, who wanted longer for Congress to draw up an actual replacement, we now know that’s “not a real date.”

“That is a place holder,” he explained on the Senate floor. “That’s the earliest they can come back but in talking with leadership and working through, we understand that everyone here understands the importance of doing it right, giving Tom Price, the HHS person, the time to weigh in and help us make this work in the appropriate way.”

Price, of course, is Donald Trump’s nominee for secretary of health and human services, who might not be confirmed until mid-February, at least according to Lamar Alexander, the Senate committee chairman who has power over such things. Given that Alexander also wants time to confer with GOP governors about how to replace the Affordable Care Act, it’s possible we won’t see a conservative health reform outline until March.

And what then? Beats the hell out of me. Trump himself seems to be operating in some alternative universe where the rules of Senate procedure don’t apply. “We’re going to be submitting—as soon as our secretary’s approved, almost simultaneously, shortly thereafter, a plan. It’ll be repeal and replace. It will be essentially simultaneously,” Trump said during his surreal afternoon press conference Wednesday. “Probably the same day, could be the same hour.” This would be credible if Republicans had a 60-vote majority in the Senate, since that’s what will be required to pass an actual replacement plan over a Democratic filibuster (reconciliation can only be used on things like taxes and spending that have a budget effect, not regulations such as the ACA’s various insurance market rules). But Republicans only have 52 seats. And they’re not going to peel off many Democrats to back the first plan that Tom Price, an arch-conservative, serves up.

Does Trump realize any of this? I don’t know. It’s not even clear to me he knows what the filibuster is (someone should ask him at his next presser). Could Senate Majority Leader Mitch McConnell simply nuke the filibuster in the face of Democratic resistance? Maybe, but for now it doesn’t appear he has the appetite or votes to press the launch button.

So here’s how our current course might shape up: Republicans will introduce plans to repeal and replace Obamacare in the next couple months, which Democrats will reject. At that point, the GOP might just pass its repeal bill and get ready for trench warfare with the Democrats over how to replace the law. According to the Washington Post, they might resort to legislative hostage-taking, much as they did during the Obama years:

According to multiple GOP individuals, Republicans are looking at whether to use coming reauthorizations of existing programs, such as the Children’s Health Insurance Program, as vehicles for Obamacare replacement measures. That could give them leverage to secure cooperation from Democrats.

Would that work? Will it actually unfold that way? Will Donald Trump himself understand any of it? Maybe, maybe not. Will we be treated to months of nonsense on barely rooted fact or logic as Republicans and Democrats grind away at this battle? Almost certainly.