Long thought to be dead, the effort to repeal the Affordable Care Act may have just gotten a new breath of life. A group of Republicans has introduced a new bill to repeal the law, commonly referred to as Obamacare, and replace it with a new structure that returns regulatory power to the states.
The Wall Street Journal reports that the bill is the work of a coalition of groups such as the Heritage Foundation and the American Enterprise Institute. The plan contains some elements of last year’s ill-fated reform plan authored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.). Sen. Graham is reportedly working separately on another health reform bill.
The plan reportedly centers on the use of block grants to states rather than itemized funding. Half of the grants would support the purchase of private health insurance for individuals and the other half would help cover low-income individuals. The bill would ban states from using the grant money to fund abortion. The new law would repeal the Medicaid expansion and allow Medicaid recipients to buy private health insurance.
The bill is expected to garner support from conservative Republicans such as Sen. Ron Johnson (R-Wisc.), who has expressed interest in another attempt at reform, but will face hurdles from moderates. Republican congressmen engaging in tough reelection battles may resist tackling the controversial topic immediately prior to the midterm elections.
While a repeal bill would be welcomed by the Republican base, last year’s attempt at repeal was not popular with voters. Although Obamacare was historically unpopular, the law received a boost from the Republican reform effort. Current polling from the Kaiser Foundation shows that voters are split on the ACA, but the law has a net positive approval rating.
Repeal of Obamacare has long been a Republican goal and was a main campaign promise of President Trump, but there are long odds against the effort. The Republicans’ slim 51-seat majority means that a repeal attempt would face a certain Democrat filibuster. A bill that would be supported by Democrats and Republican moderates would likely not be supported by GOP conservatives.
The midterm elections may seal the fate of the repeal effort. If Republicans lose their majority in either the House or the Senate, any serious effort to repeal the ACA would be doomed. At that point, the best that Republicans could hope for would be a bipartisan effort to fix the worst problems of the law.