Tuesday, July 18, 2017

Obamacare Gets A Stay of Execution . . . For Now

With the announcement that Mike Lee of Utah and Jerry Moran of Kansas have decided to vote "no" on a motion to proceed, there are now four Republican senators who have gone on record as saying they cannot support the healthcare bill "in its current form." Susan Collins of Maine and Rand Paul of Kentucky are the other two. Mitch McConnell had no choice but to pull the bill. With or without John McCain, he just didn't have the necessary 50 votes to pass it and send it back to the House.

In a desperate, last-ditched effort designed to mollify conservatives, McConnell even introduced a simple repeal only measure, only to be shot down again. This time it was Collins, Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia who did the shooting. The Affordable Care Act, for the time being, is still alive, much to the chagrin of Donald Trump, who apparently thinks 48 votes out of a possible 100 is "pretty impressive by any standard." But then this is a man who still thinks getting 306 electoral votes and losing the popular vote by 3 million qualifies as a landslide.

No doubt proponents of the ACA can breath a sigh of relief. For the last few months they've been sweating it out wondering if President Obama's signature piece of legislation was destined for the ash heap of history. But as I cautioned readers last month, this thing isn't dead yet. Trumpcare, or whatever you want to call it, is still on life support. True, things aren't looking good right now for its prospects, and if I were a betting man, I'd say the odds of Obamacare remaining the law of the land are pretty good. I should also point out that, apart from a few notable exceptions, my track record as a betting man isn't all that impressive. So you probably won't see me on a flight to Vegas anytime soon.

But getting back to repeal and replace. The sticking point for the "moderates" appeared to be the phasing out of Medicaid. States that took the Medicaid expansion are deeply concerned about what will happen to both their budgets and to the millions of people who depend on the entitlement for affordable healthcare. The latest CBO puts the number of people who would lose healthcare if the GOP bill became law at over 20 million people. A "yes" vote from these senators would've been extremely hard to justify to their constituents. Even harder to justify would've been an outright repeal with no replacement.

As for the conservatives, anything but a complete and total repeal of Obamacare they viewed as a betrayal of the pledge they took when they ran for office back in 2010. For them, the bill didn't go nearly far enough. Kicking millions of people off of Medicaid isn't cruel, they say; it's called freedom. McConnell tried - unsuccessfully it appears - to thread the needle between both factions ever since Paul Ryan dumped the House bill into his lap.

So this is where we stand. With the August recess just a few weeks away - and that's factoring in the Majority Leader's decision to keep the Senate in session two additional weeks -  Republicans still don't a bill that can get 50 votes. Without passing a healthcare bill that deals with the taxes that Obamacare imposed on the top 2 percent, the prospects of getting tax reform done this year look bleak. In other words, this could be one of the least effective Congresses we've had in years, which isn't saying much given what the GOP has done since it took the House in 2010 and the Senate in 2014.

The sad and undeniable truth is that Republicans are paying dearly for being the party of No for the last eight years. Now that they've got total control over all the functions of government, they seem incapable of governing. So lame is this party that McConnell had to change the rules of the Senate just to get Neil Gorsuch confirmed as a Supreme Court justice. Can you imagine the clusterfuck that would've occurred if they'd succeeded in an outright repeal of the current healthcare law, only to find out that they need at least 60 votes to pass a new one? Building the pyramids without stones would've been child's play by comparison.

But while the GOP spins its wheels trying to convince the nation that they know what they're doing, Democrats should not sit idly by reveling in their counterparts' misery. What they ought to be doing - and what I've been urging for months - is coming up with the necessary fixes for the law. While the ACA is not even close to being in a death spiral as its harshest critics would have you believe, it is far from perfect. Trump and McConnell, now that they've been thwarted in their attempt to repeal the law, will do their damnedest to tie it around the neck of every Democrat running for office next year. If Dems think they can run simply as the party that opposes Trump and "saved" Obamacare, I've got some bad news for them. That strategy already failed brilliantly. Voters want solutions and a party that doesn't offer any typically loses elections, be they midterm or presidential.

If I were a Democratic senator, I'd get off my butt and mosey on down to the offices of Susan Collins, Lisa Murkowski, Rob Portman, Dean Heller, and the few "moderates" still left in the GOP and take them out to lunch. Then at lunch I'd say something like, "Why don't we coauthor a bill to repair the ACA and strengthen it so everyone can have affordable healthcare and we can reduce premiums on middle-class families?" I might even get a yes or two for my efforts and, before you know it, we'd have a bi-partisan solution to a problem that besets both parties.

But then what am I saying? I'm way too smart to be a senator, Democrat OR Republican. So let's just forget it, okay?

1 comment:

Slbe11004 said...

When they affirmed over and over again the positive aspects of the ACA (kids 26 and under insured, no excluding pre-existing conditions, and several GOP governors excepted expanding Medicaid in their states), they effectively made it impossible to straight repeal. That's why they're trying to see if the "gentle" two year delay until they figure the whole thing out will fly. It won't.