With a Republican president, Senate and House beginning January 20, the party now can realize its dream of dismantling President Barack Obama's signature healthcare law.
But Ezekiel Emanuel, credited as the law's architect, says they don't have the votes for an outright repeal.
With a slim 52 vote majority in the Senate, Republicans won't have the 60 votes needed to completely scrub the law even with Donald Trump in the Oval Office, Emanuel said Thursday on Fox News Channel's "The Kelly File."
But they'll need only 51 votes to use budget reconciliation to do anything that deals with financing. (Democrats had to use budget reconciliation to pass the Affordable Care Act in the first place.)
The easiest way to kill Obamacare, Emanuel said, is to defund the subsidies that help people under certain income levels afford the increasingly high premiums.
"If you don't have subsidies, the exchange doesn't work," he said. "You can't pay for Medicaid in the states. They can wreak havoc without repealing it."
Without the subsidies, insurance companies will pull out of the exchanges that offer coverages, Emanuel said.
"Doesn't take a lot to wreck," he said. "The question is, what are you going to do for the 20 million Americans who need it, for the insurance companies who rearranged their products? Republicans keep talking about replacement but they've never given a credible bill which will get every insurance."
Asked by host Megyn Kelly how he felt to see the law he helped craft on the chopping block, Emanuel said, "What do you think? I'm very upset, because I think we did a positive stand. No matter what's your metric, we have 20 million people got insurance."
Emanuel said he sees the law as "big success," but admitted, "The public doesn't see it that way."
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