At the other end of the Republican ideological spectrum, Sen. Susan Collins (R-Maine) agrees that Republicans need the replacement first. The Portland Press Herald reports:

Collins said her “number one” goal for any ACA repeal effort would be to protect people who have purchased Affordable Care Act marketplace insurance. That group includes about 10 million people, while Medicaid expansion covers an additional 15-18 million. Maine is one of 19 states that has not expanded Medicaid. The uninsured rate has plummeted in the U.S. since the ACA took effect. “You can’t just drop insurance for 84,000 people,” Collins said, referring to people who have signed up for ACA insurance in Maine. Collins said she’s interested in an approach advocated by Sen. Lamar Alexander, R-Tenn., who recently told reporters that an ACA replacement should be the “first” focus of Congress.

Alexander’s argument is simple: “The exchanges are the first problem, they need to be repealed, the individual mandate needs to be repealed. There are a number of things that need to be repealed, but I think what we need to focus on first is what would we replace it with and what are the steps that it would take to do that?”

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With only 25 percent of voters favoring repeal of Obamacare, Republican leaders need to get out into the real world, talk to voters and ask: “Is it a good idea to take away Obamacare and say, ‘Trust us to replace it’?” Republicans may have fallen in love with their own spin, but if they run in 2018 having repealed Obamacare with no replacement, Democrats will have a field day.

We still don’t have a good answer for why Republicans do not have an alternative plan ready to go after six years of Obamacare. Republicans kept saying they were ready to govern, but on the issue they spent untold time jawboning, they really aren’t ready. They have no idea what they can pass, because ultimately they do need 60 votes in the Senate. Grown-ups would acknowledge that and get to work on an alternative, seeing whether they can find some receptive Democrats. If not, they can run in 2018 against those 23 Senate Democrats up for reelection on the grounds that they are preventing a better system while Obamacare goes into its death spiral.

There is no reason the House cannot do it all at once — repeal and replace and send it over to the Senate. House members will have fulfilled their pledge. That allows them to go back home having fulfilled their promise and given people peace of mind about what will follow Obamacare. Otherwise, the House leadership is asking its members to walk the plank so that President-elect Donald Trump gets a signing ceremony — at their expense.

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Aside from the politics, the policy of “repeal and dawdle” is terrible. Insurers have every reason to pull up stakes faster. Healthy young people have even less reason to sign up. And the people who truly need subsidized insurance face the terrifying uncertainty of losing coverage. Do Obamacare recipients rush to have expensive procedures done soon for fear of losing coverage? Are there more deaths because of an uptick in elective surgeries?

On this one, Freedom Caucus members have stumbled upon the truth. Their House colleagues might want to test-run the message when they get back to their districts. (“Lose Obamacare now, and trust us to come up with something later!”) If House colleagues are silly enough to put their own heads on the chopping block, there is no guarantee that a Senate majority can be found — Alexander and Collins are ostensibly “no” votes (for repeal without replacement) right now.

House leadership should have been better prepared to advance an alternative. Its failure to have a replacement ready is no excuse for taking a politically stupid vote to repeal and delay, which is likely to spawn a host of negative consequences.

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