Having gone through a considerable amount of time and drama even to debate the matter of reforming Health Care Reform, the United States Senate will now set about trying to find something that at least 50 senators will agree to. The theory is that whatever passes can then be brought to the conference and reconciled with the House bill. The formula that the Republican Senate leadership has hit about is called “skinny repeal.”

What is skinny repeal?

Skinny repeal would get rid of three of the more obnoxious provisions of Obamacare, the Individual Mandate, the employer mandate, and the tax on medical devices.

The individual mandate requires everyone to carry very expensive and mostly useless health insurance. The employer mandate requires companies to provide health insurance if they employ a certain number of full-time employees. The medical device tax helps to finance the Obamacare regime.

The provisions have caused a lot of unintended consequences, particularly the employer mandate that has caused companies to cut back on hiring and hours for employees. Eliminating it, by some estimates, would knock a half of a percentage point from the unemployment rate and would enhance economic growth.

The idea would be woefully incomplete

Skinny repeal would be incomplete, which is why it will almost certainly not be the final bill that would go to President Trump’s desk for signing.

The removal of the individual mandate, for example, would accelerate the death spiral that the Obamacare markets are already experiencing. Without something like the Cruz amendment that allows for free market health care plans that compete with Obamacare compliant ones, skinny repeal does not work.

The politics going forward

The politics of reforming health care reform is only going to get uglier. A bill advanced by the Senate leadership to repeal and replace Obamacare went down with nine Republicans joining all of the Democrats to vote against.

The conservative wing and the moderate wing of the Senate Republican caucus are still hopelessly divided.

Getting a formula that enough of both sides will be quite a challenge.

Meanwhile, the Senate Democrats are essentially on strike. Having made a mess of things by passing the Obamacare law in the first place, Democrats are refusing to participate in cleaning things up. They are saying no to everything, using apocalyptic rhetoric to attack every idea that the Republicans advance. They have made the political calculation that this strategy will be to their advantage in the 2018 midterms. If the Democrats take over one or both houses of Congress, they mean to set about enacting what they have really wanted all along, single payer, government run health care.