They've decided to kill us slowly

-- The emerging Republican stratagem is to create some “transition period,” as McCarthy calls it, setting a firm date on which the law would expire. That would then create a metaphorical cliff that the country would go over unless Congress acts. With the prospect of 20 million Americans losing health insurance coverage, the R’s bet that the D’s will cave and accept something they don’t like rather than nothing at all. As McCarthy put it, “Once it’s repealed, why wouldn’t they be willing to vote for a replacement? Right? You have no other options.”

-- This might be a brilliant stroke. Or, if history is a guide, it could fail spectacularly. Chuck Schumer, the incoming Senate Minority Leader, says his caucus won’t budge and pledges resistance. Democrats feel like Republicans never worked with them during the past eight years, and there is heavy pressure from the left flank of Schumer’s caucus to replicate Mitch McConnell’s strategy of obstruction now that they’re going into the wilderness. It’s a dangerous cycle that could set up an epic game of chicken.
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-- Something to ponder: Which eight Democratic senators would actually vote for a replacement to Obamacare? McCarthy thinks incumbents up for reelection in 2018 in red states like Indiana, North Dakota, West Virginia and Missouri will play ball and push their colleagues to do the same. He also thinks Schumer will be temperamentally more willing to cut a deal than Harry Reid would have been, despite whatever he is saying in public.

-- Another wrinkle: There is not Republican consensus on what a full replacement package should look like. There was much discussion when it looked like the Supreme Court would undercut the foundation of Obamacare with the decision in King vs. Burwell about what fixes conservatives could get behind. But the justices sided with the government, so the issue never came to a head. “It’s not easy,” McCarthy acknowledged. “I’ve sat around the room trying to come up with the replacement plan.”

-- To be sure, Tom Price has introduced his own legislation to replace the ACA four times, and in 2015, the House Budget Committee chairman was the chief sponsor of the only ACA-repeal bill to ever reach the White House. The president vetoed it, of course. And it is important to note that the Price alternative is quite partisan and leave no real room for negotiation with Democrats. If Republicans use it as an opening bid, the best case scenario is that the other side reads it as an unserious joke. The worst case scenario is that they take it as an insulting slap and then refuse to even come to the table.
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-- McCarthy believes there is close to universal support among Republican lawmakers for protecting people with pre-existing conditions and to let children stay on their parents’ plans until they are 26 (which does not actually cost insurers all that much). Trump endorsed both elements during the post-election “60 Minutes” sit-down.

-- Senate Finance Committee Chairman Orrin Hatch, who has jurisdiction over federal health care programs, now says it will take up to three years to repeal the Affordable Care Act – a timeline that would guarantee the law is once again a marquee issue in the 2018 and 2020 elections. “We know that to correct it is going to take time,” the Utah senator told Kelsey Snell yesterday afternoon. “I don’t see any reason for anybody to be too upset about it.”

-- Wise Republicans are trying to get out front of what they see as inevitable voter backlash if they run roughshod with reconciliation, without trying to win Democratic buy-in (or at least making a show of trying to). “There will be a multiyear transition into the replacement,” Senate Majority Whip John Cornyn (R-Texas) said in a separate conversation with Kelsey. “This is a failed piece of legislation and it is coming apart at the seams, but it is going to take us a while to make that transition from the repeal to actually replacing it.”

-- Wisconsin is a telling example because it is the home state of both the Speaker of the House and the incoming White House chief of staff. About a quarter of a million people there are enrolled in the Obamacare exchanges, and another 143,000 childless adults are enrolled in Medicaid because of the 2010 law. "We believe that the transition should be a reasonable time, whether it's a year, a year-and-a-half or two years," Scott Walker, the new chairman of the Republican Governors Association, told the Milwaukee Journal Sentinel.