January 6th, 2017

Obamacare: what’s good for the Democrat gander is good for the GOP goose

Back in 2009-2010, the Democrats couldn’t be bothered to try to fashion a health care reform bill that would get some bipartisan support. So when the people of Massachusetts warned them against a unilateral one, by electing Scott Brown as senator to replace Ted Kennedy and to block the passage of Obamacare—becoming the first Republican senator from Massachusetts since Edward Brooke in 1972—the Democrats just said “Full speed ahead!” and used reconciliation to get around the cloture problem and pass the final bill.

Remember those exciting and outrageous days? Seems like only yesterday, although it was actually seven long years ago.

But guess what? Reconciliation is the tool that can undo what was done back then:

Senate Budget Committee Chair Michael Enzi (R-WY) introduced a budget resolution Tuesday that includes “reconciliation instructions” that enable Congress to repeal Obamacare with a simple Senate majority. Passing a budget resolution that includes those instructions will mean that the legislation can pass through the budget reconciliation process, in which bills cannot be filibustered.

That means Republicans will only need 50 of their 52 members in the Senate, and a bare majority in the House, to pass legislation repealing the Affordable Care Act. According to the Wall Street Journal, the budget resolution could be passed by both houses as early as next week.

The Democrats really thought it would all work out.

Obamacare would be a wonderful success.

Or…

Obamacare would be a dependency people would never want to give up.

Or…

Obamacare would fail and a Democratic Congress and president would replace it with single payer.

Or…

Whatever happened, the presidency would remain in Democratic hands in perpetuum and any Republican efforts to change things against Democratic wishes would be met with a presidential veto.

As David French writes:

So now the Left lives with the world it made. The outgoing administration’s signal legislative achievement can be undone through simple majority. Key progressive social reforms — implemented through letters and memoranda — can be undone at the stroke of a pen. The most controversial judicial nominations will escape filibuster. In other words, if the Republicans have the will, they actually have a way to not just unwind much of the Obama legacy, they can reform the judiciary without fear of Democratic “Borking.”

One of the principal rules of politics is what goes around, comes around. Another is that majorities are never permanent. The Democrats seem to have forgotten both.

It’s not smooth sailing for the Republicans, though, in doing away with Obamacare. Not at all. There are possible deficit hitches. There is the huge task of passing something better to replace Obamacare, agreeing on how it should be structured and on what principles, and when it should take effect in order to avoid the greatest hardship and backlash.

19 Responses to “Obamacare: what’s good for the Democrat gander is good for the GOP goose”

  1. Artfldgr Says:

    They were money grubers…

  2. DirtyJobsGuy Says:

    Just like retirement savings, medical care is a tough nut. 50 years ago retirement funding was easy as most people didn’t live that long past 65. At the same time most medical care was inexpensive because there was little Doctors could do in may cases. So self pay or insurance for most people was relatively cheap. I remember as a child the headlines about Dr. Christian Barnard and the first heart transplant at a time when there was no such thing as bypass surgery etc.

    For the foreseeable future medical expenses will be high. To fund this without strangling innovation will require firmness plus some imagination. Removing medical insurance from the workplace setting is key. As an employer I don’t like making these decisions for my staff or limiting their choices. Make it easy to form groups for insurance and provide generous tax treatment. The old mutual aid societies are the perfect examples. The various Hebrew Benevolent Society, Lutherans, Odd fellows and others brought your group close down and personally to you. Let the user choose how to save money. A hospital with suite like rooms and restaurant room service is nice but provides no better care than an old hospital ward. Let the patient/customer chose for themselves. People really like to be in control.

  3. Geoffrey Britain Says:

    No matter what the republicans come up with, the democrats and media will portray it as the foulest betrayal of America… ever.

  4. Artfldgr Says:

    on another note: now that obama moved more troops into lithuania… he is now moving more troops too

    US tanks roll into Germany to bolster NATO deterrent
    http://www.foxnews.com/us/2017/01/06/us-tanks-roll-into-germany-to-bolster-nato-deterrent.html

    As Walter Cronkite used to say, we now return to the regular scheduled program…

  5. charles Says:

    “huge task of passing something better to replace Obamacare”

    This is Obamacare’s success. Folks (and a lot of it is driven by the MSM) now believe that healthcare (insurance) is to be driven by the government instead of being driven by a free market.

    Turn it back to the free market and let the chips fall where they may. period.

  6. charles Says:

    “something better to replace Obamacare”

    This is where, I think, Obamacare has been successful.

    Many folks, with the MSM leading the way, now expect the government to be driving healthcare insurance instead of the free market.

  7. neo-neocon Says:

    charles:

    It wasn’t Obamacare that did that. The health insurance market hasn’t worked like a real market, a real business, for a long long time. The rules and regulations have been growing and growing over the course of many decades, and particularly with Medicare and Medicaid, as well as laws that say hospitals must not turn anyone away, high-risk pools, and many other requirements too numerous to list, the public has come to expect government control and interference with the health insurance market.

    DirtyJobsGuy (in the first comment in this thread) has described additional reasons this has happened. As health care use, equipment, and costs have risen (partly as a result of insurance), most people can no longer pay out of pocket for anything but very simple things.

  8. Frog Says:

    The main reason health “insurance” has been a cost driver is that people do not pay what it costs, and really do not care, because it is all OPM. People hardly ever pay out of their own pocket ( until Obamacare caused a major rise in deductibles). They do pay at restaurants, so maybe we should have Restaurantocare too.
    Health care use, equipment and procedures have vastly increased the quality and quantity of peoples’ lives. Why does anyone think those benefits are too expensive? You want your son’s life expectancy to be back to 65 years instead of the present ~82? That is 17 additional years per male. How much is that worth? Mean annual salary times 17? I know educated people, usually civil litigators, who firmly believe a brain MRI should cost the same as a chest Xray.
    Forty years ago most childhood cancers were F-A-T-A-L. today >80% are C-U-R-E-D. How did that happen? Not for free, that’s for sure. A pediatric oncologist is full-time ass-busting busy if he takes three to five new patients a week and delivers good care, without a bunch of less-trained surrogates to whom he distributes the load.

  9. Manju Says:

    the Democrats just said “Full speed ahead!” and used reconciliation to get around the cloture problem and pass the final bill.

    Something’s amiss. Obamacare was not passed thru reconciliation.

    See Here.

    60-39-1 for Passage. Unless Dems had the votes to overcome a filibuster but went thru reconciliation anyway, it sure looks like this was a straight-up Roll Call.

  10. neo-neocon Says:

    Manju:

    Please notice what I actually wrote. I wrote that the final bill was passed by reconciliation.

    Initially, each legislative branch passed its own bill in the usual way (this was before the election of Brown).

    Here’s a summary of the rather complex history of the reconciliation part of the bill:

    On March 30, 2010 Obama signed the Health Care and Education Reconciliation Act of 2010, 7 days after he had signed the Patient Protection and Affordable Care Act into law. At the end of 2009, each house of Congress passed its own health care reform bill, but neither house passed the other bill. The Senate bill, the Patient Protection and Affordable Care Act, became the most viable avenue to reform following the death of Democratic Senator Ted Kennedy and his replacement by Republican Scott Brown. Lacking a filibuster-proof super-majority in the Senate, the Obama administration and House Speaker Nancy Pelosi began encouraging the House to pass the Senate bill, then pass a new bill to amend it using the reconciliation process.

    Which they did, and that was the final version. Here’s another explanation of how it all went down.

  11. John Dough Says:

    I believe the Republicans have one or more plans ready. They are not releasing the plans as the Dems (Read: Schumer & Pelosi) would immediately start attacking it with support from the Main Stream Media Marching Band along with the Actors & Entertainers Rhodes Scholars group.

    Simply put, The Democrats built a huge steel building (Obamacare) but failed to consult any structural engineers (Republicans) during the design phase. Now that the building is collapsing, they’re blaming the structural engineers. This is SOP from the Dems. Write a wide ranging all encompassing legislative Bill and hope to high heaven it works out. “Because they mean well”.

    On that last point, if I had a nickel every time one of their well meaning legislative bills overloaded the economy or collapsed, I would have enough money to pay for a scribe to enter my comments here.

  12. Kyndyll G Says:

    Off topic, but is anyone else having trouble getting new comments to show up? I’ve seen it mentioned before but never experienced it until the last day or so.

  13. Manju Says:

    Neo:

    Ok, your final bill is an amendment to an existing law (the Patient Protection and Affordable Care Act) that already overcame a filibuster.

    I can see how this kinda feels like Obamacare was passed via an end-run around the filibuster. After all, everyone expected a 2nd cloture vote. But they only got one.

    See here (from a former Parliamentarian of the United States Senate):

    Obamacare was not passed using budget reconciliation

  14. Tim P Says:

    Neo,
    Above, you said;

    It wasn’t Obamacare that did that. The health insurance market hasn’t worked like a real market, a real business, for a long long time. The rules and regulations have been growing and growing over the course of many decades, and particularly with Medicare and Medicaid, as well as laws that say hospitals must not turn anyone away, high-risk pools, and many other requirements too numerous to list, the public has come to expect government control and interference with the health insurance market.

    I agree with your statement. There is no disagreement anywhere that medical care in this country is broken.

    Here is a very telling graph showing how just how bad it has become.

    I recently came upon this site which appears to offer some ideas on what to replace Obamacare with. I am presently looking through the site and recommend yourself and others do also. It may provide some constructive ideas.

    What scares me now is that the republicans, or some republicans are getting cold feet about the repeal. Basically because they do not have anything ready to replace it with.

    If so, that shows monumental stupidity on their part. They have had six years to develop ideas and craft them into hopefully workable policy so as to provide a ready or at least partially ready replacement for Obamacare.

    While I would like to see the government completely exit the healthcare business, I do not think that it is realistic at this point. However I do think we could initiate reforms to point us in that direction so that we can eventually get there.

    A brief excerpt from one of the articles at the site I referred to above,

    Whatever an alternative’s exact features, there are three elements that are important, and perhaps essential, to its being a political and policy winner—and thus to its being instrumental in bringing about Obamacare’s full repeal. First, a winning alternative must be something that can be sold to the American people on the political stump. It must therefore be suitably simple and explainable. Second, it cannot afford to invite a political backlash by proposing ideas that are lightning rods for criticism. For example, it shouldn’t veer into important but nevertheless tangential issues like Medicare reform, and it shouldn’t threaten the existence of the tax break for those with employer-provided health insurance (although it can—and should—prevent that tax break from being an open-ended public subsidy for ever-more-expensive plans). Third, and most importantly, it must meaningfully address Americans’ trio of core goals for real health-care reform: lowering costs, dealing with preexisting conditions, and significantly increasing the number of people who are insured versus the pre-Obamacare status quo. Indeed, failing to offer solutions to each of these concerns is the easiest way for a conservative alternative to become a target for criticism. An alternative that meaningfully addresses only two of these three core goals would be toppled over like a two-legged stool.

    Perhaps the discussion should progress from whether or not to repeal obamacare, to how to repeal obamacare and what to replace it with.

  15. WN Says:

    Once the government starts a program, it never goes away. The only answer is for Republicans to provide more choice. The “freedom” to select insurance as it meets your needs across the board, and over state lines, will cause some insurance rates to drop via competition.

    Freedom and competition!

  16. Frog Says:

    Why is coming up with something (conceptually, that is, not practically) to replace Obamacare a “huge task”? The huge task was to fool the public, to Gruberize it, and pass Obamacare using every contortion in the Democratic play book. The common stocks of the big insurors, e.g. Aetna and Humana, boomed 50% shortly after Obamacare’s passage. So Ocare was seen as good for insuror profits. Hmmm.
    It really should not be hard to go back to the old, with a few tweaks such as interstate portability (if that is done Constitutionally), and returning to the basic rationale of insurance, which is that premiums reflect risk: i.e., pre-existing conditions should and must cost more. Stop with the bleeding heart stuff, how hard and unfair it is to have a pre-exist.
    85% of Americans were insured pre-Obamacare, and millions of young did not need or want coverage. That leaves the “poor”, who got plugged into Medicaid.
    So-called community rating screws way more people than it helps by raising premiums of all who pay. Yes, there will need to be an Obamacare phase-out period, but that’s no biggie.

  17. neo-neocon Says:

    Frog:

    Problem is, you already know why it’s a “huge task”: most Americans no longer accept the type of proposal you’re offering. And if people with pre-existing conditions pay more—in most case, a LOT more—they simply won’t buy insurance and there will be a million more bleeding-heart stories every day. The GOP would be voted out of office and the Obamacare reform would itself be reformed by their liberal successors.

    High-risk pools, which are subsidized for those who can’t afford them, must deal with the problem of pre-existing conditions. In fact, high-risk pools existed in most states prior to Obamacare, but they were often very expensive even with the subsidy. That will remain a problem.

    It’s a “huge task” because there is no free lunch. The GOP needs to come up with a solution that is not just “conceptual” but is practical. What good is it otherwise?

  18. TommyJay Says:

    “It’s a ‘huge task’ because there is no free lunch.”

    Well I agree that if your are going to have pre-existing coverage and high risk pools to cover them then there is a sizeable cost that has to be paid. But the numbers I’ve seen suggest that this sizeable cost is not the big one. The big one is the 20 million highly subsidized policies. The IG tried to sign-up dozens of fake illegal immigrants and found 9 out of 10 succeeded. (Yes, a small fraction of the big cost number.)

    The current insurance model of 3rd party payment combined with tort attacks on unsat. service is VASTLY inefficient. The total tort payouts are tiny but defensive medical practices cost at least $0.5T/yr. A third large issue is the asymmetry of information. Many auto owners do understand the repairs needed before speaking to a mechanic. Most don’t with doctors. And yes, doctors on average may be as unscrupulous as a mechanic or worse. An example is the new practice of hospital patients hiring medical expert advocates to represent them and treat hospital doctors/personnel as adversaries.

    So in short (too late) there IS an abundance of “free lunch” to go around in the bigger cost/benefit analysis.

    PS: Thanks for the response on Obamacare. So do we ultimately have the votes of Republicans like Snow and Collins to thank for the original 60 votes in the Senate? So the GOPe stinks on defense as well as offense?

  19. neo-neocon Says:

    TommyJay:

    No Republican senator voted for Obamacare. Take a look.

    What Snowe did was much earlier on—she had voted “yes” to letting the bill get out of committee in the first place. However, had she voted “no” it wouldn’t have mattered. It wouldn’t have kept the bill in committee, because the Democrats had plenty of “yes” votes for that without hers.

    But all the Republicans stuck together when it came time to vote against the bill. One of the many many myths on the right is that they didn’t. But they did. They simply didn’t have enough votes to stop it, because there weren’t enough Republicans, and the Democrats stuck together, too. Strict party lines for both parties.

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Previously a lifelong Democrat, born in New York and living in New England, surrounded by liberals on all sides, I've found myself slowly but surely leaving the fold and becoming that dread thing: a neocon.
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