Yes, undoubtedly under full repeal of ObamaCare, some Americans would lose coverage. But as Cato’s director of health care policies Michael F. Cannon explains, “The actual number of people who would lose coverage under full repeal is likely comparable to the number who would if and when ObamCare collapses of its own weight.”
Dick and I have known Michael for a number of years. Michael was the third speaker at the terrific Cato event Dick and I attended at the Ritz Naples this past week. Repeal of ObamaCare is a complicated matter, and Michael packed a lot of information into a short period of time on the complications facing Republicans under Repeal/Partial Repeal.
Under full repeal, however, not only would premiums automatically fall for the vast majority of Exchange enrollees, but Congress could proactively provide a safety net for those who still cannot afford coverage and enact further reforms that improve healthcare for all Americans. Medicaid block grants, expanded health savings accounts, and other reforms would make healthcare better, more affordable, and more secure through lower prices and more sustainable coverage. Congress could even do it all in one bill.
Under the GOP’s partial-repeal strategy, by contrast, the CBO estimates ObamaCare’s regulations would cause premiums to rise an additional 20-25 percent next year and to double over the next decade. The regulations would cause health insurance markets to collapse, such that ten percent of Americans would not be able to purchase coverage at any price. All told, partial repeal would leave uninsured nine million Americans who would have insurance under full repeal.
Why are Republicans even entertaining a partial repeal? Senate rules, they believe, don’t allow them to repeal the regulations with a simple majority. But that is a mistaken belief, says Michael.
With a 52-seat majority, Republicans don’t have the 60 votes necessary to overcome a Democratic filibuster of a repeal bill. But Senate rules do, in fact, allow repeal of ObamaCare’s insurance regulations through the special “budget reconciliation” process that requires only 51 votes to approve legislation. Even if the Senate parliamentarian misinterprets those rules — and this would be an egregious misinterpretation — a majority of the Senate can overrule that misinterpretation.
ObamaCare reform cannot happen with ACA’s regulations still on the books, argues Michael Cannon. “In short, the question is not whether Republicans can repeal the regulations. It is whether they have the will.”