Why Paul Ryan Is So Desperate To Vote On Obamacare Repeal Quickly

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by Jonathan Cohn at the Huffington Post

http://www.huffingtonpost.com/entry/obamacare-repeal-delay_us_5862a42be4b0eb586487380d?section=us_politics

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It’s also possible that Ryan’s crusade to pass repeal in January has nothing to do with policy and everything to do with politics ― that he wants Congress to vote before the rest of the country, and maybe even the president-elect, wakes up to the real-life changes such a vote would unleash.

What “repeal and delay” would mean in real life

Ryan and his allies envision a quick, surgical strike on Obamacare soon after Donald Trump takes office, via what’s come to be known as a “repeal and delay” strategy. The idea is to eliminate Obamacare’s funding, using a special legislative procedure reserved for bills related to the budget, while leaving most of Obamacare’s coverage provisions in place for a year or two or maybe three. In theory, the more than 20 million people now relying on the program would hold onto insurance while Republicans craft their replacement scheme.

Even conservative experts doubt this gambit would work out so neatly. Insurers that tolerated early losses in Obamacare marketplaces in the hopes of realizing future profits aren’t going to stick around for a market that’s about to disappear ― particularly if the repeal bill also takes actions, such as eliminating the individual mandate, that would tilt the insurance customer base even more toward unhealthy people with high medical expenses. If enough carriers flee, a recent analysis from the Urban Institute predicted, millions of people would lose their health insurance in just the first year.

And it’s not like Republicans can guarantee that, after a transition period, they would have a new health care scheme in place and ready to go. It’s been more than six years since Republicans first promised to craft an Obamacare replacement, yet they are nowhere near a consensus on what such a replacement should look like.

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