Senate Majority Leader Mitch McConnell and President Donald Trump called for a full repeal of Obamacare late Monday evening, a move that is sure to spark outrage from moderate Republicans.
After four more Republican senators came out against the Senate to repeal major portions of Obamacare, McConnell announced at 10:46 Monday night that he would put forth a repeal-only piece of legislation in the coming weeks. The Senate leader is calling the bluff of conservative senators, like Republican Sen. Rand Paul of Kentucky, who have called out leadership for not repealing Obamacare before moving on to a replacement.
With only a slim 52-seat majority in the Senate and some 11 Republican senators expressing unwillingness to vote yes, McConnell saw no path forward for repeal and replace. The Senate majority leader needed to obtain at least 50 Republican votes, with Vice President Mike Pence acting as the tiebreaker.
Some 30 minutes before McConnell’s announcement, Trump tweeted that “Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!”
Disagreements between conservative and moderate Republicans threatened the repeal and replace effort every step of the way in both the House and the Senate, effectively derailing the process three times. While a repeal first agenda will sit well with conservatives, moderates, like Sen. Rob Portman of Ohio and Sen. Dean Heller of Nevada, will likely not be able to throw their support behind it.
Moderates are concerned about funding for Obamacare’s Medicaid expansion program, as millions of their constituents have obtained insurance coverage through the program. Some 20 Republican senators serve in states that chose to expand Medicaid under Obamacare. If a full repeal happens with no replacement, these senators will have a large constituent base left without health insurance–a situation that does not bode well for them in the 2018 election cycle.
Another hang up for moderates will be the funding given to substance abuse treatment programs under Obamacare. For example, Portman’s home state of Ohio has become the poster child for the opioid epidemic, with double-digit increases in opioid-related overdoses in 2014 and 2015. Deaths from opioid use in the U.S. have skyrocketed from around 8,000 in 1999 to over 30,000 in 2015, the Center for Disease Control reports.
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