When the Republican health care reform bill collapsed Monday night, President Trump and Senate Majority Leader Mitch McConnell switched to a “repeal and delay” plan. They proposed to vote immediately on repealing the Affordable Care Act and then give themselves two years to craft a replacement. But with a tweet the next morning, Sen. Lisa Murkowski may have doomed the idea.
Republican West Virginia Sen. Shelley Moore Capito was the first. She tweeted her rejection early, around 7:30 a.m. She said repeal without replacement would be bad for her constituents, especially those who benefited from the Affordable Care Act’s expansion of Medicaid. Sen. Susan Collins, R-Maine, tweeted in about 90 minutes later. She said the plan would cause turmoil in the insurance markets. Judging by the Twitter time stamps, the third Republican to reject the idea was Sen. Lisa Murkowski.
“I’m concerned that if we just move forward with just a straight repeal,” Murkowski told reporters a few hours later, “with the promise that ‘we’ll get to it in two years. Trust us on this’ – I think that that adds just greater uncertainty into an area and a market that is already chaotic.”
The Republican leadership can only afford to lose two Republican votes, because all the Senate Democrats remain united against repeal.
Murkowski used to be in favor of repealing the ACA with a delay of two years. Back in 2015, Murkowski voted for such a bill.
“This law is not affordable for us in Alaska,” Murkowski said on the Senate floor then. “That is why I will support the bill that repeals the ACA and wipes out its harmful impacts. I can’t watch premiums for Alaskans shoot up through the roof.”
Murkowski said the facts on the ground are different now. She means that Alaska insurance market was healthier then. A more obvious difference: President Obama was in office then. As expected, he vetoed the repeal bill.
Murkowski didn’t declare how she would’ve voted on the replacement bill Republicans unveiled last week. It had less generous subsidies for people who buy their own plans and would’ve ended the high federal match for Medicaid expansion. It also had special funds for Alaska’s insurance market.
Sen. Dan Sullivan said he would’ve voted to proceed on the Republican replacement bill. He said he was working to make it better and looking forward to the amendment process.
“My frustration, which is pretty strong right now, is that, to me we’re close on a bill that, you know, is repeal and repair Obamacare,” Sullivan said, “but that I was very confident would protect Alaska’s interests.”
The state has calculated that the Republican proposal would have cut its revenues from Medicaid by $3.1 billion and ended the expansion that has insured more than 34,000 Alaskans. Sullivan said he he’s been working on an alternate way to cover that population.
Murkowski said she wants to begin right away to find solutions for the problems of the Affordable Care Act. She’s calling for open, bipartisan hearings.
Sullivan said he’s fine with bipartisanship but he doesn’t think Senate Democrats have any reasonable solutions.
“Their big idea right now, their big idea when they talk on the Sunday talk shows and when they talk on the Senate floor, is single payer,” Sullivan said. “The amount of money it would cost the United States government to run a single-payer healthcare system is enormous.”
Sen. McConnell said Tuesday night he still wants to hold a vote next week to proceed with a “repeal and delay” bill. Sullivan said he’s a yes. If Murkowski remains a no, it’s not clear it will pass.