The Republican effort to repeal and replace Obamacare appears dead in the water -- but some experts are suggesting that this may not be the end.

Voting on the latest iteration of the Republican effort at healthcare, the Better Care Reconciliation Act of 2017, was initially delayed pending Sen. John McCain’s return to Washington following surgery. With a mix of revisions designed to appeal to both conservative and moderate holdouts, the hope was that with McCain’s presence it would pass by a razor-thin margin. Now, however, that hope been abandoned. The defection of Republican Senators Mike Lee of Utah and Jerry Moran of Kansas, added to the prior defections of Rand Paul of Kentucky and Susan Collins of Maine, eliminated the possibility of the bill making it through a procedural vote.

“These are exciting times,” said Dustin Stamper, a director in Grant Thornton’s Washington National Tax Office. “I’m not sure anyone knows exactly what will happen. McConnell’s announcement was that he didn’t have the votes. That was really no surprise -- it was always going to be tough.”

McConnell is now calling for a total repeal of Obamacare, but on a delayed basis, according to Stamper. “He indicated plans to have the Senate vote on a bill to repeal the ACA on a two-year delay, which gives Republicans time to decide what to do,” he said. “They would probably want to repeal with a two-year delay with a transition off of ACA. It’s the kind of provision that they voted on in past.”

A bill to repeal the ACA was passed by Republicans in 2015, but was vetoed by President Barack Obama.

“A lot thought this was the direction that Congress would take when Trump won,” Stamper said. “But I would caution that it’s not totally clear that this is ultimately the direction they will take or that McConnell even has the votes to bring up the House vote. The procedure to repeal would most likely be to bring up the House bill and vote on a motion to proceed with it. Once they approve a motion to proceed, they would pass an amendment that would repeal the ACA on a two-year delay.”

But stay tuned – the situation can change any minute, according to Stamper. “It could be another potential partial bluff. Everything is very fluid,” he said. “It wasn’t long ago that McConnell was threatening that if [Senate Republicans] didn’t pass this bill he would force them to work with Democrats to shore up the ACA. That now appears to have been a bluff, despite what he said last night. Things could change very quickly.”

Although the House and Senate voted to repeal the ACA in 2015, it is not a given that they would do so today, Stamper observed. “It’s harder to vote when the stakes are higher,” he said. “It was easier to vote [to repeal] when they knew that it wasn’t going anywhere. Now it would become the concrete way they’ve chosen to go forward. It’s a tougher vote when it would become the definitive step that they have taken that they would have to run on in 2018.”

“It is pretty unclear how the House will respond,” he said.

“We’ve been telling clients to remain compliant with ACA until and if it is amended or repealed,” said Stamper. “The continuation of ACA will not impose huge compliance burdens since nobody should have stopped complying with ACA now in anticipation of repeal.”
“But the situation is fluid -- it’s changing hour to hour,” he said. “Things should be more clear in a week or two.”

Senate Majority Leader Mitch McConnell of Kentucky, Sen. John Cornyn of Texas and other Senate Republican leaders
Senate Majority Leader Mitch McConnell of Kentucky, and other Senate Republican leaders Andrew Harrer/Bloomberg

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Roger Russell

Roger Russell

Roger Russell is senior editor for tax with Accounting Today, and a tax attorney and a legal and accounting journalist.