Some supporters of health care reform have probably reassured themselves in the face of Republican threats to repeal it that the same bloody tactics GOPers used to fight ACA would be available to Democrats resisting its repeal. I’m afraid that’s that may be a vain hope.
Remember the big debate in 2010 as to whether Democrats could or should use “reconciliation” to pass ACA? Well, they didn’t, of course, but while there was a case to be made that you can’t enact something as complicated and wide-ranging as ACA as part of the budget process, there is zero doubt it would be easy to disable it simply by denying funding for the subsidies, the Medicaid expansion, the exchanges, etc., etc. All of these actions are entirely legitimate in a reconciliation bill, which cannot be filibustered. And on top of everything else, as TPM’s David Kurtz astutely observed today, the Supreme Court’s definition of the mandate as a “tax” may well make the mandate itself germane to a reconciliation bill.
It’s true that it will be difficult to treat the insurance regulation portions of the bill—which are, of course, also very popular—as germane to a reconciliation bill. But it’s unclear Democrats would go to the mats to defend those absent all the other pieces of ACA that would help avoid the big premium increases regulation might otherwise create. I suppose Democrats could withhold support for modification of the insurance regs and demand retention of other aspects of ACA in exchange. But that’s the sort of hardball tactics Senate Democrats have been less than willing or able to deploy in the past.
The best strategy for maintaining ACA, of course, is to win the damn elections.
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