Priorities: ObamaCare repeal, we hardly knew ye

Remember how Republicans planned to circle back around to repealing ObamaCare in 2018? Good times, good times. After repealing the most unpopular part of the Affordable Care Act in its tax-reform bill, the GOP seems satisfied to stand pat on the status quo, according to The Hill:

The chances of repealing ObamaCare this year are fading further, with top Republicans saying they hardly discussed repeal of the law during a Camp David retreat last weekend focused on their 2018 agenda. …

While some conservative groups and select lawmakers are pushing for ObamaCare repeal in 2018, President Trump and GOP leaders have signaled a desire to move on, at least for now, after unsuccessful repeal efforts sucked up months of the legislative calendar in 2017. Trump also declared after signing the GOP tax overhaul in December, which did away with the mandate that most people buy health insurance or face a tax penalty, that Republicans had “essentially repealed ObamaCare.”

“There’s some work we need to do on the health-care front, but I would hope we’re in a position to do things on a bipartisan basis,” said Sen. John Cornyn (R-Texas), one of the GOP leaders who huddled with Trump at Camp David to discuss the 2018 agenda.

Presumably, Republicans would have had another shot at a reconciliation-based repeal by passing a budget resolution allowing for it. Budget resolutions pass on simple majorities, so even their recently narrowed Senate advantage should have allowed the GOP to set up the effort.

However, their success in December complicated matters by taking out the most offensive part of ObamaCare. What exactly would Republicans repeal after taking out the individual mandate and tax penalties? Certainly not the must-issue requirement, which is popular with voters, nor the community rating requirements, which also have a large amount of support. The combination of those two insurer mandates is what has destabilized the individual health insurance markets, but without tying them to the individual mandate as a sweetener, Republicans wouldn’t get 40 Senate votes for a repeal.

Besides, the big cost savings recognized by the CBO in repeal came from the individual mandate, which got applied to tax reform rather than overall ObamaCare repeal. Everything else will likely result in higher deficit spending, making it nigh well impossible for an ACA repeal to qualify under reconciliation, even if Republicans had the political cojones to try it. At this point, the GOP will have to engage Democrats on solutions. Cornyn’s not offering an olive branch; he’s simply stating reality. Get ready for Alexander-Murray, in other words.

Even where reconciliation could still get used, though, Republicans seem to have lost their taste for it:

Meanwhile, Republicans say talk of welfare or entitlement reform this year is also narrowing down to an emphasis on things like job training, not the broad overhaul of Medicare, Medicaid and other entitlements that Democrats have warned against.

It was always a stretch to think that the GOP could get that done by reconciliation in this session of Congress. The majority has enough Republican senators skeptical about sweeping entitlement change — especially on a partisan basis — to assume a 52-seat majority would hold together. With the loss of the seat in Alabama, that’s down to 51, with John McCain and Susan Collins obvious impediments to that process, and almost certainly not the only ones that would emerge in an election year.

Republicans might do better just trying to focus on passing a regular-order budget before the midterms anyway. If they can accomplish a return to normality and demonstrate a talent for governance, they might be able to hold onto the House and expand their majority in the Senate in 2018’s midterms. Then they can put together a well-considered, comprehensive, and unified plan for big-ticket agenda items, which would be the first time that’s happened in their single-party control of Washington.

Addendum: The Taxpayers Protection Alliance wants Congress to repeal Medicare’s Independent Payment Advisory Board (IPAB), once known as a “death panel,” created as a part of ObamaCare for cost control. It’s still in operation, and their commissioned poll shows Republicans strongly in favor of eliminating the IPAB (73%), as well as seniors overall (54%). Without a deficit reduction, however, it will take 60 votes in the Senate to repeal that part of the ACA — and Democrats won’t go along with any more dismantling of the ACA. The best that Republicans might get is a repeal as part of Alexander-Murray.