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You are here: Home / Anderson On Health Insurance / Things that make you go hmm….

Things that make you go hmm….

by David Anderson|  May 17, 20176:00 am| 29 Comments

This post is in: Anderson On Health Insurance

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Just saw this tweet from a reporter at the Hill:

Durbin tells me it's ok for Dems to meet with Cassidy/Collins on healthcare b/c those 2 are "beyond repeal" https://t.co/F0RBQb8GvR pic.twitter.com/recMUqHDm3

— Peter Sullivan (@PeterSullivan4) May 16, 2017

When I read through Cassidy-Collins in January, my impression was that this was the contours of a deal or at least the start of a discussion on a deal:

The bill actually grapples with trade-offs. As a starting point of discussion for replace, this bill is worthwhile as it mostly focuses on further decentralizing the US health finance system to the states in the individual market and very little else. It does not do anything too controversial on non-germane subjects. It can be seen as a technical corrections bill with a conservative slant to the ACA…. A critical question will be what is the counterfactual? The counterfactual is critical in evaluating the quality of the outcomes of this bill.

It is a healthcare bill. It is a conservative healthcare bill.

Again, it is a healthcare bill. It is not a tax bill.

It is also sponsored by four Republicans which is one more than the minimally viable blocking coalition. It is a pitch to restore healthcare politics back into the realm of normal politics. That was my read on it in January and that seems to be the read Democratic Senators in seats that are not at risk in 2018 have on it now.

The most critical question on evaluating Cassidy-Collins is what is our counterfactual. Is our counterfactual a smooth and fully operational ACA? Is it a monkeywrenched ACA? Is it the AHCA minus 10% of the worst? What is the counterfactual will determine a lot of your analysis.

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Reader Interactions

29Comments

  1. 1.

    Baud

    May 17, 2017 at 6:07 am

    Cassidy and Collins will cave to McConnell in the end.

  2. 2.

    OzarkHillbilly

    May 17, 2017 at 6:10 am

    You mean there are adults in the Senate?

  3. 3.

    rikyrah

    May 17, 2017 at 6:13 am

    Collins is NOT to be trusted???

  4. 4.

    Zach

    May 17, 2017 at 6:20 am

    Makes sense to negotiate in a universe where there’s no chance that Trump gives up because President is no fun or limps towards a blowout in Congress in 2018.

    The Senate looks grim if you look only at the 2018 races (Dems can flip NV, long shot in AZ), but there’s always unexpected retirements and I could imagine some Republicans who will be vulnerable in 2020 going independent and caucusing with Dems if this goes much further… say they’re only doing it temporarily in order to get to the bottom of Trump mess.

    Edit: I would take the Collins-Cassidy deal if Collins and Cassidy recruit a third Republican (Sasse, Graham, McCain etc) to join in a scheme like this.

  5. 5.

    OzarkHillbilly

    May 17, 2017 at 6:20 am

    @rikyrah: Nobody with an (R) after their name is to be trusted. That doesn’t mean you can’t work with them tho.

  6. 6.

    BlueDWarrior

    May 17, 2017 at 6:30 am

    @OzarkHillbilly: And short of the Republicans completely giving up on passing legislation because the Trump admin has gone full Fukushima, you are going to have to break bread somewhere.

    The Democrats should be operating to minimize damage, and taking receipts when they get majorities again for what to restore and improve later.

  7. 7.

    OzarkHillbilly

    May 17, 2017 at 6:39 am

    @BlueDWarrior: There is a point where one says, “No f’n way.” but it is not before you have a bill, it is when you have a Trumpcare for the rich bill.

  8. 8.

    Morzer

    May 17, 2017 at 6:42 am

    Anything which resembles a workable, honest healthcare bill simply won’t fly with the crazy GOP base or the vicious idiots they’ve imposed on the Senate/Congress. It’s possible Cassidy and Collins genuinely want to negotiate something sane and functional, but I don’t see how they get it moving along the runway, much less into the air.

  9. 9.

    Buskertype

    May 17, 2017 at 7:01 am

    So there’s 4 repub. sponsors. I imagine Manchin and Heitkamp sign on. I don’t see another 45 votes forthcoming. I bet you could get 10-15 from each caucus to support something bipartisan, but I kinda doubt there’s more than that. I hate to say it, cause I think it would be a positive developement all told.

  10. 10.

    Hunter Gathers

    May 17, 2017 at 7:02 am

    Yes, by all means, let’s enter into good faith negotiations with a party that refuses to stand up to a criminal, treasonous President.

  11. 11.

    p.a.

    May 17, 2017 at 7:08 am

    No latenight tweetstorm after yesterday? Someone amputate his thumbs?

  12. 12.

    But her emails!!!

    May 17, 2017 at 7:18 am

    Look
    1. If the basis of the agreement on a bill is the Cassidy/Collins framework
    2. The bill abandons efforts to gut Medicaid like a fish in order to deliver tax cuts
    3. And the bill incorporates items to shore up/strengthen the ACA

    Then I say Senate Dems should go for it.

  13. 13.

    Raven Onthill

    May 17, 2017 at 7:52 am

    I’m very dubious of this; if the Senate Democrats participate, I think they will get rolled again. With the House entirely dominated by Republicans and the Senate with a Republican majority, wouldn’t the balance go towards the Republicans in a congressional conference committee? If the Dems get on board, would they be used as anything but cover for a very bad bill? All it would take is a few Democratic defectors during the final Senate vote to send a very bad bill to the President.

    Also, is one of the bills that would allow states to cut insurance for people who aren’t in the employer-funded system, not so? That would widen the red/blue state divide with dynamite, even if none of the House provisions made it to the final bill.

  14. 14.

    David Anderson

    May 17, 2017 at 8:10 am

    @Raven Onthill: Cassidy Collins is not reconciliation eligible so it would need 60 out of conference

  15. 15.

    Elizabelle

    May 17, 2017 at 8:16 am

    I don’t trust Susan (Lucy with the Football) Collins, and I don’t want to give the Republicans and their media mouthpieces the chance to say that they cleaned up Obamacare.

    Leave their filthy mitts off of it, and make the improvements once we have more Democrats in Congress.

  16. 16.

    manyakitty

    May 17, 2017 at 8:16 am

    I planned on mentioning healthcare in my Resistbot messages today. My senators from here in Ohio are Brown (good) and Portman (much less good). Do you think it’s worth discussing Cassidy Collins?

  17. 17.

    Raven Onthill

    May 17, 2017 at 8:33 am

    @David Anderson: But all it would take would be six Democratic defectors, plus Lieberman. Cassidy would likely support his own compromise, Manchin’s a squish and I don’t trust Leiberman. I think four Democratic Senators willing to go along with a half-bad bill might be found, and even a half-bad bill would still be a bad bill.

    Is there a better outcome here than just letting the whole thing die?

  18. 18.

    sherparick

    May 17, 2017 at 8:36 am

    I think “Cassidy-Collins” is another example of the Village creating a Chimera of a “compromise” and when it fails as the result of an overwhelming “No” from the Senate and House Republican leadership and caucuses, then the Village will say “Both Sides” are to blame and that liberals and people are mean when they get upset about losing health insurance and the care it pays for.

    For the following reasons, I see this proposal going no where.

    The majority of the House and Republican caucus not only want to repeal the Affordable Care Act, they also want to defund Medicaid and take the dedicated tax money that goes for Medicare and Social Security away from benefits and toward funding more and permanent tax cuts for the .01% (Medicaid, Medicare, and Social Security cuts will create bigger space under reconciliation for permanent tax cuts, thereby avoiding the 10 year expiration rule.) Although you will rarely see this reported by the beat sweeteners of the NY Times political desk, Paul Ryan and Mitch McConnell have made it clear that this is their goal. This “achievement,” along with flooding the Federal judiciary with right-wing trolls, is why they will put up with Trump’s corruption and occasional treason. For Paul Ryan, the goal as always is to make the U.S. a giant “Galt’s Gulch,” except there will be a Church cross along with the dollar sign. Ryan shares this goal with the Republican Donor class (families Koch, Hendricks, Menard, Mellon-Scaife, DeVos, Prinz, Walton, Mercers, etc. etc.). For McConnell, it is just about making that donor class happy and crushing the Democrats and the people they represent.

  19. 19.

    Baud

    May 17, 2017 at 8:37 am

    @Raven Onthill:

    plus Lieberman.

    Wait, what?

  20. 20.

    David Anderson

    May 17, 2017 at 8:45 am

    @Raven Onthill: Lieberman has not been in the Senate since 2012.

    To get to 60 means the following Senators are the minimum Democratic coalition: Manchin, Tester, Heitkemp, Donnelly, MacCaskill, Baldwin, Brown, Graham (all Senators from states that Trump won). I can understand not trusting Manchin (although he is still batting above average compared to what a generic senator from WV would be expected to vote https://projects.fivethirtyeight.com/congress-trump-score/) but if Baldwin, Brown, MacCaskill are all on board with Kaine and Durbin also vouching for the bill, it won’t be a shit sandwich.

    That assumes no Republican defections and if you think Ted Cruz, Mike Lee and Rand Paul won’t grand stand, you’re analysis differs from mine on fundamental aspects.

    One of the things to note in the 2017 Democratic Senate caucus is how few defections there have been except on the most parochial of interests. The Democratic caucus is coordinating and working together. There would be a core group of trusted liberal validaters who are saying this is a decent enough bill. I’ll trust them. At that point, Democrats will probably deliver 20-25 votes to get the bill out of the Senate with 65+ votes after Republican defections.

  21. 21.

    low-tech cyclist

    May 17, 2017 at 9:12 am

    The thing I worry about is what happens AFTER the Senate passes Cassidy-Collins, assuming that happens.

    Does the bill go to the House as a different bill from the AHCA? Or do they try to merge C-C and AHCA in conference?

    If the latter, then forget it. The bastard child that comes out of conference will be a disaster, and that bastard child will have no trouble passing the House, and Mitch will bend the rules to get it through the Senate.

    If the former, then the House will take it up, mangle it, pass the mangled version, and there’ll be a conference. Same deal from there as the previous paragraph.

    Seriously, I’m trying to see how this works out in a way that even mostly preserves the gains of the ACA. If the Senate could pass legislation by itself, there might be an argument for C-C, but it can’t.

  22. 22.

    Steve LaBonne

    May 17, 2017 at 9:17 am

    I do not trust any Republican, and especially not Collins. And there is zero chance of both houses passing anything but an awful bill. So my response to this trial balloon is:
    1. No
    2. NO!
    3. HELL NO!!!!!

  23. 23.

    Another Scott

    May 17, 2017 at 9:17 am

    @Raven Onthill: This is kinda where I am. Discussions are fine, but actual votes are extremely dangerous.

    I’ve pointed this out before (and gotten push-back before), but I’m convinced that anything that hurts the PPACA that can be spun as “bi-partisan” (via even one Democratic vote) is toxic to Democrats. The choice for voters in the fall of 2017, in 2018, and in 2020 has to be stark. No “both-sides”, no “they’re just as bad”, no “there’s no difference”. Yes, no matter what reality is, too many will try to spin things that way, but we can’t give them any ammunition on that front.

    We know the House wants a horrible bill. We know the Senate leadership wants a horrible bill. Both of them want to destroy Obama’s legacy. The way to protect that legacy, and healthcare for tens (and even hundreds) of millions of people is to flip the House and Senate. Not to try to make some bill from a horrible political party better that, in the process, will make that job harder.

    Resist! Shut down the Senate until they come to their senses and do their jobs and protect the Constitution.

    My $0.02.

    Cheers,
    Scott.

  24. 24.

    Another Scott

    May 17, 2017 at 9:23 am

    @low-tech cyclist: And we all know that when the GOP is in control they have a habit of throwing things in the conference report that only become known later.

    They cannot be trusted.

    Cheers,
    Scott.

  25. 25.

    Raven Onthill

    May 17, 2017 at 3:22 pm

    @Baud: sorry, relied on quick, careless research.

  26. 26.

    Raven Onthill

    May 17, 2017 at 4:32 pm

    I think planning on Republican defections is poor strategy; in the House, at least, the squishes invariably vote the radical party line. On the Democratic​ side, breaches of party discipline are routine.

  27. 27.

    TenguPhule

    May 17, 2017 at 4:37 pm

    The only Democratic response to Cassidy-Collins should be two middle fingers.

    And their plan should get an even worse reception.

  28. 28.

    Raven Onthill

    May 17, 2017 at 4:42 pm

    Then again, “Former Sen. Joe Lieberman (I-Conn.) is among the candidates President Trump is considering for FBI director, the White House said Wednesday.”

    Groan.

  29. 29.

    Elizabelle

    May 17, 2017 at 4:47 pm

    @Another Scott: Agreed! No touching the ACA until we have a better Congress with moar Democrats. It is coming.

    I don’t trust these Republican weasels with anything. And why help them with trying to softpedal their true natures, now that their constituents are woke.

    Leave the ACA the fuck alone.

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