By Peter Sullivan - 12-09-16 06:00 AM EST
Republicans are betting that they can force Democrats to negotiate a replacement for ObamaCare if they repeal the law first.
GOP leaders are planning a strategy to quickly repeal the law with a simple majority in the Senate, but then delay repeal going into effect for a few years to buy time to craft a replacement.
But passing a replacement won't be easy. It would require the usual 60 votes in the Senate to advance, meaning some Democratic support would be needed.
To get those votes, Republicans plan to put the squeeze on Democrats by warning that they will take the blame if ObamaCare disappears and the 20 million people who have gained coverage from the law have nowhere to go.
"When that day came and you did nothing, if you want to play politics, I think the blame would go to people who didn't want to do anything," House Majority Leader Kevin McCarthy (R-Calif.) told reporters last week.
But the strategy is risky. It is far from certain that enough Democrats, or any at all, would join with Republicans to enact a new healthcare law in time.
Democrats are already adopting the slogan, "you break it, you own it," when it comes to ObamaCare. They say Republicans would be foolish to repeal the law without putting forward a replacement.
"It's so incredibly irresponsible to forward the notion that they have been preaching repeal and replace, repeal and replace, and they're going to repeal without telling the American people what the replace is?" said Sen. Claire McCaskill (D-Mo.), who is up reelection in a red state in 2018.
"First things first, put on the table what the replace is going to be and once they've done that, then I'll be happy to comment on it."
Sen. John Barrasso (R-Wyo.), a member of leadership and a leading Republican voice on healthcare, said he thinks the pressure of the midterm elections in 2018 will convince Democrats in red states - a group that includes McCaskill - to join Republicans in crafting a healthcare bill.
"I think we're going to have some receptive Democrats doing that because one is it's the right thing to do, but also when you take a look at the 2018 Senate landscape, there are only eight Republican senators who are up, and there are 25 Democrat senators who are up," he said at an event this week hosted by Georgetown University.
"And of the 25 that are up, 10 of them are in states that Donald Trump won, and healthcare has been a major part of the discussions in those states," Barrasso added.
Sen. Lamar Alexander (R-Tenn.), chairman of the Senate health committee, said he hopes Democrats would negotiate "once it's been clear that it's repealed and we need to build a new system."
At this stage, Senate Democrats give varying responses when asked whether they'd help Republicans, ranging from flat out rejection to leaving the door open, at least slightly.
Sen. Charles Schumer (D-N.Y.), the incoming Democratic leader, took a harder line than McCaskill and some other Democrats in an interview with The Washington Post this week.
"We're not going to do a replacement," Schumer said. "If they repeal without a replacement, they will own it. Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It's all theirs."
Sen. Dick Durbin (Ill.), the No. 2 Democrat, said last week that Democrats would at least try to help with a replacement plan if ObamaCare is repealed.
"I think we'll make a good faith effort to see if we can find a proposal," Durbin said. "I hope it doesn't come to that. I'd like to stick with the Affordable Care Act."
Yet Durbin said this week that Republicans would be held accountable for their decision to repeal the law in the first place, given the 20 million people who could lose coverage.
"That is the brand of Republicanism they have to defend," he said. "And it's indefensible."
There are still obstacles that Republicans have to overcome to implement their "repeal and delay" strategy.
First, the party has not agreed on a timeline. Senate Republicans have spoken of a three-year delay, but the conservative House Freedom Caucus says that is too long and the delay should be no longer than two years, allowing the process to occur in the same congressional term.
Second, even if repeal is delayed, people could have their coverage upended much sooner.
The American Academy of Actuaries on Wednesday warned of "severe market disruption and loss of coverage" due to insurers leaving the market in a delayed repeal scenario.
Some Democrats say they think Republicans will never actually come up with a replacement plan, even after ObamaCare is repealed.
"They've had six years to come up with a replacement and they haven't," said Sen. Tim Kaine (D-Va.), this year's vice presidential nominee. "But we're going to wait and see what they do."
"We will look at it on the merits, if and when they happen to come up with something," he added. "We're suspicious that they're never going to come up with anything."
Sen. Chris Murphy (D-Conn.) called it an "absolute fantasy" that Republicans would come up with a replacement that covers 20 million people with the same level of protections for people with preexisting conditions.
"There is absolutely no replacement coming," Murphy said. "If they want to repeal this, it's not coming back."