Republicans appear ready to admit that they may never deliver on the long-held campaign promise to repeal the Affordable Care Act.
Take House Freedom Caucus Chairman Mark Meadows, R-N.C., who told Politico that “anytime you fumble twice, there’s the anticipation that you’ll fumble for the third time.”
Or Rep. Phil Roe, R-Tenn., who noted the House did everything it could do to repeal the ACA and admitted he doesn’t think taking another crack at it will do much good. Then there’s Rep. Kevin Cramer, R-N.D., who said there was a 50% chance the current healthcare law will remain in place.
Indeed, the party faces the harsh reality that multiple ACA repeal bills have now died in the Senate, all having failed to gain enough votes to pass even under budget reconciliation rules that require only a simple majority. The authors of the latest repeal bill, GOP Senators Bill Cassidy and Lindsey Graham, have insisted that the decision to table the measure is only temporary.
Meanwhile, the budget reconciliation instructions for fiscal year 2017 expired Sept. 30. The Senate has since issued a 2018 budget resolution that could allow them to repeal key parts of the law, but it primarily focuses on another GOP legislative priority—tax reform.
Congress’ preoccupation with tax reform could pay off if Republicans are able to use momentum from delivering on that issue to finally push through their healthcare agenda, Cramer told Politico.
Trump ready to go his own way
President Donald Trump appears largely resigned to accepting that lawmakers can’t deliver a win on healthcare, tweeting Tuesday that he would instead use the “power of the pen” to make his own policy:
Since Congress can't get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people - FAST— Donald J. Trump (@realDonaldTrump) October 10, 2017
While answering reporters’ questions during a White House event on Tuesday, Trump was slightly more specific about his plans, saying “I'll also be signing something probably this week” to “take care of many of the people that have been so badly hurt on healthcare.”
That “something” will likely be an executive order that changes the rules governing association health plans, allowing individuals to pool together and buy insurance across state lines. Sen. Rand Paul, R-Ky., has publicly backed the idea, but it is not a popular one with state regulators, who argue it would make insurance less available for consumers and make insurers less accountable.
Kaiser Family Foundation Senior Vice President Larry Levitt is also a skeptic, pointing out some major drawbacks of allowing association health plans in a series of tweets.
Association plans exempt from the ACA can cherry pick healthy people and make coverage unaffordable for those with pre-existing conditions.— Larry Levitt (@larry_levitt) October 10, 2017
If loosely regulated association plans are allowed, insurers will leave the ACA marketplaces as soon as they can or hike premiums a lot.— Larry Levitt (@larry_levitt) October 10, 2017
He also noted that another possible part of the executive order, allowing short-term health plans, would have dire consequences.
If healthy people can enroll in short-term plans and avoid the individual mandate penalty, the ACA marketplaces could collapse.— Larry Levitt (@larry_levitt) October 10, 2017
Trump, though, appeared enthusiastic about the idea during his remarks on Tuesday. His plan, he said, will allow consumers to buy insurance across state lines and “get great, competitive healthcare—and it will cost the United States nothing.”