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GOP's latest Obamacare repeal bill would send premiums skyward

Congressional Republicans finally succeeded in passing a bill to repeal major provisions of the 2010 Patient Protection and Affordable Care Act, better known as Obamacare. But they must be counting on President Obama to veto it, because otherwise it will send premiums skyrocketing and create havoc in the market for individual insurance policies.

The measure's problems stem from the technique the GOP used to circumvent the Democratic blockade in the Senate. HR 3762 is a budget reconciliation bill, which meant that it could not be filibustered. But reconciliation bills must include provisions that have an effect on the federal deficit, so HR 3762 could address only the parts of Obamacare that imposed taxes or expanded federal health benefits.

As a consequence, the bill would eliminate the requirement that adult Americans carry insurance, while still requiring insurers to offer policies to everyone regardless of how healthy they might be, and without charging higher premiums to people who've been sick.

That's a disastrous combination because it would encourage people to obtain coverage only when they need care, then drop it as soon as they're healthy again. Insurers would be left to cover only those who are the costliest to insure. Premiums would quickly rise, then rise more each year as fewer and fewer people signed up for coverage that was increasingly unaffordable.

This sort of "adverse risk selection" is exactly what the mandate to carry insurance was designed to guard against. Granted, the way it was implemented in the Affordable Care Act may not be especially effective, and there are other ways to address the threat. But HR 3762 wouldn't try any of them. Instead, it would throw the individual insurance market into a death spiral of soaring premiums and plummeting enrollment.

Happily, the probability that Obama will veto the bill is no less than 100%. And once he does, Republican leaders, who've actually been good about avoiding pointless showdowns with Democrats over the last year, can get back to the real work of governing.

Still, House Speaker Paul Ryan (R-Wis.) and many other Republicans have been saying that this latest futile attack on Obamacare is more significant than the 317 previous failures. And I don't get that.

OK, so 317 probably isn't the right number. But you get my point. Republicans in the House and Senate have forced votes on repealing all or part of Obamacare seemingly every month since Obama signed it into law in 2010. With the exception of a few narrowly targeted successes, such as the recent postponements of the ACA's taxes on insurance policies and medical devices, these efforts have succeeded only in putting Democrats on the record in support of a healthcare bill they've long supported.

Granted, this time they will force Obama to use his veto pen for the first time in defense of the law. But that doesn't reveal anything about the president or congressional Democrats that voters didn't already know. And let's face it, a bill that's killed by a veto is no more or less dead than one that's blocked by a filibuster or other congressional obstruction.

Nor will there be any difference in the political fallout. Republicans can't claim to have repealed Obamacare, they can only criticize Democrats for voting -- for the umpteenth time -- not to. Democrats, meanwhile, can blast Republicans for voting in favor of a massive increase in insurance premiums (not literally, but in effect).

(Actually, they can't say that about five swing-state Republicans who voted against the bill: Sens. Susan Collins of Maine and Mark Kirk of Illinois, and Reps. Bob Dold of Illinois and John Katko and Richard Hanna of New York. Centrist Democratic Rep. Collin Peterson of Minnesota, meanwhile, voted in favor of HR 3762.)

Republicans argue that forcing Obama to veto the bill will demonstrate to those who hate Obamacare that they need to put a Republican in the White House. But that was the GOP's message in 2012, too, and look what happened. So why is this time different? 

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