Repealing and replacing the Affordable Care Act, colloquially known as Obamacare, is back on the table in Washington, D.C.

During a procedural vote Tuesday, U.S. Sens. John Barrasso and Mike Enzi, of Wyoming, voted yes to beginning debate on a bill to repeal the existing health care law, also called the ACA.

Over the Fourth of July recess, senators talked to their constituents in Wyoming.

“Like any controversial issue I have heard feedback from people on both sides,” Enzi wrote in an email provided by his press secretary, Max D’Onofrio. “Hopefully as we continue to discuss the legislation, more and more people will understand how the bill benefits folks in Wyoming.”

Barrasso said through his press secretary, Laura Mengelkamp, that “people continue to tell me that we need to get rid of Obamacare,” and that “people I talk to in Wyoming want relief from Obamacare as soon as possible.”

Many Teton County residents don’t share that sentiment, and they are frustrated that neither Barrasso nor Enzi has held a town hall in Jackson recently.

The vote in the U.S. Senate was almost completely split down party lines, with two Republicans — Susan Collins, of Maine, and Lisa Murkowski, of Alaska — voting no with all 48 Democrats,

Vice President Mike Pence broke the 50-50 tie. The vote was a procedural one and an attempt to bring the discussion of health care reform back into the realm of possibility. Last week the Senate’s health care bill lacked sufficient support to be voted on.

What happens now is unclear.

Options on the table include continuing to rework the Senate’s bill or repealing the ACA without an immediate replacement.

The nonpartisan Congressional Budget Office estimated that if the ACA is repealed without a replacement bill in place, 32 million more Americans will go uninsured in the next 10 years.

Wyoming’s senators say those won’t be people who need insurance and can’t afford to buy it but, rather, people who don’t want insurance but are mandated to buy it under the ACA.

“The CBO report, just like the last one, reflects the repeal of the mandates and penalties people of Wyoming have opposed from the day Obamacare passed,” Barrasso said through an email from Mengelkamp. “Some of these people will choose not to buy insurance. Others will be able to buy insurance that meets their family’s needs rather than the demands of the government.”

Barrasso’s office and Enzi’s office did not directly answer questions about their reactions to the CBO score, the stability of the ACA’s health insurance marketplaces or the ability for moderate and conservative Republicans to agree on a replacement bill.

The News&Guide asked Barrasso on July 18 if he would support repealing the Affordable Care Act without an immediate replacement. Mengelkamp emailed a statement from the senator: “People I talk to in Wyoming want relief from Obamacare as soon as possible. I voted to repeal this failed law in the past, and I’ll vote to repeal it again.”

Though Barrasso didn’t directly answer the question it appears he would vote to repeal the ACA no matter what replacement plan, or lack thereof, was proposed. Barrasso added that he wants to “drive down costs and expand coverage.”

The News&Guide also asked Enzi if he would support repealing the ACA without an immediate replacement. Press secretary D’Onofrio reiterated that while Enzi “generally doesn’t say how he will vote on legislation beforehand” he has opposed Obamacare “from the beginning” and voted for a repeal of the law in 2015.

“The goal is to make the health care system better for those struggling under the current system,” D’Onofrio wrote, “not pull the rug out from anyone.”

In Teton County nearly 3,000 people, or 1 in 9, are covered by the ACA.

If there are 22 million more people without insurance in the U.S., local hospitals like St. John’s Medical Center predict their costs will go up. But St. John’s CEO Paul Beaupre has been quick to reassure Teton County residents that the hospital won’t turn away patients without insurance.

The never-ending debate makes it hard for hospitals like St. John’s to plan financially if the ACA is repealed and replaced or simply repealed. In a meeting last week Trustee Barbara Herz, who is also an economist, called it “sailing into uncharted waters.”

Contact Kylie Mohr at 732-7079, or @JHNGschools.

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