Repeal, Delay, Destroy, Ignore

The GOP plan for repealing and "replacing" Obamacare remains in semi-permanent limbo, and it doesn't look like Republicans are going to move on getting rid of it anytime soon, despite heated rhetoric from the Trump regime.  Why?  Because several red states would be wiped out of the individual insurance market completely.  Greg Sargent explains:

For weeks now, Republicans have employed a range of tortured talking points designed to push one idea: The GOP repeal-and-delay plan will not leave anyone without health coverage, and is merely designed as a transition that will ultimately move us seamlessly to the new, improved health care system Republicans envision, with the details to be worked out later. 

But here’s the problem. If Republicans repeal the Affordable Care Act and delay the date that repeal takes effect, to give themselves time to develop their alternative, it could still create massive disruptions in the interim, even if you presume that the GOP replacement may materialize. 

For instance, many insurers might exit the market, even if repeal hasn’t yet taken hold, simply because there is no guarantee that this GOP replacement will ever come to pass. 

A new analysis suggests that some of the impact of these disruptions might end up concentrated in Republican areas. 

The Congressional Budget Office recently examined a version of the GOP repeal-and-delay bill — one passed by Republicans in 2015 and vetoed by President Obama — and concluded that, because of insurers exiting the market, some 10 percent of Americans might be left living in an area that had no insurers participating in the individual market at all. 

It turns out that 10 percent of the population might end up being concentrated in Republican areas. 

Jeanne Lambrew, who was a key Obama administration official involved in implementation of the ACA, conducted a new analysis designed to try to determine where that 10 percent reside. Using data furnished by the Kaiser Family Foundation, Lambrew singled out counties that fill two criteria: First, that they have low populations; and second, that they currently only have one insurer serving customers on the individual market.

And guess where the bulk of those counties that would have NO individual insurance market at all are?

...many of the counties in red are in states like Alaska, Utah, Wyoming, Oklahoma, Texas, Missouri, Alabama, Tennessee, Georgia, South Carolina, Kentucky, and West Virginia. (Some counties are in swing or blue states like North Carolina, Nevada, Ohio, Pennsylvania, Wisconsin, and Illinois.) The study was conducted by Lambrew for the Century Foundation. 

Larry Levitt, a senior vice president at the Kaiser Family Foundation, tells me that this analysis broadly tracks with what Kaiser believes is a reasonable projection of the outcome under repeal-and-delay. He emails that if the GOP repeals the ACA on a delay, it could very well leave large swaths of the country with no insurers in the individual market, and that this could strand a lot of people in those areas with no insurance — even those who continue to get subsidies in the interim before repeal takes hold

A dozen red states would have their insurance markets wiped out, and major swing states like NC, Ohio and Pennsylvania would be affected too.   But it's bad enough that entire states would be nuked, Oklahoma, Wyoming, Arizona, South Carolina and Alabama's individual markets would be eliminated totally.

In other words, it would be a guaranteed bloodbath for Republicans in the House and Senate in 2018.

And they know it.

It's looking more and more like Republicans are going to let Obamacare stay, because if they repeal it, they're done.  And if they don't repeal it, well...

Democrats can use this to take advantage here if they're willing to do it.  That question remains up in the air however.  We'll see.