The Skinny On The Failure of Skinny Repeal

 

The last-ditch Republican effort to repeal the Affordable Care Act, the so-called “Skinny Repeal,” went down in flames last night as expected. In truth, the Obamacare repeal effort has been dead for quite some time. The more recent repeal efforts represent the hopeless, zombie-like staggering of the GOP towards its goal of almost a decade.

It has been obvious for months that the repeal effort was doomed to failure. As soon as the dust settled from the election, we knew that the GOP would have less than the 60-vote majority required for cloture on a full repeal of the ACA.

With “repeal-and-replace” out the window, Republican leaders shifted to a reform model. The effort immediately drew fire from both wings of the Republican Party. A quartet of moderates from Medicaid expansion states lined up to oppose anything that threatened the Medicaid payouts. With only a two-vote majority in the Senate, this would have been enough to kill the reform bill, but conservatives also lined up to oppose the bill because it fell short of full repeal, which was already a mathematical impossibility.

Conservatives such as Ted Cruz (R-Texas) and Mike Lee (R-Utah) were eventually won over to support the compromise reform effort. Moderates Rob Portman (R-Ohio) and Corey Gardner (R-Col.) also dropped their opposition to the bill.

The Republican “nays” who joined every Democrat in voting against the Skinny Repeal were two of the usual suspects, Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine). The third was GOP maverick John McCain (R-Ariz.) who explained his vote against the “shell of a bill” by arguing in a statement  that the bill, written in secret, wouldn’t actually improve the health insurance crisis gripping much of the country.

McCain will be pilloried for his vote, but to some extent he was right. No one, not even those who voted for it, think Skinny Repeal was a good bill. As Phillip Klein of the Washington Examiner described, the bill left the regulatory framework of Obamacare in place while eliminating the individual mandate. The result would most likely have been to increase the Obamacare death spiral rather than fixing it.
The worst part is that Collins and Murkowski could not even be persuaded to join their colleagues in such a watered-down bill. One has to wonder exactly what kind of health care bill, if any, that the pair would give their assent to.
Throughout the entire process, President Trump, a man who has repeatedly said that he wants universal healthcare, has been mostly AWOL. While Congress debated and dithered, the president spent his time tweeting and hurling insults at Jeff Sessions. To the surprise of few, this approach failed to swing votes to support the bill. In spite of the president’s alleged prowess at deal-making, his main role in the legislative process was to threaten to support a primary challenge against Nevada senator, Dean Heller.
At this point, Republicans have two choices. The first is to offer some concessions to Democrats to craft a bill with broader support. Such tactics will fall short of full repeal, but may help to fix at least some of Obamacare’s problems. It might even convince Collins and Murkowski to vote “yes.” Who knows?
The other alternative is to harden the party’s divisions with another of the circular firing squads so common in the wake of GOP defeats (and victories as well, for that matter). That will mean that Obamacare remains fully intact while Republicans wait on voters to grant them a supermajority (plus two more to offset Collins and Murkowski). In the meantime, Americans will suffer under Obamacare’s high premiums, few choices and the individual mandate. Never mind that voters are unlikely to give Republicans more power if they can’t get anything done with the power that they already have.
Some will say that Democrats win when Republicans offer a compromise, but it is the second scenario where Democrats really win. Obamacare will remain in place for the foreseeable future and Barack Obama’s legacy will be secure.
What most voters really want is for the two parties to work together to solve problems. Unfortunately, the current model has the country lurching from one-party rule to stalemate and back again as each party plays to its base and ignores moderates and independents. If neither party is willing to work with the other to get things done for the good of the country, then voters should consider firing them both.

BREAKING: McConnell Calls For Repeal

The Wall Street Journal is reporting that Majority Leader Mitch McConnell (R-Ky.) has abandoned the Republican health care bill and is calling for full repeal of Obamacare. The bill has been considered dead following the decision of Senator Mike Lee (R-Utah) and others to vote “no.”

McConnell said, “It is now apparent” that the repeal and replace effort will not be successful. The new plan is to hold a vote on repealing Obamacare with two-year delay.

The core problem for Republicans was the decision of a number of moderate Republicans to demand a phaseout of Obamacare’s Medicaid expansion. It remains to be seen if these senators will vote for a simple repeal bill.

 

 

 

 

Republican Senators Say Health Bill is Dead

John McCain (R-Ariz.) and other Republican senators are saying what everybody seems to already know about the Republican repeal/reform-and-replace effort. After eight years of campaigning to repeal Obamacare, it increasingly seems that the Republican effort is about to die within sight of its goal.

“I think my view is it’s probably going to be dead,” McCain said on “Face The Nation,” adding, “but I am- I’ve been wrong.”

McCain said that if the current bill fails, Republicans should try again with a bill that aims to win some Democrat votes. “Introduce a bill,” McCain said. “Say to the Democrats, ‘Here’s a bill.’ It doesn’t mean they control it. It means they can have amendments considered. And even when they lose, then they’re part of the process. That’s what democracy is supposed to be all about.”

The close margins in the Senate, 52 Republicans to 48 Democrats, mean that, unless some Democrats cross the aisle to vote for the Republican bill, the GOP can only lose two votes and still be able to pass the bill. The GOP health plan has come under fire from moderates like Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) as well as from conservatives like Ted Cruz (R-Texas) and Mike Lee (R-Utah).

Senator Bill Cassidy (R-La.) agreed with McCain’s assessment on “Fox News Sunday.” “Clearly, the draft plan is dead,” Cassidy said, “but we don’t know what’s in the serious rewrite” of the bill.

Even Senate Majority Leader Mitch McConnell (R-Ky.) admitted the bleak future of the bill. McConnell said that, while he isn’t giving up on repeal, Republicans may need to work with Democrats on a short-term fix for Obamacare.

President Trump and other Republicans from Ben Sasse (R-Neb.) to Rand Paul (R-Ky.) have called upon congressional Republicans to simply repeal Obamacare if they cannot agree on a replacement. A repeal bill would face the additional hurdle of a cloture vote that would require 60 votes for passage.

Sasse suggests a new version of the 2015 Obamacare reconciliation bill. Unless Collins, Murkowski and other GOP holdouts on the Medicaid expansion reverse themselves, this bill would also fall short of even a simple majority.

Without a change of heart from either the Republican moderate or conservative wing, the effort to repeal or reform Obamacare seems to be reaching a dead end. While the future of health insurance in America is uncertain, it is certain that the Republican base would view a failure to repeal Obamacare as the betrayal of a core promise.

The failure to reform Obamacare while they have the opportunity, the single most visible goal of the Republican Party for most of the past decade, could rip the party apart.

Sasse, Paul, and Trump Call For Obamacare Repeal Instead of Reform

In statements echoed by President Trump on Twitter, two prominent Republican senators have called for the GOP to skip the health care overhaul and focus on simple repeal of Obamacare if Republican Senate leadership cannot find 50 votes to move the current health care reform bill forward. Earlier this week, Majority Leader Mitch McConnell (R-Ky.) announced that a vote on the health care bill would be delayed until after the July 4 recess.

In a letter to the White House quoted in the Wall Street Journal, Sen. Ben Sasse (R-Neb.) said, “On the current path it looks like Republicans will either fail to pass any meaningful bill at all, or will instead pass a bill that looks to prop up many of the crumbling Obama care structures.”

“We must keep our word,” Sasse continued. “Therefore, if on July 10 we don’t have agreement on a combined repeal and replace plan, we should immediately vote again on… the December 2015 Obamacare repeal legislation that the Congress passed but President Obama vetoed.”

Within a few minutes of Sen. Sasse’s discussion of re-introducing the 2015 bill, HR 3762, President Trump tweeted support for the idea. “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” Trump said on Twitter.

Sen. Rand Paul (R-Ky.) also endorsed the idea. “I have spoken to @realDonaldTrump & Senate leadership about this and agree. Let’s keep our word to repeal then work on replacing right away,” Paul tweeted.

The 2015 bill in question, HR 3762, was not technically a full repeal of Obamacare either since it also amended the Affordable Care Act rather than repealing it outright. A full repeal would require 60 votes for cloture in the Senate, which is far out of reach. The bill passed the Senate in a largely party line vote on December 3, 2015 by a 52-47 margin.

Sasse has not suggested a strategy for passing a 2017 version of the bill. The problem for Republicans on passage of the current health care reform bill is that nine Republican senators are reportedly in opposition to the bill. Assuming no Democrats cross the aisle, Republicans could lose no more than two senators and still be able to pass the bill.

The current Republican opposition to the health care reform is from both the center and the right wings of the GOP. Moderate Republicans such as Susan Collins (R-Maine) and Rob Portman (R-Ohio) argue that the bill hurts too many people on Medicaid in their states while conservatives such as Ted Cruz (R-Texas) and Mike Lee (R-Utah) say that the bill does not go far enough in reforming Obamacare. With eroding support from both ends of Republican political spectrum, the current bill has little chance of passage.

Sasse’s plan to revive the 2015 bill is a partial answer in that it should bring the conservatives back on board. The problem is that Republicans would still need moderate votes to move the bill forward.

When the bill originally passed in 2015, Republicans held two more seats in the Senate than they do today. Back then, two Republicans crossed party lines to vote against the bill: Susan Collins and Mark Kirk (R-Ill.). Kirk lost his seat to Democrat Tammy Duckworth in 2016, but Collins is still in the Senate and could be counted on to vote against the bill once again. That leaves Republicans with a one vote margin.

Earlier this year, The Resurgent reported that four Republican senators who had voted for the 2015 bill would refuse to vote for a bill that did not allow a slow phase out of the Obamacare Medicaid expansion. If Shelly Moore-Capito (R-W.V.), Rob Portman (R-Ohio), Corey Gardner (R-Col.) and Lisa Murkowski (R-Alaska) stick to their pledge, it would doom Sasse’s plan.

Still, a deficit of five votes is a more surmountable obstacle than the deficit of nine votes that the GOP currently faces. It is possible that pressure could be brought to bear on the four senators who previously voted for the bill that would keep them in the “yes” column.

An additional risk would be with the reform that still must come after the passage of the near-repeal. Democrats might be persuaded to join the reform effort if most of Obamacare was gutted, but they might also adopt a you-break-it-you-bought-it policy that would allow them to campaign against the Republican-created chaos in the health care markets in 2018 and beyond. Given recent Democrat obstructionism, there is little doubt which course they would take.

Still, as the Republican health care reform seems increasingly dead in the water, Sasse’s plan, long shot that it is, may be the only viable option to keep the GOP promise to repeal and replace Obamacare.

Obamacare Reform Is Looking Doubtful This Year

If you’re wondering whatever happened to the Republican health care reform bill, you are not alone. When we last heard from the American Health Care Act, House Republican leaders were waiting on the Congressional Budget Office to score the bill before submitting the legislation passed in the House to the Senate. The CBO scored the bill in late May, but the silence from the Republican ranks has been deafening. The congressional website does not show any action on the bill since it passed the House on May 4.

Readers of The Resurgent are aware that the Republican health care bill falls short of full repeal. Senate rules require 60 votes for cloture on a repeal bill and Republicans would not be able to find eight Democrats to join them in ending a Democrat filibuster. Even if Republicans eliminated the filibuster entirely, they would not have enough votes for full repeal because at least four Republicans have pledged to oppose a repeal bill that does not provide for a phase out of the Obamacare Medicaid expansion.

Now some Republicans are saying that it is doubtful that they will be able to pass even an incomplete health care reform bill. “I don’t see a comprehensive health care plan this year,” Senator Richard Burr (R-N.C.) said in Politico. “It’s unlikely that we will get a health care deal, which means that most of my time has been spent trying to figure out solutions to Iowa losing all of its insurers.” Burr serves on the Senate Heath, Education, Labor and Pensions Committee.

In the Wisconsin State Journal, Senator Ron Johnson (R-Wisc.) agreed that the first priority to would probably be to act to preserve the health insurance markets in their current form. Johnson said that a short-term “market stabilization” bill could be passed that would fund the Obamacare exchanges with billions of dollars to help prevent insurers from exiting the marketplaces. Such an approach would reduce volatility in the Obamacare markets and buy time for Republicans to agree on a reform bill.

“To me, this may be a two-part process. I would admit that’s probably a minority view in the Republican Senate right now,” Johnson said.

Senator Jeff Flake (R-Ariz.) also tried to tamp down expectations. “There are some still saying that we’ll vote before the August break,” he told the Washington Post. “I have a hard time believing that.”

The fundamental problem is that conservative and moderate Republicans do not agree how to handle various aspects of the health care issue. Although Republicans have been united in their desire to repeal and replace Obamacare since the day it was passed, they disagree on the details of what should come next.

In the eight years since Obamacare became law, Republicans such as Tom Price, formerly a Georgia congressman and now Secretary of Health and Human Services, have written legislation to repeal Obamacare and reform the health insurance industry, but the party has not coalesced around any single bill. When Donald Trump eked out a squeaker of a victory in the Electoral College, Republicans were caught flat-footed and did not have a plan for how to exploit his victory. Indications were that, as late as early February, Republicans had not even started writing an Obamacare reform bill. The Senate considers the House bill dead on arrival and is writing its own version of health care reform, which may be available as early as this week.

President Trump’s antics are also hurting the possibility of passing a health care bill. The investigation into the Trump campaign’s possible connections with Russia and the firing of FBI Director James Comey are distractions that make it even more difficult to find a compromise that is acceptable to all GOP factions. The president showed leadership in the fight to pass the AHCA in the House, but has largely been missing-in-action on the issue in the month since the House vote.

Not all Republicans are pessimistic on health care. Senator John Cornyn (R-Texas) was quoted in The Hill as saying, “We do need to take care of our business, and I think you mentioned healthcare, and that’s certainly front and center in the United States Senate — something we’re going to have to get resolved here in the next few weeks.” Cornyn said that he thought a Senate bill would be “done by the end of July at the latest.”

Repeal of Obamacare has been the centerpiece of the Republican platform since 2010. The fact that repeal is not possible, even with Republican majorities in Congress and a Republican president, is not going to please most Republican voters. If the new Republican administration leaves Obamacare completely intact, it may well face a mutiny from the grass roots.

New Cruz? Texas Senator Works For Health Care Compromise

Texas Senator Ted Cruz has developed a reputation as a firebrand. Cruz has made refusal to compromise a trademark of his career in Congress and has often had strong words for fellow Republicans who disagreed with him on strategy. Now a new behind-the-scenes report by the Wall Street Journal reports that Cruz may be turning over a new leaf.

The Journal reports that Cruz began working quietly with moderate Republicans to find a consensus on health care reform that has a realistic chance of becoming law. Cruz was instrumental in forming a working group of 13 Senators that had its origin in a February steak dinner with Sen. Lamar Alexander (R-Tenn.). The group includes Republicans concerned about the effect of an outright repeal of Obamacare’s Medicaid expansion and pre-existing conditions rules such as Rob Portman (R-Ohio), Tom Cotton (R-Ark.), Cory Gardner (R-Col.) and Mike Lee (R-Utah). Cruz has reportedly been working with House Freedom Caucus Chairman Mike Meadows (R-N.C.) for the past month.

Senators on both sides of the aisle expressed surprise at Cruz’s new strategy. “It’s a ‘you live long enough, anything can happen’ moment,” said Lindsey Graham (R-S.C.).

“It would be a first for Sen. Cruz,” noted Chris Murphy (D-Conn.).

The GOP’s 52-vote majority in the Senate means that Republicans can lose no more than two votes and still be able to pass an Obamacare replacement. A defection of two Republicans would require Vice President Mike Pence to cast the tie-breaking vote. At least five Republican moderates are considered to be doubtful in their support for the American Health Care Act.

The working group is expected to be vital in bringing various Republican factions in the Senate together to forge a compromise that can replace as much of Obamacare as possible. Cruz’s participation and support may help bring other conservatives such as Mike Lee and Rand Paul (R-Ky.) on board with the Republican reform effort.

In the past, Cruz has had difficulty with consensus building and passing legislation. He is perhaps most well-known for his role in the 2013 government shutdown and attempt to defund Obamacare. With Republicans outnumbered by Democrats, the shutdown failed to halt the implementation of President Obama’s namesake health bill. Cruz was also known for failed attempts to prevent an increase in the debt ceiling and compromise spending bills under the Obama Administration.

Cruz may be realizing that the role of majority party senator is very different from that of one who serves in the opposition. When a party is in power, it is expected to deliver results in the form of advancing its legislative agenda. It is not enough to just say “no” when your party controls both houses of Congress and the White House.

“They’re giving him a leadership role and he’s going to have to make the most of if it,” said Rick Tyler, who served with Cruz’s presidential campaign. “If he can pull it off it’s a huge victory. But it’s fraught with danger.”

The upside for Cruz would be an enormous amount of prestige and notoriety if he shows an ability to build a coalition to pass a landmark reform bill. The boost for Cruz could potentially reach beyond his normal conservative base and lay the groundwork for a second presidential campaign in 2020.

Without the support of Cruz and other Senate conservatives, a reform effort would necessarily have to reach across the aisle to Senate Democrats. That would mean fewer conservative reforms in a watered-down bill. The alternative would be to delay reform until after the 2018 elections or until health insurance markets become so dysfunctional that the public demands action.

A potential pitfall would be alienating the conservative base whose expectations are for a full repeal of Obamacare. Even though Republicans do not have the votes for a full repeal, Mr. Cruz has helped stoke those expectations over the past few years. Many conservatives view anything short of full repeal to be a betrayal. Cruz must help the party overcome that view and sell the reform bill to the conservative base.

Health care reform gives Ted Cruz an opportunity to break out of his stereotypical role as a roadblock in the Senate. If Cruz can prove that he has the ability reach out and build a working majority with senators who don’t share his views, it would represent a major milestone in his career make him an even greater force in the Senate.

 

AHCA May Be Best Chance to Replace Obamacare In Our Lifetime

The House of Representatives finally passed a bill to gut Obamacare and many conservatives are upset. Admittedly the bill is not full repeal. It is far from perfect. If I was going to write a health care reform plan, the American Health Care Act would not be it. Still, I’m very glad that the House passed the bill and I fervently hope that the Senate moves the legislation forward. Why? Because it is the only health care reform that has any chance of passing.

Many myths have grown up around Obamacare and the Republican repeal and replace effort. Over time, we have forgotten that Obamacare was not passed by a budget reconciliation. “HR 3590, the Patient Protection and Affordable Care Act,” was passed on Christmas Eve 2009 after a cloture vote by 60 Democrats ended a Republican filibuster. It was a traditional bill that requires a traditional bill to repeal.

So, what was the controversy about the budget reconciliation? After Scott Brown (R-Mass.) was elected to the Senate, the Democrats could no longer break Republican filibusters. If the Democrat-controlled House amended the ACA, it would be subject to another cloture vote, which the Democrats would lose. The answer was to have the House pass the bill unchanged and use the budget reconciliation process to pass a second bill, “HR 4872, The Healthcare and Education Reconciliation Act,” by a simple majority vote. This bill was subject to the same limitations that the GOP now faces in passing their own budget reconciliation.

Even though Republicans hold the presidency and control both houses of Congress, they were not granted a blank check by voters. A full repeal would require 60 votes for cloture in the Senate and there are only 52 Republicans. The mathematical problem is obvious.

But what about the 2015 repeal bill that was vetoed by President Obama, you may ask. Republicans didn’t have 60 votes in 2015 either, but they passed a repeal bill then. Why can’t they do it now?

The answer is that the 2015 repeal bill was not a full repeal either. The 2015 bill, was also a reconciliation bill that carried the unwieldy title, “HR 3762 To Provide for Reconciliation Pursuant to Section 2002 of the Concurrent Resolution on the Budget for Fiscal Year 2016.” The text of the bill states in Section 102 that the ACA “is amended,” not repealed.

If the 2015 bill was better that the AHCA of 2017, it is for two reasons. First, there were 54 Republicans in the 114th Congress where there are only 52 now. The GOP could afford to lose more votes in the Senate in 2015 that it can today.

Second, four Republican senators who voted for the 2015 bill now say that they won’t vote for a bill that does not provide for a phase out of the Medicaid expansion. Sens. Rob Portman (Ohio,) Shelley Moore Capito (W.Va.), Cory Gardner (Colo.) and Lisa Murkowski (Alaska) refuse to back the same bill that they voted for two years ago. Sen. Susan Collins (R-Maine) voted against the 2015 bill and would presumably do so again. Other Republicans are reluctant to repeal the popular provision concerning pre-existing conditions. It is these five senators and House moderates, not the Republican leadership or President Trump that are forcing a more watered-down version of the bill.

Some conservatives suggest that Republicans should get rid of the filibuster to pass a repeal. We wouldn’t need 60 votes then and the Democrats will probably kill it anyway the next time they have a majority, they argue.

The problem with this strategy is that full repeal could not even win a simple majority vote. The five Republican defectors in the Congress and the Tuesday Group of 50 Republican moderates in the House would kill it.

Removing the filibuster would also mean that Democrats would only need simple majorities to replace Republican health care reform with a national single-payer system the next time they control both houses of Congress and the presidency. It would also usher in a host of other bad ideas from gun control to a higher minimum wage to higher taxes to onerous regulations on practically everything. It is true that Democrats might one day choose to remove the filibuster, but it is certain that if Republicans remove it now, for no strategic reason, Democrats will have a field day when they return to power.

What, then, are the options for Republicans on Obamacare? One option is to wait and hope for a filibuster-proof majority. If you favor this option, be aware that the last time that Republicans had a 60-vote majority was the 61st Congress from 1909 to 1911. It is extremely likely that before the Republicans get a supermajority, Obamacare will implode, health insurance premiums will skyrocket, insurance companies will cancel policies and hell will freeze over. I have little doubt that if Republicans hold out for the perfect, full repeal bill that I will die of old age with Obamacare still intact. (I’m only 45.)

Waiting until 2018 might give the Republicans a few more votes to craft a better compromise. It is also possible that two years into the Trump Administration, voters might deliver a rebuke to Republicans in the form of Democrat majority in either the House or Senate that makes any sort of conservative impossible. In any event, it is doubtful that the numbers would change enough in the GOP’s favor to justify putting off a cornerstone promise of the campaign for two years. The longer Republicans wait to take action, the more entrenched Obamacare will become.

A better option is to take baby steps toward the full repeal of Obamacare starting now with the AHCA. The current bill has the support of moderates as well as the Freedom Caucus and has decent chance of becoming law. While far from ideal, it is a reasonable bill that can hopefully be improved further in its journey through the Senate. Even if it became law in its current form it would mark a vast improvement over Obamacare.

The Republican reform bill should not be viewed as a final step, but as a first step toward total repeal. Without a supermajority, it may take years of nibbling at the edges of Obamacare to fully repeal the behemoth, but conservatives have to start somewhere. The logical place to start is the bill that has the support of the two disparate factions of the GOP. The only bill that has a chance of becoming law.

Conservatives must decide whether it is worth trading a chance to gut Obamacare now to wait for a perfect bill in the distant future. The answer should be obvious. We should not allow the perfect to be the enemy of good and the possible.

Seize the day and start saving American healthcare!

 

 

 

California Insurers Warn Of Collapse of Health Care Exchanges

Californians may be about to experience the collapse of the Obamacare exchanges in their state. Insurers in the Golden State are threatening to raise premiums and exit the Obamacare insurance exchanges if the Affordable Care Act’s cost sharing payments are not made. The payments, which are made to insurance companies by the federal government, subsidize the losses that insurers accrue from insuring people with pre-existing conditions without charging higher prices.

In April, the Trump Administration said that it planned to continue the payments, which total $7 billion per year, and also threatened to withhold the money in an attempt to pressure Democrats. The payments were absent from the compromise spending bill that the parties agreed on to avert a government shutdown.

In the past, the money for the payments was appropriated by the Obama White House because the Affordable Care Act authorized the payments, but never appropriated them. House Republicans sued President Obama to stop the payments on the grounds that only Congress has the constitutional power to appropriate funds. The House won the lawsuit, but the White House payments were allowed to continue pending appeal.

Now two California insurers say that if the government fails to make the payments, it could be disastrous for California’s health insurance markets. The Washington Free Beacon reports that Covered California, the state Obamacare exchange, says that premiums could rise by as much as 49 percent without the government subsidy to insurance companies. A private company, Molina Healthcare, threatened to exit the exchange entirely without the payments.

“If the CSR [cost-sharing-reduction payments] is not funded, we will have no choice but to send a notice of default informing the government that we are dropping our contracts for their failure to pay premiums and seek to withdraw from the Marketplace immediately,” J. Mario Molina, the CEO of Molina Healthcare wrote. “That would result in about 650,000 to 700,000 people losing insurance coverage in 2017, and we would not participate in Marketplace in 2018 resulting in over 1 million Americans losing health coverage.” The company currently insures more than a million Californians.

The prospect of insurers fleeing the market and premiums rising drastically underscores the urgent need for the passage of a health care reform package. The same market forces that affect health insurance in California operate in the other 49 states as well. If voters around the country see insurance premiums skyrocket while having fewer insurers to choose from, the backlash will most likely be against the party in power. Even though President Obama and the Democrats created Obamacare, President Trump and the Republicans were hired to fix the mess, not preside over the collapse of the health insurance industry.

President Trump and the Republicans are between a rock and a hard place on healthcare. The Republican Congress is unlikely to approve the insurance company subsidies so if President Trump wants to continue the payments he must continue the Obama Administration’s appeal against the House Republican lawsuit. As insurers and voters fret, Republican moderates and conservatives continue to dither over the details of how to reform Obamacare. Meanwhile, the clock is ticking on the ability to use a budget reconciliation to avoid a Democrat filibuster.

Health care and health insurance are issues that affect the lives of virtually every American. As Obamacare collapses and prices rise, it is vitally important that Republicans unite to solve the problem. If the party drops the ball on this cornerstone of every campaign for the past seven years, the consequences might be dire, not only for the Republican Party, but for the country as a whole.