More Republicans are expressing anxiety over plans to repeal Obamacare before reaching agreement on a replacement plan.
And now one GOP senator has said clearly the two steps should happen simultaneously.
The senator is Tom Cotton of Arkansas, and during an interview on MSNBC’s “Meet the Press Daily” on Thursday, he said, “I think when we repeal Obamacare, we need to have the solution in place moving forward.”
The statement came on a day when Republicans all over Capitol Hill were talking about repealing Obamacare, but leadership was pushing in one direction while several members were conspicuously pushing in another.
House Speaker Paul Ryan (R-Wis.) and Senate Majority Leader Mitch McConnell (R-Ky.) have signaled that they intend to pursue a “repeal-and-delay” strategy ― acting quickly to strip out the law’s funding and expenditures but leaving elements in place for some period while they work on creating and implementing an alternative.
On Thursday, Ryan said that his goal was to finish crafting that legislation by the end of 2017, with the understanding that it might take longer to put the new system in place.
Cotton, during the MSNBC interview, said he had no problem with letting parts of Obamacare live for a little while so that the more than 20 million people getting coverage through it can keep some kind of insurance. But Cotton made clear his preference for agreeing on the Republican alternative before voting to repeal the law once and for all.
“I don’t think we can just repeal Obamacare and say we’re going to get the answer two years from now,” Cotton explained. “Look, this is a very complicated problem. Health care is a very complex issue. We haven’t coalesced around a solution for six years, in part because it is so complicated. Kicking the can down the road for a year or two years is not going to make it any easier to solve.”
Just hours before, Ohio Gov. John Kasich issued a similarly stark warning while speaking to reporters.
“There’s room for improvement,” the Republican governor said, according to an account in The Hill, “but to repeal and not to replace, I just want to know what’s going to happen to all those people who find themselves left out in the cold.”
Also raising concerns about a quick repeal vote were Republican Sens. Susan Collins of Maine and John McCain of Arizona, although both stopped short of declaring that repeal and replacement should take place simultaneously.
“I’m not ruling anything in or out,” Collins told reporters Thursday. “I just feel like we need a detailed framework, preferably specific legislation, to accompany the repeal effort so that we can reassure individuals who have been receiving subsidized insurance that they’re not going to fall through the cracks and so that the insurance markets have time to adjust to a dramatic change. The insurance markets cannot turn on a dime.”
“Well I think it’s wise to move forward with a repeal because we said we would, but I think we also better get the replacement,” McCain told The Huffington Post. “We’re going to have to move quickly on the replacement so that people will not be left high and dry.”
Republicans plan to eliminate Obamacare’s revenue and spending by using the budget reconciliation process, in which a simple majority can pass the bill. But Republicans have only 52 seats in the Senate,which means they can afford to lose only two votes for their plan to work. (In case of a tie, Vice President-elect Mike Pence would break it, presumably siding with the GOP leadership.)
Collins, Cotton and McCain are not the only Republican senators speaking up about the perils of quick repeal votes. Lamar Alexander of Tennessee has also said he thought Republicans should hold off repealing Obamacare until they have a replacement.
Alexander is chairman of the Health, Education, Labor and Pensions Committee, which shares direct jurisdiction over health care legislation and would likely play a key role in writing both repeal and replacement legislation.
Sen. Rand Paul (R-Ky.) has also said repeal and replacement should happen simultaneously, and on Thursday the chairman of the House Freedom Caucus, Rep. Mark Meadows (R-N.C.), told McClatchy News, “Some of us have been bantering around. ... Do a repeal vote. Vote on a replacement the same day.”
Of course, it’s one thing to raise concerns about a quick repeal vote or tell a television interviewer it’s not the way to proceed. It’s quite another to insist upon a slower, more deliberate strategy ― particularly if there is pressure from party leaders to vote quickly after Republicans have long promised their supporters they would repeal the law.
On the other hand, Republicans also face more outside pressure to slow down and think through an Obamacare alternative ― not just from advocates and trade groups but also from respected conservatives.
Earlier this week, two influential conservative health care advisers, Joseph Antos and James Capretta, cowrote an opinion article urging Republicans not to repeal Obamacare without a replacement in hand. Since that time, an editorial in the conservative Washington Examiner and a column from Washington Post conservative writer Jennifer Rubin have made the same point.
Among the points they’ve raised is one that Republicans on Capitol Hill have not addressed much: How to make sure insurance companies keep selling policies during the transition so that people who have coverage now won’t lose it.
Still unclear, as usual, is what President-elect Donald Trump thinks about this. Obamacare repeal was a central promise of his campaign, and he’s been tweeting about the program’s problems all week. But some tweets also warned Republicans not to act in such a way that leaves them politically responsible for the law’s problems in the coming years.
“It will fall of its own weight ― be careful!” he tweeted.
Jeffrey Young contributed reporting to this article.
CORRECTION: This article originally misstated how many votes the Republicans could afford to lose in the Senate for their strategy to work. They can only afford to lose two, not three.
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