Republicans have been patiently waiting for the opportunity to get rid of Obamacare, and are now looking forward to 2017 when they will have that chance. The Republican Party now has full control over the White House, the Senate, and the House of Representatives. Republicans expect to eliminate the Patient Protection and Affordable Care Act without even needing a Democratic vote, just as the Democrats passed the Act through without a single Republican supporting it.
What repealing the ACA does to the US health care system remains to be seen. Millions of Americans could be negatively impacted by the repealing of the ACA, yet the Republicans are standing firm on their desire to get rid of the ACA. People are critical of the Republican’s approach of shoot first and deal with the consequences later. Republicans expect a new system to be in place between two and three years later, as they work on a new system of health care reform, which will leave consumers and insurers in a dangerous situation.
Republicans have outlined a strategy to deal with Democrats, who plan to filibuster all efforts to kill the ACA. Republicans may rush to create a budget for the fiscal year that has already begun. By law, this type of measure cannot be filibustered. Congress would seek to pass a budget reconciliation bill to get rid of the ACA which Democrats would be unable to filibuster.
This would damage the subsidies in the ACA that allowed millions of uninsured people to gain coverage through Medicaid or some type of private insurer. Republicans believe that they have a better plan for making insurance more accessible and affordable to lower income Americans. The Republicans want to place an emphasis on tax credits and health savings accounts.
The plan is flawed according to many people based on the statutory limits on the reconciliation process. According to the law, reconciliation bills cannot include items that do not have a direct effect on federal spending or revenue. Major parts of the ACA do not have taxes or subsidies; they are insurance regulations to help people with preexisting health conditions be able to afford coverage.
The ACA requires that insurers have policies to offer for everyone and that they no longer base premiums off of the medical history of the applicant. Republicans are aware of the provisions and plan to repeal them through reconciliation.
Those who do not like the ACA as a whole often support the regulations. Potential regulations without the tax penalties and premium subsidies of the ACA could damage the market for individual insurance policies. Premiums will be higher, as coverage will mainly be for people who need treatment. This could lead to healthy people not enrolling and insurers leaving the market entirely. Analysts expect the market to collapse in some parts of the country before the design of a new bill.
Republicans are trying to get Democrats to go along with the plan. The market is already flawed in some states, due to the deficiencies in the ACA. Rather than addressing the issues in the ACA, the Republicans are more interested in starting over, which may make things worse in the short term and very uncertain in the long term.