As congressional Republicans move swiftly the effect the orderly and long overdue demise of Obamacare, Democrats are offering hysterical jibes on the theme that the GOP has no plan to replace it with and when they do come up with one, it will likely kill a lot of people. Sen. Rand Paul, R-Kentucky, plans to offer an Obamacare replacement bill very soon. As of this writing, the details of the bill have not been made public, but the general outlines of a replacement proposal are starting to take shape.

The Republicans would set up a nationwide insurance marketplace in which companies would vie for customers across state lines.

Mandates on policies would be lifted so that customers will be able to shop around for those that best fit their needs. Health care savings accounts would be a feature. One proposal would involve groups aside from employers, such as industry associations and even churches, to offer group policies. Medicaid would be block granted to the states, allowing them to craft their own systems for handling the health care needs of the poor.

The sad truth of the matter is that Obamacare is doomed no matter what the Republicans do. Sky rocketing premiums, huge deductibles and the exodus of insurance companies from the exchanges are combining to place the system into a death spiral. The young and healthy are not signing up, leaving the sick to languish.

The only question that remains is whether the system will be buried in an orderly fashion or whether it will die chaotically, with all of the misery that entails.

Unfortunately, while Senate rules allow for the repeal of Obamacare with 51 votes, its replacement will require 60 votes which means it needs Democrats. Democratic senators will, therefore, have a decision to make.

Since Obamacare is going regardless of their desire to infuse life into the zombie health insurance system, they are going to have to deal with its replacement. Will they oppose everything, holding Americans who need health insurance as a hostage or will they realize the error of their ways and choose to participate in cleaning the mess they made in 2010?

Their decision has some bearing on the outcome of the 2018 midterms.

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