Republican health care bill dead — doesn’t mean Obamacare is safe



  • Pool/Getty Images

    The GOP effort to repeal Obamacare appears dead for
    now.

  • One GOP senator says the party is “too divided” for a
    restart right now on healthcare.
  • The Trump administration could seek to weaken Obamacare
    through a number of executive measures.

After numerous resurrections, false starts, and missteps,
the Republican attempt to repeal and replace Obamacare on a
straight party-line basis looks like it is truly dead.

The defeat of the attempted
“skinny repeal”
of Obamacare on Thursday appears to be enough
to put the idea to rest for now. GOP lawmakers expressed
doubts that another bill would come up, and the brutal stretch of
must-pass legislation ahead on the calendar likely puts the
GOP Obamacare effort on the back burner.

Nevertheless, the White House has attempted to revive the
push by getting behind a plan advanced by Republican Sens.
Bill Cassidy, Lindsey Graham, and Dean Heller. The plan would
have shifted the funding for Medicaid and other healthcare needs
to the states in a block-grant form.


According to reports
, the trio met with President Donald
Trump regarding the plan and brought in Rep. Mark Meadows, the
head of the conservative House Freedom Caucus.

Trump used the bully pulpit of Twitter over the weekend to lay
into Republicans for failing to pass a repeal and replace bill,
even going so far as to call GOP senators “quitters” and

threaten the healthcare
of members of Congress.

But many Republican leaders have simply moved on.

Senate Majority Leader Mitch McConnell said it
was “time to move on”
 after last
week’s healthcare bill failure and focus on other
priorities before the Senate recesses in mid-August.

Seante Majority Whip john Cornyn, the second-highest ranking
Republican, said in floor remarks on Tuesday that the way forward
on healthcare was a bipartisan approach before pivoting to talk
about tax reform.

Sen. Orrin Hatch, the head of the Finance Committee,
told Reuters
 that the Republican conference was too
far apart on the issue to sustain another attempt on repeal and
replace.

There’s just too much animosity and we’re too divided on
healthcare,” Hatch said.

And Sen. John Thune — the third-highest ranking GOP senator
— told Politico’s Burgess Everett and Jennifer Haberkorn that the
healthcare effort is off the table.

Until somebody shows us a way to get that elusive 50th
vote, I think it’s over,” Thune
told Politico.
 “Maybe lightning will strike and
something will come together but I’m not holding my
breath.”

Additionally, the math makes any sort of revival for the repeal
and replace bill nearly impossible. With Sen. John McCain gone
through August for treatment on brain cancer, McConnell could
only lose a single Republican vote to pass a bill. Sens. Susan
Collins and Lisa Murkowski, who voted against every GOP
healthcare measure, are enough to sink any push.

There’s still work to be done

The US healthcare system could still see some adjustments
throughout the rest of the year.

For instance, there have been repeated calls from both sides
of the aisle to work on a bill that would stabilize the
individual marketplace — in other words, what people think of as
the Obamacare exchanges. Ideas include guaranteeing critical cost-sharing subsidies via
congressional appropriation
, setting up a stability fund
for states to try to bring down premiums, and rolling
back parts of the employer mandate.

Those could happen in separate legislation or as part of the
Children’s Health Insurance Program (CHIP) reauthorization, which
must be passed by the end of September.

While the end of GOP-overhaul efforts could mean fixes to
the Obamacare markets, it does not mean the law is free of
danger.

The White House and the Department of Health and Human Services
could use a variety of tactics to stir up trouble in the
Obamacare markets and cause its “collapse,” including yanking the
cost-sharing payments, halting the enforcement of the
individual mandate, and cutting off funding for key programs
designed to get people into the markets.

Complicating all of this is a jam-packed schedule for Congress in
the back half of the year. Before the end of September alone,
Congress needs to pass legislation to avoid a shutdown, raise the
debt ceiling, and reauthorize several government programs.

Throw on top of that the GOP’s pivot to tax reform, which the
White House wants done by the end of 2017.

A revived health bill would “take time,” said Greg Valliere,
chief strategist at Horizon Investments. “Lots and lots of time.”

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Republican health care bill dead — doesn’t mean Obamacare is safe

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