As I’ve discussed previously, Republican plans to repeal Obamacare are not going well for them. Donald Trump is still talking about immediate repeal, while having no idea what is actually going on. Repeal might not be possible as more Senators, in addition to those mentioned in the previous post, are jumping ship. Jonathan Chait writes that their plans to destroy Obamacare may have died, reporting that additional Republican Senators are now pushing to include a replacement plan with legislation to repeal Obamacare.
Over in the House, Paul Ryan is also talking vaguely about including portions of a new plan in the repeal legislation.
Including a replacement plan could very well kill off any Republican plans to repeal Obamacare. From a public relations stand point, they will have difficulty obtaining public support for a health plan which does not include popular components of the Affordable Care Act. Politico confirmed this in a new poll:
Voters want — and expect — President-elect Donald Trump and the GOP-controlled Congress to repeal the 2010 health care law, according to a new POLITICO/Morning Consult poll released Tuesday, but they are skeptical of repeal without a plan to replace Obamacare and some of its most popular elements…
Testing eight separate elements of the law, more voters want to keep each of the eight provisions than want to repeal them, in some cases by overwhelming margins.
Nearly two-thirds of voters, 66 percent, favor keeping a provision that prohibits insurance companies from denying coverage to patients with pre-existing conditions. Sixty-three percent of voters want to keep the requirement that insurance companies allow policyholders to keep their children on their plans until age 26. Fifty-six percent think subsidies for low-income Americans to buy insurance should stay, and the same percentage wants to keep federal funding for states to expand their Medicaid programs.
A 55-percent majority also wants to keep the requirement that businesses and companies with more than 50 full-time employees offer health insurance to those employees, while only 27 percent want that provision repealed. Many Republicans say that requirement has led businesses to slash jobs and hours to avoid hitting that threshold.
And 53 percent of voters want to keep requiring insurance companies to cover prescription birth control, while just three-in-10 want that requirement repealed. (The Supreme Court ruled in 2014 that employers may exclude contraceptive coverage for their employees if it violates the employers’ religious beliefs.)
Pluralities of voters also want to keep two other provisions of the law, though by narrower margins: 46 percent want to keep the elimination of lifetime and annual limits on health reimbursement to individuals, while 32 percent want that repealed. And 33 percent of voters want to repeal the long-derided medical-device tax, compared to 37 percent who want to keep it.
The most-popular elements of the law are also well-regarded by Republicans. Sixty-three percent of Republicans want Trump and Congress to keep the prohibition on denying coverage to those with pre-existing conditions, and 56 percent want to retain requiring insurance companies to allow the children of policyholders to stay on their plans until age 26.
In other words, as has been the case all along, the public opposes Obamacare by name but supports its components when asked.
Besides the public relations issues, the repeal of Obamacare might be dead due to Senate rules. The Senate can repeal Obamacare as part of a budget resolution with a simple majority, but a bill which repeals Obamacare and establishes a replacement program can be blocked with a filibuster if it lacks sixty votes. If Republicans cannot get a simple majority for repeal now, they could wind up with a choice of continuing Obamacare or only replacing it with a plan which can obtain bipartisan support. Such a plan will very likely be much like Obamacare, even if under a different name.