# The Repeal of Obamacare/ACA: Step-bystep, Inch-by-inch **URL:** \ **Category:** The BBQ Pit\ **Created:** [January 2, 2017, 5:06pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146 "2017-01-02T17:06:13Z")\ **Posts on this page:** 20\ **Page:** 57
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [July 28, 2017, 2:43pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1121 "2017-07-28T14:43:27Z")
> [@elucidator](#): > > There’s a possible big-ass fly in the ointment: Loser Trump is going to be pissed. He might accept defeat in a dignified and generous fashion. Ha! Good one! > > Or he will go on a rampage of sabotage. That’s the other possibility. Remember how he was talking about that, screwing it up until the Dems beg for mercy? That’s my bet. Love to be wrong, but I’m probably not. The right wing is going to rage at McCain but also the entire Senate for not repealing Obamacare – it’s probably going to be a long August and September for Republicans in their home districts / states. OTOH, it’s entirely possible that the instability they’ve caused to Obamacare markets might kill Obamacare and force everyone back to the table. It’s hard to say how that would play politically. But McCain probably figured - and I think he’s right - that Republicans killing Obamacare outright would have been a massive political disaster. Even if Obamacare fails because of instability, not everyone’s going to see it that way or know whom to blame. But there’d be a definite bad guy if that had passed. It could be argued that the senate, supposedly the older, wiser body of congress, functioned as it was supposed to, though “function” is subjective. ---
**Author:** ![CalMeacham](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/calmeacham/32/35_2.png) [@CalMeacham](https://boards.straightdope.com/u/CalMeacham)\ **Post date:** [July 28, 2017, 2:45pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1122 "2017-07-28T14:45:34Z")
> [@wolfman](#): > > Brother and Sisters, let us not forget rest of the picture and take a moment to pay our utmost contempt to The Koch brothers who have spent tens of millions over the last decade trying to buy legislators for the primary purpose of defeating Obamacare. At least for the moment, by the thinnest razor edge of margins, our democracy is not yet totally for sale. “yet” is the operative word. They failed by only one, unexpected vote. This will merely persuade them that they still have to buy a couple more Senators for the next round. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [July 28, 2017, 2:49pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1123 "2017-07-28T14:49:34Z")
Keep in mind though, that the House version of the bill (AHCA aka BCRA) failed 43-57. No “replace” bill got close to 50 votes. The only reason the “skinny repeal” even got 49 votes is because they knew it wouldn’t become law. ---
**Author:** ![CarnalK](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carnalk/32/486_2.png) [@CarnalK](https://boards.straightdope.com/u/CarnalK)\ **Post date:** [July 28, 2017, 2:54pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1124 "2017-07-28T14:54:06Z")
> [@jasg](#): > > Well, John Boehner was right. I don’t know about that. Looking at Boehner’s reported remarks, istm that something like this “skinny repeal” is what he thought would be likely. He just didn’t think a full repeal was possible. > [@](#): > > “When it’s all said and done, you’re not going to have an employer mandate anymore, you’re not going to have the individual mandate,” Boehner said. “The Medicaid expansion will be there. The governors will have more control over their Medicaid populations and how to get them care, and a lot of Obamacare taxes will probably go.” ---
**Author:** ![Fiveyearlurker](https://avatars.discourse-cdn.com/v4/letter/f/da6949/32.png) [@Fiveyearlurker](https://boards.straightdope.com/u/Fiveyearlurker)\ **Post date:** [July 28, 2017, 2:57pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1125 "2017-07-28T14:57:34Z")
Trump currently railing against filibuster rules and stating that we need to move to a majority rule in the Senate. Does he genuinely not realize that the bill that failed last night only needed a majority and that the didn’t get that? ---
**Author:** ![Happy\_Lendervedder](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_lendervedder/32/8488_2.png) [@Happy\_Lendervedder](https://boards.straightdope.com/u/Happy_Lendervedder)\ **Post date:** [July 28, 2017, 2:58pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1126 "2017-07-28T14:58:27Z")
It’s possible McCain and the GOP caucus know McCain won’t be running again and therefore doesn’t have to worry about a target on his back for his vote. The bill had to die, they needed someone to fall on the grenade, and the guy with brain cancer was probably the best choice. Great optics, though, I think I even saw a tear begin to form in the corner of the Turtle’s eye last night after the bill failed. ---
**Author:** ![Spice\_Weasel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spice_weasel/32/5435_2.png) [@Spice\_Weasel](https://boards.straightdope.com/u/Spice_Weasel)\ **Post date:** [July 28, 2017, 3:12pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1127 "2017-07-28T15:12:25Z")
> [@Happy\_Lendervedder](#): > > It’s possible McCain and the GOP caucus know McCain won’t be running again and therefore doesn’t have to worry about a target on his back for his vote. The bill had to die, they needed someone to fall on the grenade, and the guy with brain cancer was probably the best choice. This is a good theory. Boy, are we fucked. ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [July 28, 2017, 3:29pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1128 "2017-07-28T15:29:28Z")
> [@elucidator](#): > > Or he will go on a rampage of sabotage. That’s the other possibility. Remember how he was talking about that, screwing it up until the Dems beg for mercy? That’s my bet. Love to be wrong, but I’m probably not. I look forward to **jsgoddess** ’ comments, because she’s unquestionably a more knowledgeable observer here than I am. But here’s how I see it: There’s a number of ways Trump can sabotage the Exchanges. (He can’t do much about the Medicaid expansion.) The biggest is not paying the CSR subsidies. If there are no CSR subsidies, this would have a huge impact on the premiums of Exchange policies, which would mostly hit people who are earning enough to get little or no subsidies for purchasing policies on the Exchanges. The screams of higher earners carry nontrivial weight with Congress, and my understanding is that the CSR subsidies can be reinstated in the appropriations bills, where the Dems have a great deal of leverage. The second-biggest is nonenforcement of the individual mandate. Just like the GOP sued Obama for failure to enforce particular aspects of immigration law (and won), the Dems could do the same to Trump here, and would probably be on even more solid legal ground. The problem here is that such a suit would take time to work its way through the courts, so it would still mess up the rates for 2018. After that, you get down to the smaller stuff: shortening sign-up periods, widening actuarial-value ranges, spending ACA money on anti-ACA propaganda, making the ACA websites more challenging to use, etc. Taken together, these things can make a difference in terms of how many people buy policies, and the AV ranges reduce the utility of the policies by a few percent. Like non-enforcement of the mandate, the anti-ACA propaganda is probably open to a lawsuit, but most of the other small stuff probably isn’t, in my non-lawyerly WAG judgment. ---
**Author:** ![Merneith](https://avatars.discourse-cdn.com/v4/letter/m/57b2e6/32.png) [@Merneith](https://boards.straightdope.com/u/Merneith)\ **Post date:** [July 28, 2017, 3:31pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1129 "2017-07-28T15:31:02Z")
> [@Fiveyearlurker](#): > > Trump currently railing against filibuster rules and stating that we need to move to a majority rule in the Senate. Does he genuinely not realize that the bill that failed last night only needed a majority and that the didn’t get that? No, this isn’t the first time that he’s whined about the 60 vote requirement holding up his signing party. He’s genuinely ignorant, here. ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [July 28, 2017, 3:36pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1130 "2017-07-28T15:36:52Z")
> [@Fiveyearlurker](#): > > Trump currently railing against filibuster rules and stating that we need to move to a majority rule in the Senate. Does he genuinely not realize that the bill that failed last night only needed a majority and that the didn’t get that? Okay, any sentence about Trump that begins with the words, “Does he not genuinely realize,” "or “Doesn’t he understand,” or words to that effect… well, you know the answer ahead of time, don’t you? ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [July 28, 2017, 3:39pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1131 "2017-07-28T15:39:50Z")
> [@Fiveyearlurker](#): > > Trump currently railing against filibuster rules and stating that we need to move to a majority rule in the Senate. Does he genuinely not realize that the bill that failed last night only needed a majority and that the didn’t get that? If he chose to realize that, he’d have to rant against his own allies. Not that that’s stopped him with Sessions, but he can _fire_ Sessions, which gives Sessions less room to be problematic. ---
**Author:** ![AlsoNamedBort](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alsonamedbort/32/3213_2.png) [@AlsoNamedBort](https://boards.straightdope.com/u/AlsoNamedBort)\ **Post date:** [July 28, 2017, 3:44pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1132 "2017-07-28T15:44:43Z")
> [@scr4](#): > > It wouldn’t have made a difference. If McCain stayed home, the “no” votes from Murkowski and Collins would have been enough to kill the repeal. Although, if McCain had stayed home, presumably McConnell would have done _something_ to get one of them to change their mind. With McCain “on board” they pretty much assumed those were two lost votes and didn’t even try. ---
**Author:** ![CalMeacham](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/calmeacham/32/35_2.png) [@CalMeacham](https://boards.straightdope.com/u/CalMeacham)\ **Post date:** [July 28, 2017, 3:48pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1133 "2017-07-28T15:48:14Z")
> [@scr4](#): > > Keep in mind though, that the House version of the bill (AHCA aka BCRA) failed 43-57. No “replace” bill got close to 50 votes. The only reason the “skinny repeal” even got 49 votes is because they knew it wouldn’t become law. How do you know that? The hold-outs were looking for a guarantee that the House wouldn’t accept the “skinny repeal” and vote on it. Fortunately, it didn’t leave the Senate. But, for all their talk of this only being a “starting point” that would be fixed up before a proper vote, I have to admit that I don’t trust them an iota not to have gone ahead and passed the “skinny repeal” as it stood. Then they could say – “Okay, NOW we have to fix it up.” It’s a terrible way to make laws and completely irresponsible, but I don’t think it would have stopped them. ---
**Author:** ![wolfman](https://avatars.discourse-cdn.com/v4/letter/w/a8b319/32.png) [@wolfman](https://boards.straightdope.com/u/wolfman)\ **Post date:** [July 28, 2017, 3:49pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1134 "2017-07-28T15:49:01Z")
> [@Fiveyearlurker](#): > > Trump currently railing against filibuster rules and stating that we need to move to a majority rule in the Senate. Does he genuinely not realize that the bill that failed last night only needed a majority and that the didn’t get that? In fairness, if they hadn’t been hemmed in by reconciliation rules, and had full room to maneuver in it everything economic toward 50 votes, they may have been able to make it palatable enough to get a pass. Not that Darth Imbecilus understands it at that level. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [July 28, 2017, 4:10pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1135 "2017-07-28T16:10:33Z")
> [@wolfman](#): > > Not that Darth Imbecilus understands it at that level. To be fair to Trump (did I just say that?!), his next tweet did say “Even though parts of healthcare could pass at 51, some really good things need 60. So many great future bills & budgets need 60 votes…” ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [July 28, 2017, 4:12pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1136 "2017-07-28T16:12:23Z")
Actually, does the budget really need 60 votes in the Senate? ---
**Author:** ![RTFirefly](https://avatars.discourse-cdn.com/v4/letter/r/c77e96/32.png) [@RTFirefly](https://boards.straightdope.com/u/RTFirefly)\ **Post date:** [July 28, 2017, 4:12pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1137 "2017-07-28T16:12:27Z")
> [@scr4](#): > > No “replace” bill got close to 50 votes. The only reason the “skinny repeal” even got 49 votes is because they knew it wouldn’t become law. That may have been the story the (always caving) GOP moderates were willing to settle on in order to justify their votes. Really, most of the action has been less about what is true about the various bills, than what false arguments the moderates can agree with themselves to accept in order to stop being pressured by party leadership. And a pro tip to legislators: if you don’t want a bill to become law, the most effective means is to simply _not vote for it._ That’s not rocket surgery, guys. 🙂 ---
**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\ **Post date:** [July 28, 2017, 4:18pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1138 "2017-07-28T16:18:29Z")
> [@marshmallow](#): > > These Republican ghouls are only happy when they hurt people or destroy something beautiful. Heaven help their next target now that these arsonists have a pent up load of nihilistic hate to unleash. The West Wing was a lie. Even spiteful bigots need to find comfort somewhere. > **[Sullen Jeff Sessions Scrolls Through Minority Incarceration Statistics To...](https://www.theonion.com/sullen-jeff-sessions-scrolls-through-minority-incarcera-1819580109)** > > WASHINGTON—Needing a pick-me-up to shake his glum mood, Attorney General Jeff Sessions reportedly scrolled through some statistics about minority incarceration rates Thursday to cheer himself up. “African-Americans: 13 percent of overall population,... ---
**Author:** ![cmyk](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cmyk/32/3353_2.png) [@cmyk](https://boards.straightdope.com/u/cmyk)\ **Post date:** [July 28, 2017, 7:05pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1139 "2017-07-28T19:05:58Z")
Hey Pubbies, look what I found in my keyboard. McCain’s thumb… 👎🏼 ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [July 28, 2017, 7:10pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1140 "2017-07-28T19:10:45Z")
> [@RTFirefly](#): > > I look forward to **jsgoddess** ’ comments, because she’s unquestionably a more knowledgeable observer here than I am. But here’s how I see it: > > There’s a number of ways Trump can sabotage the Exchanges. (He can’t do much about the Medicaid expansion.) > > The biggest is not paying the CSR subsidies. If there are no CSR subsidies, this would have a huge impact on the premiums of Exchange policies, which would mostly hit people who are earning enough to get little or no subsidies for purchasing policies on the Exchanges. The screams of higher earners carry nontrivial weight with Congress, and my understanding is that the CSR subsidies can be reinstated in the appropriations bills, where the Dems have a great deal of leverage. > > The second-biggest is nonenforcement of the individual mandate. Just like the GOP sued Obama for failure to enforce particular aspects of immigration law (and won), the Dems could do the same to Trump here, and would probably be on even more solid legal ground. The problem here is that such a suit would take time to work its way through the courts, so it would still mess up the rates for 2018. > > After that, you get down to the smaller stuff: shortening sign-up periods, widening actuarial-value ranges, spending ACA money on anti-ACA propaganda, making the ACA websites more challenging to use, etc. Taken together, these things can make a difference in terms of how many people buy policies, and the AV ranges reduce the utility of the policies by a few percent. Like non-enforcement of the mandate, the anti-ACA propaganda is probably open to a lawsuit, but most of the other small stuff probably isn’t, in my non-lawyerly WAG judgment. Actually, that’s a good run-down. The only things I’d add off the top of my head are new regulations around special enrollment periods to reduce the number of opportunities people have to enroll, plus the non-renewal of navigator contracts, meaning most states don’t have anyone for people signing up for Obamacare to call for help. [Previous page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=56) [Next page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=58)