(Bloomberg) — Congressional Republicans are considering a lightning-strike rollback of the Affordable Care Act early next year to kick off the Donald Trump era, but first they have to agree on a plan limited enough to hold their caucus together.
Republicans won't have much room for error to successfully repeal "Obamacare," a top campaign promise of Trump and congressional Republicans. Even if they delay the repeal to allow more time to come up with a replacement, there will be pressure to use the legislative maneuver to push through other top GOP priorities, such as defunding Planned Parenthood.
But Senate Republicans would have to keep unified the 52 senators they expect to have when the new Congress convenes Jan. 3.
The Republican plan would take advantage of reconciliation, a budget-related mechanism to circumvent the 60-vote threshold in the Senate and prevent Democrats from being able to block legislation on their own. By striking early, the GOP could set itself up to invoke the same procedure again later in the year on a broader range of targets, including tax cuts.
The quick-strike bill, like one vetoed earlier this year by President Barack Obama, H.R. 3762, would likely set what amounts to an expiration date for the law's financial underpinnings, leaving Congress to act at a later date on any replacement plan. That's because more than six years after the law's passage, Republicans still don't have a consensus on how to replace the ACA.
Early win
But passing something in Trump's first 100 days would allow Republicans to claim a big win early on, and conservatives are demanding the GOP deliver quickly.
"In order to give a clear and unambiguous message there's a new occupant in the White House, one of the first things that should be done after the oath of office is passage of a bill through reconciliation repealing Obamacare and defunding Planned Parenthood," Rep. Trent Franks, an Arizona Republican, said Monday in a interview.
Franks, chairman of the House Judiciary subcommittee on the Constitution, said he worries that some in Congress may seek more time to pass a bill. But he said the bill should be passed "almost the first moment after the oath of office." Congress needs to send the message that when people vote based on promises made during a campaign, "that their votes will matter," he said.
House Majority Leader Kevin McCarthy told reporters Tuesday at a Washington Post breakfast that the first 100 days of Trump's administration may include action on ACA repeal, although "repealing is easier and faster" than replacing.
Having a "transition period" after a vote to repeal the ACA would create a deadline for Congress to pass a replacement, he told reporters later Tuesday.
"If you have a date certain that something is going away" lawmakers will be motivated to pass a replacement, McCarthy said. Democrats who try to obstruct a replacement would risk being blamed for allowing Obamacare to lapse without a new plan, he said.
John Cornyn of Texas, the No. 2 Senate Republican, said Monday that an Obamacare repeal is "going to be high on the list right when we come back."
"It will be early, because we have to get that done," Cornyn said. "January would suit me just fine." He said Republicans may use the reconciliation procedure again later in the year to push through other matters, such as a tax overhaul.
'Does no harm'
Lamar Alexander, chairman of the Senate Health, Education, Labor and Pensions Committee, predicted during an interview with reporters that it would ultimately take "several years" to fully move to a new system with less federal control. He said that while Republicans can do some things with reconciliation, they'd ultimately need 60 votes.
"We need to gradually move those decisions back to states and to individuals and do it in a way that does no harm to people today," the Tennessee Republican said.
"If we want a lasting solution eventually we're going to have to have 60 votes in the Senate to get it."
While a lightning-strike bill could be used for other priorities Republicans agree on, House Budget Chairman Tom Price of Georgia predicted in a recent interview it would be focused on something similar to the ACA repeal bill lawmakers have already passed because expanding it would require more time for committees to work.
"There is an opportunity there," said Price, who Trump named Tuesday morning to be his secretary of Health and Human Services. "All this has to go through the process obviously."
Democratic ire
The idea for a lightning-strike bill has been percolating among Capitol Hill Republicans since long before the election, and it's sure to provoke howls from Democrats.
