Concerns are growing among Republicans about moving forward with their plan to repeal ObamaCare without putting forward a replacement at the same time.
Republican congressional leaders are moving quickly to pass an ObamaCare repeal bill, but want to delay when it takes effect. That would give them time to develop a new healthcare plan that could be presented later this year.
But several Republican lawmakers across the ideological spectrum are warning against the strategy, saying it would create uncertainty in the market while serving only to kick the can on difficult decisions.
Some Republican senators are pointing to President-elect Donald Trump‘s own comments in favor of doing repeal and replacement at the same time.
Send Rand Paul (R-Ky.) on Friday night tweeted that he had spoken to Trump and said the president-elect supported his plan to repeal and replace simultaneously.
“I just spoke to @realDonaldTrump and he fully supports my plan to replace Obamacare the same day we repeal it. The time to act is now.” Paul tweeted.
If Trump came out against the congressional plan to repeal without a replacement immediately available, it could kill the plan.
“We’re going to do it simultaneously,” Trump told CBS’s “60 Minutes” shortly after the election. “It’ll be just fine.”
Sen. Tom Cotton (R-Ark.) was one of the first lawmakers, along with Paul, to object to the lack of an immediate replacement plan.
“I don’t think we can just repeal ObamaCare and say we’re going to get the answer two years from now,” Cotton said on MSNBC Thursday evening. “We haven’t coalesced around a solution for six years in part because it is so complicated. Kicking the can down the road for a year or two years is not going to make it any easier to solve.”
Healthcare policy experts warn that if ObamaCare is repealed without an immediate replacement, even on a delay, many insurers are likely to drop out of the market, leaving few or no options for the uninsured in many states.
The situation could deteriorate further if the mandate for everyone to buy insurance is immediately repealed. That could leave only the sickest people in ObamaCare plans, causing premiums to spike.
Paul wrote an op-ed in Rare this week warning of such a scenario. He called for an immediate replacement or else Republicans “risk assuming the blame for the continued unraveling of Obamacare.”
Paul told The Hill that he will be “advocating very strongly in my caucus that we should vote simultaneously on repeal and replacement.”
Speaking of his colleagues he added: “Some of them think they can wait. I think it’s a huge mistake to wait.”
Sen. Bob Corker (R-Tenn.) also expressed concerns about the plan, though he noted that his views do not seem to be carrying the day so far.
“It’d be best to do it all at one time, and not have the uncertainty,” Corker told The Hill. “I realize that’s not the path that’s been taken. I think everyone would acknowledge that it’s fraught with potential destabilizations of the market and never finding a replacement, but that’s the path that obviously is being taken.”
Speaker Paul Ryan‘s (R-Wis.) declaration on Thursday that defunding Planned Parenthood would also be a part of the ObamaCare repeal bill is also being greeted with trepidation by some Senate Republican centrists who support Planned Parenthood.
“Obviously I’m not happy to hear that the Speaker wants to include defunding of Planned Parenthood, an extremely controversial issue, in the package,” Sen. Susan Collins (R-Maine) told reporters on Thursday, though she did not say definitively whether she would end up voting for the bill.
Collins also objects to repealing ObamaCare before introducing a replacement, and said at the very least that Republicans should put forward a “detailed framework” of a replacement before voting to repeal.
Sen. Lisa Murkowski (R-Alaska) has reservations about Planned Parenthood defunding being included in the bill.
“I can’t tell you what she plans to do, but I can tell you she is concerned about defunding Planned Parenthood as she is a longtime supporter of Planned Parenthood and has opposed broadly defunding the organization,” Karina Petersen, a spokeswoman for Murkowski, wrote in an email.
Sen. Bill Cassidy (R-La.) said that he wants to “begin the process” of moving towards a replacement at the same time as repeal, though he left some flexibility, adding, “you can’t flip a switch.”
Cassidy said he pointed to Trump’s comments on “60 Minutes” in favor of simultaneous repeal and replace in the Senate Republican lunch with Vice President-elect Mike Pence on Wednesday.
So far, not a single Republican senator has said he or she will vote against the repeal bill if it does not include a replacement. (Paul is opposing an earlier step, the budget resolution, due to concerns over the federal debt.)
Republicans still face enormous pressure to act, having campaigned for years on promises to repeal and replace ObamaCare. But the process for achieving it is fraught with difficulty.
Some Republicans worry that if ObamaCare’s taxes are repealed early this year, there won’t be money left to fund a replacement bill. Republicans are consideringkeeping some of the ObamaCare taxes in place, but that option is facing strong pushback from the conservative House Freedom Caucus.
Rep. Mark Meadows (R-N.C.), the chairman of the House Freedom Caucus, while calling for all of the taxes to be repealed, also wants a replacement to come forward simultaneously.
“The replacement program, whatever you want to call it, then needs to be implemented, I believe needs to be voted on the same day,” Meadows said Thursday, adding that is his opinion and not an official Freedom Caucus position.
“We have to show that everyone is going to be able to maintain coverage, which they will,” he added.
Republican leaders, meanwhile, have declined to make that pledge that no one will lose coverage.
President Obama slammed Republicans on Friday for the repeal and delay strategy, challenging them to put forward a fleshed-out proposal.
“If they’re so convinced they can do it better, they shouldn’t be afraid to make that presentation,” Obama said in an interview with Vox. “It is really interesting to try to figure out why is it that they’re trying to rush the repeal so quick? What is it that they’re afraid of?”