Republican efforts to repeal Obamacare while imposing a delay on replacement plans could prove to be fiscally problematic.
From strictly a budgetary perspective, the “repeal and replace” plan being floated by Republicans can be viewed as simply an immediate $680 billion tax cut bill combined with an uncertain promise to achieve savings down the road.
Furthermore, those savings can only come from reducing the number of people with insurance or dramatically lowering the generosity of that insurance -- both politically unpopular options -- because you can’t keep just the good parts of Obamacare (for instance the ban on exclusion for pre-existing conditions) without the “bad” parts (subsidies for insurance and some type of mandate to keep healthy people in the insurance market).
This combination -- the immediate easy choice of a tax cut and the vague promise to make harder choices in the future -- is the definition of avoiding hard choices. Making it even more toxic is that the delay period itself might unravel the individual insurance market, making any replacement scheme even more costly or unworkable.
There are clearly ways to make Obamacare work better and there are ways to make it align with a more conservative vision for health insurance. However, Republicans will lose that opportunity by rushing through “repeal” without “replace” using the budget reconciliation process and its limits on what parts of the law can be altered (in an attempt to circumvent a Senate filibuster).
To read more about the difficulty with “repeal and delay” check out:
The Tax Policy Center’s analysis on how repeal primarily reduces taxes on upper-income earners.
The Brookings Center for Health Policy with a post on the budgetary costs of repeal and delay and a study about the threats to the individual health insurance market and some possible solutions.
Republican health care economist Gail Wilensky on how repeal and delay harms conservative health care reform.
The Committee for a Responsible Federal Budget on the use of reconciliation.