Collins announced an ACA replacement plan yesterday, partnering with Sen. Cassidy (R-LA). The plan is meant as a compromise bill that lets states decide their level of participation: blue states can keep the ACA as-is, deep red states can avoid the law altogether, and the rest get compelled to at least enroll their uninsured in crummy catastrophic insurance. See this great Vox explainer for details.
The relative merits of the Collins-Cassidy plan vs. the ACA can be debated elsewhere, but the key point is this: the Collins replacement plan, as well as any other conceivable replacement plan, are dead-on-arrival in this Congress because of how many votes would be needed to pass. Unlike the ACA repeal bill being considered now, which only requires 50 votes to pass the Senate (with VP supplying the tie-breaking vote), any replacement bill requires 60 votes to pass the Senate. This is because the types of things you need in a replacement bill don’t fit under the arcane rules of budget reconciliation that allow certain bills to pass with only 50 votes–see more detailed explanation here. This means Collins would need to hold all R’s and peel off 8 from the Dem caucus to pass it out of the Senate, which is extremely unlikely, especially given how unified the Dem caucus seems to be right now. Early reviews of the Collins-Cassidy plan are not good at all, with the plan getting an icy reception from both sides of the aisle. Even if a bipartisan replace plan could magically pass the Senate, it would still need be conservative enough to pass the House without losing more than 23 R’s, and then be acceptable enough to Trump for him to sign it into law. Not. Gonna. Happen.
In contrast, the threat of the repeal bill passing is very real since it only needs 50 votes in the Senate. Repeal without replacement is like throwing a grenade into the health care system, likely sending insurance markets into a tailspin. Collins has expressed multiple concerns about repeal, but she still voted to allow the repeal process to move forward. She has indicated a willingness to vote for the final repeal bill so long as there’s “at least a detailed framework” of what a replacement might look like. Thus, she seems perfectly willing to vote for repeal and blow up the ACA as long as a replacement bill is under consideration, even though she must know that passing a such a bill is near impossible.
Therefore, our call to action must be to get her to unequivocally oppose the repeal bill. If a viable replace bill that can get 60 votes ever comes along, it can include the repeal stuff in it, so there is no need for a separate repeal bill at all.
The danger is that the average American has no idea how the Senate works, so by publicizing her DOA replacement plan, Collins is giving Mainers false hope. It’s not okay to vote quietly to kill the ACA, then say you did all you could to pass a replacement.
So let’s keep calling to hold Collins accountable: You can try all you want to pass an even better health reform bill, but outright ACA repeal must be completely off the table.
Thanks for all you do,