WASHINGTON — Here’s the idea: Swiftly pass a repeal of President Barack Obama’s health care law, perhaps soon enough for Donald Trump to sign it the day he takes the presidential oath. Then approve legislation restructuring the nation’s convoluted health care system — despite Republican divisions, Democratic opposition and millions of jittery constituents.
What could go wrong?
Here are hurdles the GOP will face:
• SPEED vs. DELIBERATION.
Trump and congressional Republicans will be under intense pressure from their core conservative supporters to repeal Obama’s 2010 health care law. After all, Congress already sent Obama a repeal bill last January, which he vetoed, and many GOP voters will see no reason for delays this time.
But there probably won’t be anything fast about Congress’ effort to replace Obama’s law, which is likely to take many months.
While the replacement effort is underway, Republicans will risk aggravating 30 million people who are covered by the law or buy policies with prices affected by its insurance marketplace.
• A SOLUTION.
Nothing’s been decided, but here’s one scenario:
The new Congress, which convenes Jan. 3, tries to quickly approve legislation repealing Obama’s health care law, maybe completing it by Trump’s Jan. 20 inauguration or soon after. But the repeal would not take effect until the future, perhaps a year later, to give lawmakers time to fashion a replacement. The version Obama vetoed had a two-year delay.
Seemingly acknowledging that process, Vice President-elect Mike Pence said Sunday on “Fox News Sunday” that Trump “wants to focus out of the gate on repealing Obamacare and beginning the process of replacing Obamacare.”
Because Republicans will control the Senate by just 52-48, Congress will first have to approve special budget procedures to prevent Democrats from stopping repeal legislation by filibuster. Bill-killing filibusters require 60 votes to end.
But those special rules would apply only to items that affect the federal budget. Republicans, for example, would need a simple Senate majority to end IRS penalties against people who don’t buy insurance but would still need 60 votes for other changes.
• GOP RISKS.
One GOP danger: Congress and Trump might repeal Obama’s law, but while they’re laboring on a replacement, nervous insurance companies begin pulling out of markets and raising premiums. Insurers have been doing that under Obama, but now it would occur under a Republican government.
