House GOP leader: Repeal ObamaCare now, replace it later

House Majority Leader Kevin McCarthy (R-Calif.) said Tuesday that Republicans could repeal ObamaCare even before they have come up with a replacement. 

“I don’t think you have to wait,” McCarthy told reporters. “My personal belief, and nothing’s been decided yet, but I would move through and repeal and then go to work on replacing.”

{mosads}That option is the easiest for Republicans in the sense that it allows them to deliver on their promise for swiftly repealing the law while buying them time to work out a replacement plan, which Republicans have so far not detailed in the form of consensus legislation. They could move forward with repeal, through a special process called reconciliation, as soon as January.

But healthcare experts, including some Republicans, have warned that this approach would cause chaos for ObamaCare enrollees and the insurance market in the uncertain time between when ObamaCare is repealed and when any replacement is enacted. 

McCarthy and other Republicans have called for a transition period, meaning ObamaCare would not immediately go away once repeal passes, but would instead be phased out over two years or some other time period. 

Even with that transition period, though, experts warn insurers could bail on the current system once they learn it is being phased out, leaving ObamaCare enrollees with no options for 2018. 

In contrast to McCarthy’s comments, for example, Iowa insurance commissioner Nick Gerhart, a Republican, wrote this month that he hopes a replacement is passed at the same time as repeal, to reduce uncertainty. 

“If the new Congress passes a bill to repeal all of the ACA [Affordable Care Act], I hope that a replacement for the ACA is stapled to that bill,” Gerhart wrote. “An immediate repeal would lead to devastating consequences in the disruption of people’s care, and create even more uncertainty for millions of Americans.”

The task of doing both at the same time is complicated for Republicans, though, because the rules allow the core of the health law to be repealed under special rules in the Senate requiring just 50 votes. A replacement, though, would require the usual 60, necessitating support from Democrats.

The Republican base will be agitating for repeal and does not want to wait to get 60 votes in the Senate to allow for a replacement. 

McCarthy said that he thinks doing repeal first would increase pressure on Democrats to come to the table and get to 60 votes for a replacement. 

“You know this is going away five months from now, and you’re going to avoid it?” McCarthy said, speaking of Democrats.

He said Democrats would be to blame if no replacement ever ended up materializing because of an inability to get 60 votes in the Senate. 

“When that day came and you did nothing, if you want to play politics, I think the blame would go to people who didn’t want to do anything,” McCarthy said. 

But the prospect of repealing ObamaCare with no replacement immediately clear would put a cloud of uncertainty over the 20 million people who have gained coverage from the health law.