It won't go away that easy

Obamacare won't be riding into the sunset, Republicans will. Image via EvilSpeculator.

I've long been convinced Republicans would not be able to repeal the Affordable Care Act because they don't have any ideas for that promised replacement—they can't come up with any ideas virtually by definition, because the parts their constituents want to keep are dependent on the parts they're committed to getting rid of—but I haven't been smart enough to see how it works out in a practical sense, in the sausage-making process. This is now coming clear, in a series of Tweets by the genial young Matthew Chapman, a Texas video game designer who's turned out since the election to be one of the great Twitter ranters.

It starts with the Congressional Budget Office, which must review the budgetary consequences of the repeal. Apparently they've done this with a Ryan-sponsored proposal:

NOTE TO REPORTERS: I'm told the House repeal bill will be delayed because the CBO score was horrific. @PeterSullivan4 @sahilkapur

— Topher Spiro (@TopherSpiro) February 22, 2017

(Topher Spiro runs health policy analysis at the Center for American Progress.)

It's going to cost hundreds of billions to get rid of it, as you probably knew already. Which doesn't mean much on its own, since as you also already knew, Republicans only care about deficits when a Democrat is president.

But in an almost evenly divided Senate there are no ways of passing it.

Since no Democrat will vote for repeal, they can't use the normal procedure, in which the Democrats would kill it with a so-called filibuster (refusing to close debate and move to a vote). Instead, they must use the budget reconciliation process, for which (according to the Byrd Rule) the bill either has to be budget-neutral, or contain a sunset provision, where the new law expires after some fixed period and the older law comes back into effect, and the deficits are pushed out by mathematical manipulation into the fictional time after the law expires (this is what happened with the Bush tax cuts that led to the famous Fiscal Cliff massacre of 2013). So it's back to the drawing board.

Meanwhile insurance companies have to know by April whether the ACA is going to continue to exist or not so they can start devising their policy offerings for 2018. Since Congress isn't going to be able to manage repeal by then no matter what, they'll have to put it off for at least a year while Ryan attempts to whip up a Plan B. And Republican congresspersons continue getting more and more spooked by constituents' unexpected affection for the law. And the problem of how you get rid of the thing in a budget-neutral way or a way you can successfully pretend is budget-neutral (that's what the sunset provision really is) remains as insoluble as ever.

Stay tuned, but I don't think it's ever going to happen.

Cross-posted at No More Mister Nice Blog.