There was an presidential communication regarding a potential change in Republican legislative strategy:
A statement by the President: pic.twitter.com/SnJXbXN8lT
— Real Press Sec. (@RealPressSecBot) June 30, 2017
How would this work?
The simple answer is that the House and Senate would pass updated versions of H.R. 3762, the Restoring Americans’ Healthcare Freedom
Reconciliation Act of 2015. And then President Trump would sign. Here is how the CBO describes it in January 2017:
would repeal portions of the Affordable Care Act (ACA)—eliminating, in two steps, the law’s mandate penalties and subsidies but leaving the ACA’s insurance market reforms in place. At that time, CBO and JCT offered a partial assessment of how H.R. 3762 would affect health insurance coverage, but they had not estimated the changes in coverage or premiums that would result from leaving the market reforms in place while repealing the mandate penalties and subsidies….
The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026….
And then once there is a guarantee of 18 million more people being uninsured in the first year of implementation, Congress would pass a Replace bill. I think there is a presumption that Democrats would cave quickly and supply a significant number of votes for a very conservative bill in order to mitigate damage. It is a threat to shoot the hostage and then perhaps allow first aid to be administered.
There are several major mechanical problems with this idea. The most important one is money. Health care, as you may have noticed, is expensive. Covering people is expensive. And the first people to be covered are more likely to be more expensive than the last people to be covered. A repeal bill takes most of the current pay-fors (higher taxes) and burns them to the altar of Grover Norquist. A Replace bill would need to conform to Pay-Go rules which means every dollar on healthcare spending must be met by a combination of increasing taxes or offsetting cuts somewhere else in the budget. Replace in a Pay-go world is a major challenge for a party that is not allergic to raising taxes. It is an incredible challenge for a party that won’t raise taxes at all.
There is a far more important mechanical issue. There are not 218 votes in the House nor 50 in the Senate for a straight repeal without a replacement. As the CBO reported in January, the template Repeal bill would lead to 18 million people losing insurance in the first year and then 32 million by the end of the budget window. The AHCA and BCRA tempered those losses. Even with those tempered losses, these bills are polling at the same level of popularity as Nickelback. Democrats have an incredible club to beat Republicans on while motivating Democratic base voters for the mid terms now. That club gets even bigger on a Repeal only vote. That club does not go away if Replace is a multi-month legislative process that produces a massively underfunded bill that brings coverage losses down to “only” AHCA or BCRA levels.
I think that two-stepping Repeal and then never really replacing could have happened in the first three weeks of January in a mad rush to have legislation to be signed in the evening of January 20, 2017. But that ship has sailed.
Nora
And once again this president shows he has no concept of how government works. No doubt it seemed simple to him: if the replacement part is so hard, leave it out and just repeal. Of course it only seems simple if you think on the most superficial level, but I just described Trump, so there we go.
Patricia Kayden
Democrats have no incentive to play along. Trump Care is a huge mess and there is zero benefit to Democrats to play any part in passing it.
Yep. And this may be why Republicans didn’t just repeal the ACA. Sadly for them, their attempt to replace the ACA is just as bad as a straight repeal.
JPL
Fortunately there are moderates left, who will not let that happen. At least, I hope so.
Jeffro
Have any reporters, ever, made any attempts to pin down these GOP cowards on what’s so incredibly horrible about Obamacare? I mean, I know some Republican senators and the Mango Madman have said it’s “collapsing” – could we get a little better reporting on the fact that, well, it’s NOT?
low-tech cyclist
@JPL:
As a number of commentators have said, it’s going to come down to safety in numbers. If we’re counting on 3 Republicans to vote against while 49 vote for, it ain’t happening – one of the three will be bought off somehow, because Moderates Always Cave. As long as there are a dozen or so Republicans who would rather vote against it if there are already >3 votes against it, Mitch won’t bring it to a vote because the herd will feel safe in its herd-ness, and there won’t be 40 votes for the bill.
Jeffro
I’m also kind of surprised there isn’t more reporting on how desperate the GOP is to destroy Obamacare, and how that links to their upcoming plans for “tax reform” (quotes intended).
If they leave Obamacare alone, they could pass tax cuts that sunset in 10 years and that’s oodles of money for their puppet masters…speaks volumes that they have to have it all, All, ALL.
Bruce K
@JPL: I don’t have much faith that there are that many principled moderates remaining in the GOP, but on the other hand, there have got to be at least half a dozen for whom a straight repeal would be the career equivalent of chugging a cup of the Jonestown punch.
low-tech cyclist
@Jeffro:
The question to them should be, “then you’d be OK with Obamacare if there were cheap, easy fixes to keep it from collapsing?”
If yes, then “the Dems have fixes, are you ready to work with them to fix it? If not, why not? If so, why aren’t you already doing it?”
If no, then “that really means you’re against Obamacare even if it doesn’t collapse. Why?”
The Dangerman
Would repeal only still allow it to be called Trumpcare? Because that’s the most important part of this bill for the Nectarine Narcissist.
Bruce K
@The Dangerman: Don’t underestimate the appeal of nullifying something Obama did. Obama made the cheeto look like a fool in public, and that’s a thousand times worse than potentially killing a million people.
Betty Cracker
Do you think there’s any chance these asswipes cobble together a compromise bill and vote on it today before leaving for the holiday?
The Dangerman
@Betty Cracker:
Asswipes have a useful purpose in our lives; these clowns are as useful as a hemorrhoid.
As for chances, isn’t calling for “repeal only” a sign of surrender?
Doug R
It’s not like you to say sorry
I was waiting on a different story
youtube.com/watch?v=HILqmhgsCN0
JPL
@Betty Cracker: I thought the plan was to send the bill to the CBO before voting. They could be feeling desperate to get something done, before Trump explodes or implodes though.
Shalimar
At least someone told them how press secretaries work since their last message about Syria. Press releases are supposed to say “Statement by the President” or whoever else the spokesperson works for who is issuing the statement, not “Statement by the Press Secretary.”
Kay
That’s a great admission the GOP made there- Republicans are wholly dependent on Democrats to pass anything useful – they have a far Right President and a far Right Congress yet “health care” turns completely on Democrats?
Why not just hire Democrats?
japa21
@Jeffro: The problem with that, of course, is that it would be so blatant and obvious that they were only caring about the 1% that it would rebound against them. This is why they get so upset when it is pointed out that this is really a gift to the rich disguised as a healthcare bill.
Chris
@Kay:
Is it too early to repeat once again that “Democrats are the only people in Washington treated like they have any agency or responsibility?”
Amir Khalid
It must be outright impossible for a party that wants to slash taxes — on the rich, at least — to almost nothing.
It’s been clear all this while that enacting the tax cuts is the Congressional Republican party’s real goal here. But it’s painted itself into a tactical corner again and again these few months. Maybe it will realise it can’t repeal Obamacare this way. Then it might start trying to attach those big tax cuts to some other legislation that would harm the public more surreptitiously than a repeal of Obamacare. (I know, not bloody likely, given how much they want Obamacare repeal in itself, as partial catharsis for their hate of all things Obama and Democratic.)
Kay
They’re telling is the only thing they’re capable of is destroying something. It’s funny in a way- all those silly ass-kissing stories about how Trump is a “builder”- what has he built? It’s all demolition.
DBaker
Question: How does a straight repeal without a replacement pass muster with the Senate Parliamentarian? The tax cut probably does, but what about the other ACA provisions?
low-tech cyclist
At the time, it seemed like they were still expecting Trump (or at least someone on his team) to set the agenda. The notion that he was so incompetent that he couldn’t even hire competent people and actually delegate responsibility to them hadn’t sunk in with them yet. If they knew then what they know now, we’d have been in deep shit.
Enhanced Voting Techniques
So Trump care is failing so Donny needs to lash out and bully someone I see.
DBaker
@Kay: That’s always been true – the Freedumb Caucus and the “moderates” (nothing really moderate about them) have totally different goals, for example, the Freedumb caucus will not vote for debt ceiling increases while the moderates will. Trump was always going to have a tough time governing and by going hard core GOP rather than “reaching across the aisle” for things like infrastructure projects made their administration’s job impossible.
In some ways, the money/power guys are fine if nothing happens in Congress since their real power lies with the courts and in the states. That is how they have increased their power since the GOP took over the house in January, 2011.
oldster
“I think that two-stepping Repeal and then never really replacing could have happened in the first three weeks of January in a mad rush to have legislation to be signed in the evening of January 20, 2017. But that ship has sailed.”
And I give a lot of credit to a million pink knitted hats that women all over America (and the world) wore on Jan. 21.
We’ll probably never know, I guess. But I firmly believe that this opening act of the Resistance genuinely shocked the Trumpists, and rocked them back on their heels.
Tim C.
@oldster: Damn right it did. They never expected to win and they still haven’t come to grips with the cost of winning. Cleek’s Law is fun when you are in the opposition and aren’t held to any kind of standard at all by your voters or media. But then it comes at a hell of a cost when you actually have to run anything. Ever see that Simpson’s episode where Homer gets elected Sanitation Commissioner? It’s like that… only so much worse.
soapidsh
It’s important to remember that Nickelback has sold more than 50 million albums worldwide.
MattF
@Betty Cracker: The current word-of-mouth opinion is ‘nope’. Senator Mitch is aiming at the window between the 4th of July and the August recess, but it’s looking less likely as time goes on. At present, they’re floating suggestions from the peanut gallery.
Bodacious
As Republicans try and ‘drown us in the bathwater’ along with government in general, I still believe that the Dem’s will hold the line. But either way, I am really hoping that the responsible Dem’s are not following the Republicans by complaining for years without formulating a solution. Which ever way this plays out, it does require the repairs that need to occur for Obamacare to succeed. There are solutions required, and I hope that the Dems are working everyday toward that goal, because at some point they will get the microphone back.
Shalimar
@soapidsh: And Trump got 62,984,825 votes. He’s more popular than Nickelback.
Raven Onthill
Groan, er, croak.
Another damnfool idea.
Applejinx
This is extremely dangerous for anybody who actually uses health care rather than just hoping they don’t get sick or injured.
I’m pretty sure Democrats will allow ‘repeal and not replace’ for political gain. Which is appalling. But I think that’s where things stand.
Carlito Brigante
@Nora: Trump truly is clueless. And does not care to get a clue.