With repeal of the Affordable Care Act looming, some Senate Democrats have expressed willingness to work with Republicans on a replacement plan, Politico reported.
Republicans can use the budget reconciliation process to effectively repeal the ACA but they will need at least eight Democrats on their side to reach the 60-vote threshold required to prevent filibuster on replacement legislation.
- Even if a repeal occurs, an ACA replacement may not even come for four years, Politico's Jennifer Haberkorn reported on Thursday.
Republicans are exploring various approaches to repealing the ACA and implementing a replacement plan. Whatever path they take, they will likely need several Democrats to come along for the ride if they intend to pass legislation that comes close to covering as many patients as the ACA has.
On Thursday, House Republicans laid out their goal for a replacement would ensure "universal access" for health coverage, The New York Times reported.
Getting eight Democrats on board could be difficult. Senator Cory Gardner (R-OH) told Politico there are seven Senate Democrats that will face political pressure to work with Republicans, including Senators Heidi Heitkamp (ND), Joe Manchin (WV), Joe Donnelly (IN), Jon Tester (MT) and Claire McCaskill (MO).
For Democrats to support a Republican replacement plan, it would likely have to achieve many of the same goals as the ACA. Getting a handful of centrist Democrats to agree to a plan that also has support among the most conservative Republican Senators will be no easy feat. Analyses of existing Republican health reform proposals show they reduce the number of patients with coverage, Sarah Kliff wrote for Vox in November. It seems unlikely that Senate Democrats would support legislation that covers significantly fewer patients than the ACA.
This opens up the possibility that legislation with relatively equal levels of support on both sides of the aisle ends up being passed. Republicans will likely face pressure from voters to maintain coverage rates achieved under the ACA. If they encounter resistance within their own party on legislation that extends coverage to millions of patients, they will be pressured to work with Democrats or risk angering voters by taking away their health insurance, as Brian Beutler reported for the New Republic earlier this month.
For now, the future of health reform is a guessing game. Senator McCaskill, who told Politico she would consider voting for a Republican replacement plan, is skeptical that Republicans can even come up with a viable alternative. “They’ve had six frickin’ years to figure it out,” she said.