posted at 9:01 pm on December 13, 2016 by John Sexton
Nancy Pelosi, who used her position as House Speaker to help pass Obamacare, is now saying Republicans will have second thoughts about repealing the law. From the Hill:
“There’s division among the Republicans within their own ranks as to timing and substance,” Pelosi told a group of reporters gathered in her office in the Capitol.
“I don’t think they’re going to repeal the Affordable Care Act.”
Pelosi says the reason Republicans will eventually balk at the price tag associated with removing the individual mandate but keeping some version of guaranteed issue, i.e. people can not be turned down because of preexisting conditions:
“You can’t keep them. You can’t afford them, because the costs would be so astronomical,” she said…
“The one thing … that I think the Republicans are more interested in –– not the 20 million or whatever –– are costs,” she said. “What are the costs going to be to their constituents?”
Pelosi is right that the regulation against denying people with preexisting conditions is one of the more popular features of Obamacare. A recent Kaiser Family Foundation poll found that 69% of respondents, including 63% of Republicans, support it. Other popular provisions included keeping children on their parents plan until age 26 (something several states had pre-Obamacare) and the online exchanges for buying insurance. The least popular provision was the individual mandate with just 35% support overall and 21% among Republicans.
Pelosi’s argument is that you can’t have one without the other. If not for the mandate forcing younger people to buy insurance they mostly don’t use, insurers would have to significantly raise rates to cover all the sicker people with preexisting conditions. The woman who once famously said Democrats would have to “pass the bill so you can find out what is in it” is now suggesting that enough people have found out that Republicans are stuck with it.
There’s just one problem. Repeal is likely to happen some time soon while replace could be a ways off. Pelosi is right that there must ultimately be some kind of trade off between not allowing insurers to refuse people with preexisting conditions and the mandate intended to help pay for that, but it’s a decision that fits into the replacement discussion. If Republicans were planning to do repeal and replace at essentially the same time, maybe this would cause some hesitation, but for now that doesn’t seem to be the plan. The balance of features and unpleasant realities will likely be hammered out months, or maybe even years, after repeal happens.