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Senate Republicans are moving into high gear on their effort to repeal the Affordable Care Act, making it likely that within the next few weeks theyll either pass something and keep the process hurtling forward, or abandon it altogether.

Judging from what theyre saying, it looks like the latter is the most likely scenario: They fail to pass their version of repeal, then say, Well, we tried, shake that albatross off their shoulders, and move on to the rest of their agenda. It would leave many in the party infuriated, but it might be the best of the bad options available to them.

The latest developments suggest Senate Majority Leader Mitch McConnell (R-Ky.) may be hoping to rip the Band-Aid off as quickly as possible and get this whole thing behind them. Heres a report from Politico:

After spending a month deliberating over a response to the Houses passage of a bill to repeal the law, Senate Majority Leader Mitch McConnell (R-Ky.) is accelerating the partys stagnant work as a jam-packed fall agenda confronts congressional leaders and President Donald Trump. Republican leaders want resolution to the tumultuous Obamacare repeal debate by the Fourth of July recess, Republican sources said, to ensure that the whole year isnt consumed by health care and that the GOP leaves room to consider tax reform.

Its a gut-check situation for Republicans, who are about to be confronted with tough choices that may result in millions fewer people with insurance coverage as a condition for cutting taxes and lowering some peoples premiums.

While its possible that McConnell is pushing this accelerated schedule because he thinks itll produce a bill that passes before anyone has a chance to realize whats happening, that seems like a long shot, particularly given how many Republicans are expressing doubts about whether they can get the 50 votes they need to pass it (the current GOP margin in the Senate is 52to 48):

Thats a whole lot of skepticism. One big problem theyre facing is that there are multiple factions and working groups among Senate Republicans, all potentially coming up with their own very different versions of the bill. Thats a result of McConnells decision not to run the bill through the ordinary committee process, since he didnt want there to be public hearings at which Democrats would have a chance to speak and question witnesses. In that vacuum, everyone wants to exercise their own influence. So apart from the 13-member group that McConnell appointed, theres also a group led by Sen. Susan Collins (R-Maine) and Sen. Bill Cassidy (R-La.), and a group led by Sen. Rob Portman (R-Ohio).

But the intractable problems are likely to be substantive. Can senators from states that have benefited hugely from the ACAs Medicaid expansion such as West Virginia, where 28 percent of the state population is now enrolled in Medicaid, including 170,000 citizens who got it because of the expansion come to an agreement with senators such asTed Cruz (Tex.) and Mike Lee (Utah) who would like to see Medicaid undermined if not utterly destroyed? And can they all agree on something that can also get a majority in the House, where ultra-conservative Freedom Caucus members wield so much power?

So here are the potential outcomes:

The hurdles in front of that last outcome seem insurmountable, but anything is possible. But if it doesnt happen, that sets up still another possibility: Once the repeal effort is behind us, we might actually take some steps to improve the health-care system.

In this scenario, Republicans would no longer be able to dismiss any reform idea with, We cant think about that, because we have to repeal Obamacare. You might even get some innovative thinking.

For instance, the Nevada legislature passed a bill allowing anyone to buy in to Medicaid. If you cant get other insurance or you dont like whats available on the exchanges, you could just pay premiums and join the government program. Gov. Brian Sandoval (R) hasnt said whether hell sign the bill and there are details to be worked out, but once ACA repeal is off the table, you could see other states deciding that now they have to try some new things. States that have seen private insurers depart the individual market could turn to the same solution. Some Republican states might even accept the ACAs Medicaid expansion (perhaps with some tweaks so they can say theyre being tougher on the shiftless poor), because all that federal money is just waiting to pour into their states and insure their citizens.

Im not saying Id trust Republicans anywhere to do the right thing when it comes to health care. But maybe this experience has taught them that theyd better come up with some solutions that actually help people. Anythings possible.

See the rest here:
Are Republicans ready to give up on repeal? Here's what might happen next. - Washington Post (blog)