This article provides a genuine public service, an explanation of why repealing Obamacare is so very very difficult. As the title says Repealing and Replacing ObamaCare – Much Confusion is in “The Process”. Provided at the link is an explanation of just how intricate and immensely difficult the process is which is in large part a consequence of the way the legislation was first introduced. Repeal cannot be done by the President on his own. The undoing of Obamacare must go through the Congress. The Senate is 52-48 Republican so that a repeal, which requires 60 votes, can never occur. The need is to find a way to keep at least 50 of the 52 Republicans together so that they can piecemeal amend the existing legislation to modify its effects and change the nature of the system.
If this interests you, you should read the entire article, but the following gives you a summary of the summary you find at the link.
The Republicans are going to attempt to repeal that bill by modifying it; and have to also plan for a full unity road block of Democrats providing them no support. That means the Republican repeal/modification needs to pass the house and senate without a single Democrat vote. . . .
This process takes three phases. In phase #1 you are repealing a bill through modification knowing you need to use the Senate Reconciliation process (51 vote threshold). That means the repeal/modification bill itself cannot have any federal budgetary impact beyond 10-years. Any bill/modification that HAS budgetary impact, beyond ten years, cannot use reconciliation in the Senate and must reach the higher hurdle of 60 votes.
Additionally, phase #2 and phase #3 will take place over time, through the regular process, as the House and Senate debate their constituent provisions. This is how the law should have been written in the first place – but it wasn’t. Phase #2 and phase #3 mean compromise, because the higher vote thresholds will be required.
All of the changes that people want in a replaced ObamaCare bill (purchasing across state lines, etc.) can only come after the entanglement/modification of the law takes place.
Which brings us to the second major issue, why not just repeal the entire thing and start over? “The hand grenade approach”. As explained:
Firstly, a clean “repeal bill” would be “new legislation” that would require 60 votes of support in the Senate. That means 8 Democrat Senators would be needed to eliminate ObamaCare. They don’t exist. Secondly…
POLITICS! Repeal alone would mean 100% of Americans could immediately be thrown into a state of immediate loss of coverage, and tens of millions – especially those currently using medicaid- certainly would. And not a single Democrat would be in a hurry to create another construct with the 2018 election coming and their ability to say “republicans destroyed your healthcare” etc.
Thus, if repeal and replace is to happen at all, this is what must take place:
Phase #1 – Dismantle the underlying financial construct of the law through new law targeting the underlying financial architecture. This process allows reconciliation (lower vote threshold in the Senate).
Phase #2 – HHS Secretary Tom Price rewrites the rules and regulations to focus on patient centered care. Most of the tens of thousands of pages are rules and regulations. Secretary Price uses the new architecture created under phase #1 to rewrite the rules.
Phase #3 – The wholesale reforms and changes to the law: malpractice/tort reform, purchasing across state lines, etc. are additions – new bills – (higher vote thresholds) to add to the law that provide the changes most ObamaCare critics are demanding.
Maddening. But what you will now see unfold is whether Trump actually has the ability to guide this process through the various stages required, while the entire world of the left does everything they can to stop the process while half of those who are lining up on his own side have agendas of their own which will often not coincide with whatever is required to finally see this misshapen disaster finally discarded.
The one certainty I have is that Trump wants to see Obamacare gone but understands the care he needs to take.