How to Repeal and Replace Obamacare under a Trump Administration
Background: Republicans promised the American people a full repeal of Obamacare dating back to 2010, when the health care law was first passed. In fact, since Republicans took control of the House in 2010, Congress voted over 60 times to repeal parts or all of the law. Republican Congressional Leadership and President-elect Donald Trump have all promised to repeal this unaffordable, unworkable, and unfair law.
In 2015, Congress used a filibuster-proof process known as budget reconciliation to pass an Obamacare repeal bill (H.R. 3762), that was ultimately vetoed by former President Barrack Obama in 2016. Now that the American people voted to keep Republican majorities in both chambers of Congress and give Republicans the White House, Congress must act immediately to repeal Obamacare once and for all. There are no more excuses.
Obamacare “Two Budget” Repeal Strategy: Just as they did in 2015, Republicans should use budget reconciliation to repeal Obamacare. Budget reconciliation allows Congress to pass legislation with a simple majority in order to avoid a filibuster in the Senate. Ironically, Democrats used this same method to help pass parts of Obamacare in the first place. Due to conservative opposition, Congress failed to pass a budget for fiscal year 2017, creating an opportunity to pass two budgets, each with reconciliation possibilities, this year.
In the first budget, Congress should include the full repeal of Obamacare. This budget should pass the House and Senate easily and be placed on President Trump’s desk for his signature soon after he takes office. The next best option would be for Congress to take the reconciliation bill that repealed Obamacare, but was vetoed earlier last year (H.R. 3762), and pass it again with additional language repealing the Obamacare insurance mandates – a central reason health insurance premiums continue to rise. The third and minimal option would be for Congress to simply re-pass H.R. 3762, which does not include the repeal of insurance mandates and other important provisions. Repealing Obamacare does not mean that individuals on the federal and state Obamacare exchanges would immediately lose their health care plans. Instead they would have an ample period of time to transition back to an insurance plan on the individual market without losing coverage.
Congress should then pass the normal budget for fiscal year 2018 that lowers spending levels and includes other conservative priorities. This will give Congress time to work on an Obamacare replacement plan that restores consumer choice, strengthens the doctor-patient relationship and lowers costs. Replacement reforms Congress should consider include improving and expanding health savings accounts, removing government barriers that stop patients from participating in direct primary care arrangements, allowing patients to buy health insurance across state lines, and equalizing the tax treatment of health insurance for individuals and businesses, among others.
Obamacare Repeal Timeline Slipping: This January, Congress took an import first step to repeal Obamacare by passing the FY 2017 “shell” budget resolution (S. CON. RES. 3). Heritage Action key voted “Yes” on the resolution since it’s “the only way to expedite the repeal of Obamacare.” This resolution begins the process of budget reconciliation by setting up instructions for the House Ways & Means Committee, the House Energy & Commerce Committee, the Senate Finance Committee, and the Senate Health & Education & Labor & Pensions Committee to write a budget reconciliation bill that repeals Obamacare. Once the bills pass out of their respective committees they move to the Budget Committee. The Budget Committee then passes one unified repeal bill which the House and the Senate can then pass with a simple majority and President-elect Trump can sign into law.
Unfortunately, despite passing the budget resolution in early January, Congress has still not written the budget reconciliation bill repealing Obamacare. Seven in ten Americans believe the longer Congress waits, the less likely Obamacare repeal becomes a reality. Congress cannot allow the timeline to continue to slip. Not only does it delay work on other legislative priorities, but millions of Americans are suffering from the harmful side effects of Obamacare as premiums and deductibles continue to rise and health insurance choice falls.
Conclusion: Some repeal proponents assume Republicans must have a replacement plan at the same time as repeal, but this ensures momentum for full repeal stalls. Republicans may have a difficult time agreeing on any one single replacement plan, and Democrats will refuse to negotiate, instead doing everything in their power to sink the replacement plan and therefore Obamacare repeal.
Congress will use any excuse to avoid doing the right thing. As former Senator Jim DeMint and current President of the Heritage Foundation strongly wrote: “When I was in the Senate, they would use every excuse to avoid fighting for conservative priorities. “Wait until we get the House.” Done. “Wait until we get the Senate.” Done. “Wait until we get the White House.” Done and done. There are simply no alternatives left but to repeal Obamacare and win the fight (a shocking prospect for some!)”
Members who truly want to repeal Obamacare must insist on repeal immediately. This proposed two-step process gives Republicans the best chance to repeal Obamacare and honor their commitment to the American people who put them in power while providing plenty of time to enact a replacement plan. Conservatives must continue to urge their member of Congress write and pass the budget reconciliation bill to repeal Obamacare as soon as possible.