Image Credit: Gage Skidmore

Obamacare Replacement’s Worst Enemy: Senate Math

Healthcare Reporter Caitlin Owens

As of Nov. 9, Republicans now own Obamacare, and they know it. Sen. Lindsey Graham of South Carolina put it this way: “We’ve got our chance to repeal and replace Obamacare. If we screw it up, then we’re going to get blamed.”

That means they have to get enough votes for a replacement — and since they’re going to lose some Republicans, the hunt is on for Democrats who might be willing to help them.

Why would they lose Republicans? Because there are two factions in the GOP, and one of them might prevent a replacement from ever materializing if some kind of coalition can’t be formed.

Here’s how one GOP leadership aide describes the two inter-party groups:

· Salt the Earth-ers: This group just wants complete repeal of the health care law, and isn’t as interested in what comes next.

· Uproot and Replant-ers: This group wants to keep certain parts of the law and recognizes the need to think about how people will be affected. This is probably the larger group, and Trump himself falls into this category.

The more Salt the Earth-ers that defect from the replacement plan, the more Democrats will be needed to help the rest of the Republicans pass it.

That’s especially true in the Senate, where they’ll need 60 votes to pass anything, and Republicans will only have 52. So they’ll probably need at least eight Democrats to get on board.

And right now, most Democrats have no interest. Their message to Republicans: Don’t talk to us until you have a replacement plan. “This is all them now,” said Missouri Sen. Claire McCaskill.

So how does any Obamacare replacement get to 60?

1. Republicans make friends with less fiery Democrats.

It’s possible. Even Hillary Clinton’s running mate, Virginia Sen. Tim Kaine, said that while Democrats are 100 percent against repeal, “the difference between replacement and reform and improve is just semantics.”

Delaware Sen. Tom Carper said he’d be open to replacing the individual mandate with “something that has the same effect, to make sure at the end of the day, we have a pool of folks in the exchange…that can be insured.”

2. Or, Republicans can play hardball.

If there’s no coalition, there’s always the option of forcing votes on things that are hard to say no to. Republicans are already talking about chopping up a replacement plan into smaller, popular bills — like letting young adults continue to stay on their parents’ health plans until age 26 — — instead of passing one big Obamacare alternative.

I don’t think ‘I’m waiting for another comprehensive bill’ will be a good enough explanation” for Democrats who vote no, said Missouri Sen. Roy Blunt.

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