Let’s make a deal: health care reform
So, who’s bluffing? Will conservatives (and even some moderates who oppose the bill) prove correct when they say they have enough votes to block the current version of GOP health care reform on Thursday? Or will Trump be able to use his famous deal-making skills to rally the troops for the bill’s passage?
If I had to bet, it would be on the former rather than the latter. Which is fine with me. This bill needs to change:
Critics of the measure, mainly conservatives who say the bill doesn’t go far enough to gut Obamacare and slash premiums for their constituents, insist they have more than enough support to kill the measure. Already, 27 members of the Freedom Caucus are firmly or leaning against the plan, known as the American Health Care Act.
Rep. Thomas Massie (R-Ky.), one of those conservatives, told Breitbart Radio that he had “personally spoken to 29 colleagues, conservative colleagues” who continued to oppose the GOP health plan late Tuesday. That doesn’t count the half-dozen other Republicans who have publicly signaled their opposition.
“We think the negotiation starts when one party says no. That’s why we’re going to say no,” he said. “This is worse than Obamacare and we’re going to own it. We’re going to own it lock, stock and barrel.”
It would have been nice had the GOP decided on their favored Obamacare replacement prior to the 2016 election. But it’s not surprising that they didn’t. There are huge problems inherent in any effort on health care reform, as I’ve described before. Nor was the particular balance of moderate and conservative Republicans the same in the previous Congress as it is now. And it’s now that matters.
I see zero prospect of a positive outcome on this issue. Democrats are united behind socialized medicine. Conservatives lack the votes to return to a free market healthcare system. The RINOs will not agree to the political fallout that voting for a free market healthcare system will bring. So RINOs will only vote for a limited repeal of Obamacare. If conservatives hold fast, they’ll get blamed for the logjam and eventual collapse. Which will garner the votes for an ‘improved’ Obamacare, rebranded as Trumpcare.
I have written several times now, the best way forward after the election was simply to let the exchanges collapse under their own weight, which they were in the process of doing.
Of course, this works better if you haven’t promised for 7 years to repeal it when you had the House, Senate, and Presidency.
Except for the ten million or so who benefit from obamacare, it has failed. Everyone else (Gruber’s “stupid poeple”) has seen costs rise and rise, and options shrink and shrink. A small minority benefits and a vast majority pays for those benefits.
I too would like to see the feds butt out, but that will never happen until it is no longer possible to support their involvement. It will take a while, but eventally interest due on the debt will dwarf all other budget items. When that happens the clueless will ask “how did we get here?”.
Parker:
How many of those ten million are now covered because they got into Medicaid and had not previously done so? I am betting somewhere around 80-85%. If that is so, what we can now conclude is that Obamacare’s real benefit was to get more people into Medicaid. Beyond that, it merely raised prices for the average subscriber and forced people into coverage they otherwise would not have bought by imposing financial penalties on them if they did not do so. I think this is called bait and switch. Not, I would hazard to say, a good way to govern. But then. . .
F,
Last time I looked the estimate on subsidized insurance recipients was in the ballpark of 10+ million.
What happens tomorrow in the House will determine my support for Republicans. If they vote for TrumpCare, it’s over.
The perfect is the enemy of the good.
The nation trembles at the prospect of The Other Chuck’s ire.
And it is not about “health care reform”, for Pete’s sake. It is about coverage, aka insurance except when it’s Medicaid. Then it is about redistribution.
Frog, no ire, but plenty of disgust. Starting in 2010 the one thing unifying Republicans was repeal of Obamacare. How many times did a Republican congress vote to repeal? Now with control of both houses and the presidency, they’ve decided that they must outdo Obama in setting up a better government run health program. There’s not even an attempt to let insurance companies cross state lines, let alone remove the mandates on coverage. This may benefit young people who will be able to opt out without tax penalties, but other than that it is little more than Obamacare-lite.
I’m not a big fan of David Stockman, but his remarks about this mess of a bill echo my thoughts:
…the Ryan plan merely fiddles with the regulatory straight jacket on the insurance market that caused premiums to soar under Obamacare. Ryan’s nanny state requisites include retention of the ban on annual and lifetime benefit caps, limits on age based premium variation, mandated coverage of preexisting conditions, coverage of children until the age of 26 etc…
http://www.zerohedge.com/news/2017-03-22/stockman-thursdays-defining-moment-defeat-obamacare-lite-or-be-buried-welfare-state
What this amounts to is fiddling with Obamacare and is not unlike what a Democrat controlled congress and president might attempt.
Fixing this requires massive change that probably can’t be done via reconciliation. If I were in charge, I’d pursue two paths. One is a regular order bill to do it right with hearings, drafts and arguments. This could be done in the house but might fail in the senate. As a temporary alternative you do a Obamacare recovery plan for major medical + HSA with easy group formation.
This will require some big selling but is needed. Oh by the way where is the President? It’s still his 100 days, but he’s out wallowing in twitter land on wiretaps and NATO debts? He will get smaller every day and pretty soon everyone will ignore him. What then?
The other Chuck,
Why are you or anyone else surprised that congress is just ‘fiddling’ with insurance reform.
Trump didn’t support a repeal of the ACA. Given the rules of the senate, fiddling is all congress can do– though there have been indications the senate could include more regulation overhaul in the bill than was originally thought.
I’m annoyed enough to keep relatively silent for the moment.
Pulling the teeth of the enforcement provision is important. But how Republicans could not muster enough principled support to kill it outright, tells me more than I wish I had known about both some of the American people and quite a number of the Republicans.
This is the most important issue in the relation of the citizen to the state before us. And these complacent cowardly people cannot muster the energy to kill even this one thing.
Effen slaves
DNW: This is the most important issue in the relation of the citizen to the state before us.
Exactly.
The bill should not pass. In addition to the new entitlement, it fails to reform the individual market.
Why are we still calling this problem “Health Care Reform”?
There is nothing wrong with Health Care in the United States.
There are problems with delivery, there are problems with costs, there are problems with insurance coverage, but, thus far, there are minimal problems with Health Care, per se.
Although, if we continue to allow medical schools to accept unqualified people into their programs in an effort to increase the percentage of “health care personnel” to patients , as well as in the name of diversity, we will have problems with health care itself very shortly.