WASHINGTON (MEDIA GENERAL) — The Obama and Trump administrations took over Capitol Hill on Wednesday as each leader met with their respective party members to plot the future of Obamacare.
Republicans plan to bulldoze the program while Democrats will desperately try to keep conservatives from pulling the plug.
Within weeks, the Affordable Care Act could be dismantled piece by piece or demolished completely as Republicans control Congress and the executive pen moves to the hand of President-elect Donald Trump.
Trump has repeatedly pledged to undo President Barack Obama’s signature healthcare law, but the final replacement product remains murky.
Obama brainstormed with House and Senate Democrats in the Capitol Visitors Center on Wednesday to find ways to halt, or at least slow, the death of the Affordable Care Act (ACA).
Meanwhile, Republicans huddled with Vice President-elect Mike Pence to hash out a plan to fulfill an election year promise to “repeal and replace” Obamacare and avoid shouldering the blame if it comes crumbling down like a house of cards on millions of insured Americans.
Obama meets with Democrats
Democrats haven’t controlled the Senate or House of Representatives for several years, but on January 20 they will also lose the security of Obama’s presidential veto which he’s faithfully wielded to quash dozens of Republican efforts to wipe out the ACA.
With that in mind going forward, Democrats must rely on procedural scrappiness and public relations craftiness to ward off GOP efforts to unravel the program.
Obama reportedly avoided the issue of compromise when talking to Dems and focused instead on strategies for safeguarding his legislative baby.
“The president’s message was one of confidence – confidence in the Affordable Care Act, and what it means and does for people; confidence in its implementation,” said House Minority Leader Nancy Pelosi (D-Calif.) following the meeting.
Pelosi also warned GOPers that they’re playing with fire if they plan to push through a repeal without a proper replacement.
“It’s one thing to say to people, ‘This is what you can get (for insurance coverage).’” It’s another thing to say, ‘This is what will be taken away from you,’” Pelosi declared.
Democrats indicated they will consider ideas from Republicans if they’re deemed “workable,” but won’t cross the aisle to salvage every scrap.
The tone was stern but not overly antagonistic.
Pence huddles with GOP
On the other side of the Capitol, Republicans clearly displayed motivation to repeal Obamacare; what they don’t have yet is a sturdy replacement plan.
Mr. Pence reassured politicians and the public that “the president-elect spoke about an orderly transition, and it will be that,” and would facilitate the process through congressional and executive actions.
There was a similar message of encouragement from House Speaker Paul Ryan (R-Wisc.), saying, “The point is in 2017 we don’t want people to be caught with nothing; we want to make sure that there’s an orderly transition so that the rug is not pulled out from under the families who are currently struggling under Obamacare, while we bring relief.”
Rank-and-file Republicans are beginning to worry about getting stuck with the blame if party leaders don’t hammer out final details quickly.
Pence told reporters, “There’s a broad range of ideas about how we do this, and Republicans have been offering those ideas again and again literally every year since Obamacare was first signed into law.”
What Pence didn’t – and couldn’t – do is say which version will serve as the final replacement vehicle.
Sen. John Cornyn (R-Texas), Republicans’ second-in-command, has suggested that a full replacement could take three years, but many rank-and-file members are determined to take immediate action and demonstrate their commitment to following through on campaign promises.
Party leaders are trying to avoid a ready-fire-aim approach that delivers short-term goodwill with constituents but long-term headaches as millions of voters could lose health coverage.
Sen. Rand Paul (R-Ky.) recently warned fellow conservatives, “If Congress fails to vote on a replacement at the same time as repeal, the repealers risk assuming the blame for the continued unraveling of Obamacare.”
Trump has said his plan will still compel insurances companies to cover pre-existing conditions and allow adult children to stay on their parents’ health care plans until the age of 26.
Those are two extremely popular but expensive provisions, presenting yet another challenge as the party tries to scrabble together a suitable replacement that doesn’t bust the federal budget or break the banks of insurance companies.
How House and Senate repeal votes work
The House passes bills (including repeals) on a simple-majority basis.
If 218 members vote to repeal Obamacare, that is sufficient. Republicans currently hold 241 House seats so this portion will be a cake walk.
The Senate will be much trickier.
Republicans hold 52 of 100 total Senate seats, which is not enough to overcome a string of inevitable Democratic filibusters.
To overcome a filibuster, the GOP will need 60 votes, requiring the defection of eight Democrats.
Since that won’t happen, Republicans plan to strip Obamacare to the bone through technical procedures.
Senate rules allow for budgetary items, like Obamacare and its associated costs, to be modified through the “reconciliation” process.
Reconciliation items require the approval of the Senate parliamentarian and a simple majority of senators to move forward. (Pence could be called on to break a 50-50 tie.)
In other words, Obamacare would still officially stand, but Republicans will have stripped nearly all the meat from its bones.
Coincidentally, Democrats employed the same reconciliation process to pass the final version of Obamacare in 2010 after losing their supermajority with the death of Massachusetts Sen. Ted Kennedy.
That maneuver could soon come back to bite them in the procedural backside.
The Senate’s budget chairman already submitted an ACA repeal resolution, which will be debated and then slated for an initial vote next week.
After that, the repeal will be in the House’s hands and then make its way to Trump’s desk as he enters the Oval Office.
Follow Chance Seales on Twitter: @ChanceSeales