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You are here: Home / Anderson On Health Insurance / Alexander-Murray; outcomes and distribution of concessions

Alexander-Murray; outcomes and distribution of concessions

by David Anderson|  December 6, 20178:16 am| 27 Comments

This post is in: Anderson On Health Insurance, Election 2018, All we want is life beyond the thunderdome

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The Washington Examiner had a piece earlier this week on how House Republicans want another pound of flesh to pass Alexander-Murray:

A top House Republican said Democrats need to make concessions that make them “wince” in order to get a vote on two Obamacare stabilization bills….Cole, a member of the House’s whip team, said the two bills are going to be a tough sell to Republican as they’re currently written.

“If that is what you want to get through, you had better put something with it that Republicans like because in the package right now there isn’t anything commensurate with what they are being asked to give up,” he told reporters on Monday.

This is a fundamental misreading of leverage and policy preferences.

There are four major elements in Alexander-Murray. The first is a two year appropriation for Cost Sharing Reduction subsidies. Secondly, outreach activities would be sent to the states instead of HHS. Finally there would also be reasonable changes to 1332 requirements and window-dressing changes to Catastrophic plans.

What happens if CSR is appropriated when measured against current reality instead of CBO baseline?

  • Significant money (CBO estimates $194 billion) is pulled out of the individual market
  • Senator Collins has an easier time voting yes for the tax bill
  • Late October, the following occurs:
    • Headlines “ACA rates drop for 2019….”
    • Subsidized buyers go from seeing really good deals to normal deals (from Avalere)

That is what would happen if Alexander-Murray passed this afternoon with no modifications.

Why would Democrats want or need to make further concessions?

Making it easier for Senator Collins to vote for the tax bill increases the probability that thirteen million more people are uninsured according to the CBO. That is not a Democratic policy preference.

Muddling the messaging that the Republican Party owns healthcare is not a Democratic political preference going into the midterms.

Making insurance more expensive for subsidized buyers is not a Democratic policy preference.

Walking away from an Alexander-Murray bill that funds CSR produces acceptable outcomes for Democrats. I do not understand the analysis that suggests that Democrats are the ones who need to offer concessions for the outcomes that Alexander-Murray delivers.

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Reader Interactions

27Comments

  1. 1.

    rikyrah

    December 6, 2017 at 8:20 am

    Uh uh
    No giving into sociopaths ?

  2. 2.

    aimai

    December 6, 2017 at 8:26 am

    These people are profoundly sociopathic as well as stupid. They literally can’t figure out what people are talking about when they are talking about politics, policy, human lives. Their only motivation is spite and they are proud of that so they willingly display their cards because, to them, the humiliation of their opponents, the use of the legislative process to humiliate and crush the other party, is the real goal. They think its so natural and normal that they can’t imagine the couterparties goals.

  3. 3.

    kindness

    December 6, 2017 at 8:35 am

    Earlier Murray said she wouldn’t offer up or support the bill if the Republican Tax cuts for Gazillionaires package passed. I hope she holds to that. All too often there are Democrats who think crawling on their belly will bring concessions. It doesn’t. It just brings the mockery from Republicans that crawling deserves.

    I’m with you on this one. Democrats need to wipe their hands of this mess and let Republicans own it.

  4. 4.

    oatler.

    December 6, 2017 at 8:42 am

    @rikyrah: Tom Perez already has a semi for this.

  5. 5.

    Brendan in NC

    December 6, 2017 at 8:55 am

    Because the default Republican position is always that the Democrats need to make concessions.

  6. 6.

    Roger Moore

    December 6, 2017 at 9:04 am

    I do not understand the analysis that suggests that Democrats are the ones who need to offer concessions for the outcomes that Alexander-Murray delivers.

    It’s very simple; it’s based on the belief that problems are always caused by Democrats failing to grant the Republicans enough concessions. If that’s your default starting point for every analysis, you’ll always wind up with the same answers, regardless of the actual political situation.

  7. 7.

    Ben Cisco

    December 6, 2017 at 9:12 am

    “You gon need to help us screw you over.”

    FOH

  8. 8.

    Patricia Kayden

    December 6, 2017 at 9:32 am

    Democrats need to just walk away and not make any concessions at all. They gain nothing from making concessions which only hurt the American people (at least those who are not mega rich).

  9. 9.

    El Caganer

    December 6, 2017 at 10:00 am

    @aimai: Not fair! Spite isn’t their only motivation – there’s greed, too.

  10. 10.

    schrodingers_cat

    December 6, 2017 at 10:19 am

    @aimai: They are also ignorant and proud of it.

  11. 11.

    Major Major Major Major

    December 6, 2017 at 10:20 am

    @oatler.: he does?

  12. 12.

    oatler.

    December 6, 2017 at 10:28 am

    @Major Major Major Major:
    “:@TomPerez
    Follow Follow @TomPerez
    More Tom Perez Retweeted Sahil Kapur
    Alexander-Murray would reduce the deficit by $3.8 billion and has widespread bipartisan support. Where are you, Mitch McConnell?”

  13. 13.

    Major Major Major Major

    December 6, 2017 at 10:45 am

    @oatler.: could just be the usual deficit hypocrisy posturing nonsense that the party out of power does. At the end of the day though it’s… a retweet.

  14. 14.

    gene108

    December 6, 2017 at 10:56 am

    The chances of anything bipartisan passing are next to zero. Doesn’t matter what it is.

    Republicans want to freeze Democrats out of all legislative decision making, except to bail them out on getting a budget passed.

    The House has frozen Democrats out of legislation, since John Boehner’s day and Ryan isn’t looking to reform anything. If Republicans can’t pass a bill with only Republican votes, then it won’t come to floor for a vote, like what Boehner did with immigration reform and various jobs bills.

    Until the media accepts and reports that Republicans have broken our government and treats them like the crooks they are nothing is going to change.

    We are in a cold civil war, where the only path to restoring government is to beat the other side so badly they will not try this shit again for a few decades.

  15. 15.

    randy khan

    December 6, 2017 at 11:00 am

    The Democrats’ position should be pretty simple: Not passing this costs you Collins’ vote on your tax bill. We don’t see anything we would need to give.

  16. 16.

    piratedan

    December 6, 2017 at 11:00 am

    I have no issue if Dems tell these sociopathic a-holes to fuck off

  17. 17.

    randy khan

    December 6, 2017 at 11:02 am

    @gene108:

    Of course, the Republicans seem to be unable to get enough votes from their caucus to keep the government open, so that gives the Dems leverage. I know my minimum price for that would be pretty high, starting with DACA and CSRs.

  18. 18.

    Shalimar

    December 6, 2017 at 11:10 am

    Not sure why Democrats even speak to Republican colleagues at this point. Whatever you negotiate with their representative, the rest of them will always ask for more. They even do it to Ryan and McConnell. The Republican caucus will not agree to anything.

  19. 19.

    The Moar You Know

    December 6, 2017 at 11:27 am

    The House has frozen Democrats out of legislation, since John Boehner’s day and Ryan isn’t looking to reform anything.

    @gene108: Far longer. The “majority of the majority” rules the GOP has been running under in the House used to be called “the Hastert rule” until Hastert (Republican House Majority Leader under Bush) got caught paying hush money to the teenage boys he’d raped.

    I still call it “the Hastert rule” and when people ask me who Hastert is, I tell them what I just wrote above. It shuts the Republicans up for a few minutes. You take what you can get these days, right?

  20. 20.

    Origuy

    December 6, 2017 at 11:32 am

    Some Republicans won’t vote for it if there is anything that Democrats like. Their whole goal is to make Democrats unhappy.

  21. 21.

    The Moar You Know

    December 6, 2017 at 11:36 am

    Of course, the Republicans seem to be unable to get enough votes from their caucus to keep the government open

    @randy khan: They’re OK with that. They probably won’t be after a month. It’ll fuck me good and hard, but at this point we need to let the GOP shut the government down and then sit on our hands and do nothing. When the press asks, just refer them to Trump’s tweet that he didn’t want Dems involved. Nothing else, just that. I see zero reason to help them at this point. They’ve been pulling this shit since the 1990s, Dems have saved the day every time, and all we’ve ever gotten in return is abuse and blame. Fuck that. Their voters need to be taught that their choices have adverse consequences.

  22. 22.

    Villago Delenda Est

    December 6, 2017 at 11:37 am

    The Freedumb Caucus is dumb.

    Film at 11.

  23. 23.

    What Have The Romans Ever Done for Us?

    December 6, 2017 at 11:46 am

    @Brendan in NC: Pretty much this. Also, they don’t want to give Collins what they promised in return for her vote and are looking for a way to blame the Democrats for welching on their agreement.

  24. 24.

    Kelly

    December 6, 2017 at 11:50 am

    So the R’s abandon CSR payments without thinking it through and accidently give me a better deal on my Obamacare. Sorta related: R’s pass a corporate tax cut at 2 am in a big hurry without thinking it through and the AMT provision will accidentally INCREASE corporate taxes by maybe $300 billion. I’ll take my wins where I can get them but counting on the R’s screwups makes me a bit tense.

  25. 25.

    Raven Onthill

    December 6, 2017 at 11:57 am

    Advice to Democrats: don’t make deals with fascists.

    Sheesh.

  26. 26.

    randy khan

    December 6, 2017 at 12:00 pm

    @The Moar You Know:

    In general, I don’t think there’s any reason to help Republicans. I will make an exception for keeping the government open (because I want the government open) so long as it’s the Republicans who are making the concessions, not the Democrats.

  27. 27.

    gene108

    December 6, 2017 at 12:49 pm

    @The Moar You Know:

    What Boehner instituted is worse than the Hastert Rule. If there are 240 Republicans in the House, the Hastert Rule would allow a bill to come to a vote, if it could get 121 Republican votes and the balance with Democrats.

    Boehner wouldn’t let a bill come to the floor for a vote, unless it could get 218 Republican votes, at the minimum, i.e. the bill only needs Republican votes to pass, thus freezing the Democrats out of the legislative process completely.

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