House Speaker Paul Ryan has lots of reasons for aiming to make good immediately on the GOP's favorite campaign pledge of the Obama era—repealing the Affordable Care Act (ACA). But as we know, Republicans have never come up with anything more than a loose set of principles for a "replacement" (no dollar amounts, for example), and that may be exactly why Ryan is gunning for such quick legislative action, writes Jonathan Cohn.
Ryan and his allies aren’t slowing down, at least not so far, and there are likely two main reasons.
One is that the repeal bill is likely to dictate the size and shape of an eventual replacement, by stripping out Obamacare’s revenue ― including some $350 billion in taxes that fall exclusively on the wealthiest Americans. Cutting upper-income taxes is a perennial priority for Republicans. But without that money at the disposal of lawmakers, it’s pretty much impossible to craft a conservative scheme that would come anywhere close to the scale of insurance coverage that Obamacare does. [...]
The other likely reason to rush a repeal vote would be to avoid public scrutiny of both its short- and long-term effects.
Having to debate the actual “replacement” and the Obamacare provisions that would be lost in the process would be a real headache for Republicans—who had to entirely distort voters' views of the ACA in order to thoroughly demonize the law. Why? Because many of the ACA's features are actually very popular, even among Trump voters, as the following recent evaluation by the Kaiser Foundation shows.
(Note: the chart below is purely based on Trump voter responses.)
In the meantime, Cohn assembled some top lines from news reports over the last several weeks:
The Obama administration announced that the number of people signing up for insurance through HealthCare.gov, the federal website that 39 states use to administer Obamacare plans, is even higher than last year. State-run sites such as Covered California are reporting similar surges.
An independent think tank, The Commonwealth Fund, published a study showing that fewer people are skipping medical care because of cost ― most likely because, thanks to the health care law, so many more people have health insurance.
Standard and Poor’s Global Ratings reported that insurers selling Obamacare plans are seeing better financial results this year, suggesting that premiums are finally coming into line with the actual medical expenses of their customers ― and that this year’s big rate hikes may be a “one-time pricing correction.”