WASHINGTON ― Congressional Republicans are marching determinedly toward a new session, insisting that a quick repeal of Obamacare will be a top agenda item.

Outgoing Senate Minority Leader Harry Reid (D-Nev.) doesn’t think they really have it in them.

“They don’t have enough nerve to repeal Obamacare. And if they do, they are just a lot more visionless than I can imagine,” Reid told The Huffington Post in an interview this week. “Let them repeal it. They will rue the day.”

Republicans are saying publicly that the plan is to pass an immediate repeal of President Barack Obama’s signature law, but still leave Obamacare in place for several years while designing a replacement. Experts and industry groups have warned that state insurance markets could fall apart during such a transition, particularly if the repeal legislation removes key pieces of the Obamacare structure like the penalty for people who don’t buy insurance. Insurers, wary of markets that lack lots of healthy customers, would raise rates even more than they already have ― and in some cases pull out of the state markets altogether. A study from the nonpartisan Urban Institute predicted that, in the first year alone, more than 4 million people could lose health insurance.

The disruption would come in the midst of a heroin and opioid epidemic that is ravaging the country, particularly in regions that voted heavily for Donald Trump. Congress recently approved a billion dollars to combat the crisis, but repealing Obamacare could reduce access to treatment and send the epidemic spiraling further out of control.

In the HuffPost interview, Reid raised the idea that Republicans might not mind ― and might even welcome ― such deterioration in the hopes that it would pressure Democrats to negotiate a new health care regime. Such cooperation would be necessary. Senate Republicans have the votes themselves to kill Obamacare by stripping away its funding, but they will need 60 votes, enough to overcome a Democratic filibuster, in order to eliminate the law’s regulations and put a new program in place.

“I think once it’s repealed, you will have hopefully fewer people playing politics and [instead] coming together to try to find the best policy,” said House Majority Leader Kevin McCarthy (R-Calif.), who has a habit of being more explicit about GOP strategy than is wise. Once the suffering becomes visible, McCarthy reasoned, “the blame will fall on the people who didn’t want to do anything.”

Let them repeal it. They will rue the day. Harry Reid on the GOP's approach to Obamacare

Already, House Minority Leader Nancy Pelosi (D-Calif.), like Reid, has predicted that Republicans will balk when it ultimately comes time to vote on ending the health care law. Her soon-to-be counterpart in the Senate, Chuck Schumer (D-N.Y.), has said that under no circumstances will Democrats bail Republicans out of a health care debacle of their own making ― a no-compromise approach that Reid applauded. “If he were here, I’d pat him on the back,” he said of Schumer.

Should Republicans actually try to paint Democrats into a corner with a rapid repeal, Reid painted a bleak picture of the ensuing damage.

“Can you think of — maybe there is something more cold and calculated and mean-spirited than that: ‘Let’s have a few people die.’ Because that’s what’ll happen. You get rid of Obamacare, people are going to die,” he said.

“In the last few days, doctors have written columns and op-ed pieces in major newspapers talking about how terrible it would be to not have Obamacare. And if these people are going — ‘We’re going to repeal it, we know it’s going to be horrible, but it’s going to be so horrible that in a few years, maybe they’ll work with us’ ― by then, there’ll be dead bodies all over,” Reid said.

The senator’s claim that Obamacare repeal could cost lives is incendiary. It’s also grounded in academic research.

Although the precise links between insurance status and health are murky and the subject of frequent debate, the consensus among public health experts is that people with insurance end up healthier and less likely to die prematurely. This shouldn’t be surprising, given the data showing that people without insurance are less likely to receive medical care ― not to mention the overwhelming evidence that having insurance protects people from financial hardship, which carries its own health consequences.

And then there are the hundreds of thousands of people with substance-use disorder who would be unable to access treatment if the Affordable Care Act were erased.

The Senate is a great place. Is it a better place than when I came? Of course it is. Harry Reid

That Reid must entertain the possibility of Obamacare repeal as he prepares to leave the Senate is a remarkable illustration of just how unsettled his and Obama’s legacy remains. Though the senator has served in the upper chamber for 30 years, his political biography will be most defined by what has taken place in the last eight ― work that now stands threatened by the incoming Trump administration.

With Obama in the White House, the stimulus and auto bailout were passed, along with the Affordable Care Act; a debt ceiling standoff was averted but a government shutdown was not. During that time, Reid also moved to change the rules of the Senate, lowering the threshold of confirmation for Cabinet appointees and most federal judges.

Looking back, the Nevada Democrat said he has no regrets about pursuing rules reform, even if Trump and Senate Majority Leader Mitch McConnell (R-Ky.) can now fill the lower courts and executive offices without fear of filibuster. Nor does he regret waiting until Obama’s second term to embrace the so-called nuclear option, although he and Obama could have accomplished far more had they made that leap earlier.

“I couldn’t have gone nuclear sooner because we had to do it at the right moment. I tried my best in years past to hang on to this,” Reid explained.

Part of what makes Reid comfortable with the rules change is the belief that it would have happened anyway ― perhaps not led by him and not in 2013, but at some point the rules and constructs of the Senate were going to change. The filibuster, Reid said, is not “some part of the Ten Commandments of the Constitution, it’s not.”

Whether Reid, in his eight years running the Senate, merely adjusted to modern congressional realities (such as the rise in rank partisanship) or actively facilitated the legislative body’s demise depends on one’s political perspective. His legacy is both monumental and divisive. He is hailed by Democrats as the personification of a principled political brawler and decried by Republicans as a disruptive party hack.

Reid largely doesn’t care about the public’s perception. He is unwaveringly proud of his partnership with Obama, copping to no regrets over their time working together. What he doesn’t countenance is the idea that he left the institution of the Senate in a worse place.

“It’s a different place. I believe the change is always for the better. This is an evolving situation, and I will look back at all the good times when I first came here, but those times are gone. There is no need to talk about them,” he said.

“The Senate is a great place,” Reid added later. “Is it a better place than when I came? Of course it is. I always look at the glass half full, not half empty. That’s why I’m doing this interview with you two.”

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