It’s looking more likely that the Senate will vote on a last-resort effort to repeal Obamacare.
The so-called “skinny repeal” plan, if passed, would roll back certain aspects of the Affordable Care Act (ACA), including the individual and employer health insurance mandates, and lead to the House and Senate working together to compromise on one final bill.
The Congressional Budget Office scored the “skinny” plan Wednesday night and found that it would leave 16 million more Americans without health insurance.
Already, governors from 10 states have come out against the bills being proposed in the Senate:
“The bill still threatens coverage for millions of hardworking, middle class Americans,” they wrote in a letter to Senate Majority Leader Mitch McConnnell and Senate Minority Leader Chuck Schumer. “The bill’s Medicaid provisions shift costs to states and fail to provide the necessary resources to ensure that no one is left out, including the working poor or those suffering from mental illness or addiction. The Senate should also reject efforts to amend the bill into a “skinny repeal,” which is expected to accelerate health plans leaving the individual market, increase premiums, and result in fewer Americans having access to coverage.”
Instead, the governors called on the Senate to work with them.
The letter was signed by Democratic governors John Hickenlooper of Colorado, Terry McAuliffe of Virginia, John Bel Edwards of Louisiana, Steve Bullock of Montana, and Tom Wolf of Pennsylvania. Republican governors Brian Sandoval of Nevada, John Kasich of Ohio, Charlie Baker of Massachusetts, Larry Hogan of Maryland, and Phil Scott of Vermont also signed the letter.
The opposition, in particular from Sandoval and Kasich, to the “skinny repeal” plan is key. On Wednesday, Nevada Senator Dean Heller voted against a repeal-without-a-replacement plan, as did Ohio Sen. Bob Portman. Both Heller and Portman have been critical of the healthcare plans put forth by the GOP, and losing those votes could put a “skinny repeal” plan in jeopardy.
What ‘skinny repeal’ would look like:
- The “skinny repeal” bill would repeal both the individual and employer mandates, which requires individuals to have health insurance, and employers to provide health insurance to employees. If they don’t, they face a penalty fee under Obamacare. It would also repeal some of the taxes that the ACA put in place – most significantly, a tax on medical-device makers. The skinny bill would likely leave everything else untouched.
While the text of the “skinny repeal” bill hasn’t been released yet, the bill would be nowhere near as extensive as the full-repeal plan or the BCRA. But it would seek to alter the much-criticized mandates that Republicans have targeted for years.
Getting rid of the individual mandate with no other changes to the bill, according to the Congressional Budget Office, would leave 15 million more Americans without health care by 2026. The change would also lead to a 20% increase in premiums, the CBO said. It could also send the ACA marketplace into a “death spiral,” health experts warn.
Why the Senate might resort to a ‘skinny repeal’
Chris Krueger, an analyst at the Washington-based Cowen and Company, compared getting every GOP senator on board with a bill to squeezing a balloon, because it’s so hard to align both moderates and conservatives on a plan.
That was clear Tuesday night with the vote on a revised version of the BCRA, in which nine Republican senators voted against the bill – including both conservatives and moderates – and again on Wednesday, when seven Republican senators voted against a repeal-only bill.
If the Senate is successful in passing a skinny repeal, Senate Republicans would then need to find common ground with House Republicans to get to a bill that both chambers can agree on. That could be a rather lengthy process.