What You Really Need To Know About Obamacare — Because It's Not Dead Yet


Let's start here: Obamacare ain't dead, yet.

Thursday morning's headlines may have gotten people excited, one way or another, but the step the Senate just took is exactly that — a step.

This is neither a definitive win or loss for the Affordable Care Act, but it is still important. Oh, and complicated. Very, very complicated.

But in the spirit of un-complicating things (that's a word, right?), I'll highlight four basic facts you should know, bolding important terms to remember.

What the Senate Voted on

Fifty-one Republican senators won a majority-rules procedure to pass a budget resolution, which is the first step in the GOP's round-about plan to dismantle key parts of Obamacare.

Here's how it works.

A budget resolution outlines how the country should spend its money (think resolving to stick to a certain budget). After the Senate passes the resolution, the baton is passed and the resolution makes its way to the House of Representatives for approval.

The key part in that baton passing is for the Senate to write an instruction for reconciliation. This literally instructs the House to reconcile (or change) certain laws in ways that will fall in line with the budget.

Now, take a wild guess which laws Congress will target? That's right, the key laws included in Obamacare.

Now, you might be asking why Republicans didn't try to do things this way already. The answer is, they did. Thing is, though, their efforts require a president's seal of approval.

So you already know what Obama did (and what Hillary would have done) when the majority-Republican House and Senate tried to take down his signature law.


But with Trump in town, the idea is that the three Republican-led authorities of government (House, Senate and President) will work together to make things happen.

Where We Go From Here

Politico's expert on health care politics, Dan Diamond, outlined a list of major boxes Republicans will have to tick in order to repeal Obamacare.

Twitter/Dan Diamond
Twitter/Dan Diamond

The next step on the list is for Paul Ryan and co. in the House to pass the budget the Senate just gave them. That's pretty much a given, and will probably be done Friday.

The next step is for them to actually write the bill that will strike whatever parts of the Affordable Care Act they choose. The budget resolution the Senate just passed instructs them to do so by January 27.

So the next two weeks will be interesting to watch.

Why It Happened While You Were Sleeping

The budget being passed after midnight looks super suspicious. But that was kind of the point from Democrats' perspective.

The Senate actually began meeting on Wednesday evening, but the procedure to pass the budget lasted so long because the Democrats engaged in "vote-a-rama."

Dems raised over 160 amendments — essentially asking each time, "But what about young people under 26? But what about pregnant women..." and so forth.

Republicans were always going to do things their way, but they still had to sit trough the process, presumably annoyed, like Birdman during that one Breakfast Club interview.


Vote-a-rama had two strategic benefits for Democrats. First, the vote was prolonged, which made a spectacle of the event. Second, they forced Republicans to say "no," over and over again to many of the provisions in Obamacare that people find popular.

I mean, check out how bad it looks on paper.


It serves Democrats well to draw this process out as long as possible, highlight in detail what Republicans are doing and hope the public doesn't like what they see.

Senator Chris Murphy told Politico,

They're going to try to rush this through so fast that the American public can't see what they did. It's in our interest to make this process go long enough so that people can see what a debacle this is.

Next thing you know, it'll be 2018, and you'll be seeing commercials for mid-term elections with a scary voice talking about how such-and-such senator voted to take health care away from you.

How It Would Be Replaced

What the GOP senators did between Wednesday night and Thursday morning doesn't necessarily mean they don't want to let young people stay on their parents' plans or want pre-existing conditions to keep other people from getting healthcare.

In fact, President-elect Trump has said he wants to keep those provisions. Also, in their replacement for Obamacare, Republicans may well improve the best features of the ACA, and then some.

There's just one big problem: There is no replacement yet. In fact, that's the reason why one Republican, Rand Paul of Kentucky, voted against passing the budget.


After the resolution did pass, Bernie Sanders said,

They want to kill ACA but they have no idea how they are going to bring forth a substitute proposal.

But President-elect Trump said during his Wednesday morning press conference he'd like Obamacare to be repealed and replaced "simultaneously."

Trump also said he'll submit a plan once his nominee for secretary of Health and Human Services, Tom Price, is confirmed. So, there are lots of things to watch in the next few months:

What types of plans will Republicans raise to replace Obamacare? Will they be able to actually repeal and replace simultaneously? Can Democrats in the Senate do anything to make a couple of Republican senators get cold feet, and steal the narrow majority?

Tune in next time on C-SPAN (no, seriously).

Citations: Politico, CNN