Obamacare

Perception is reality. . .

Featured image for a few weeks. Then, something happens and perception changes. I agree with John that the failure of the House to pass Obamacare replacement legislation this week doesn’t necessarily mean GOP House members won’t be able to pass important legislation on other fronts. Health care legislation represents a special challenge because it is so complex, because the stakes are so high, and because Obamacare screwed things up so badly. However, »

House Leadership Pulls Health Care Bill

Featured image It became apparent this afternoon that the health care bill promoted by Republican leadership in the House did not have enough votes to pass, and the bill was pulled by Speaker Paul Ryan, despite President Trump’s earlier insistence that a vote be held. Based on the Washington Post’s account, it appears that Trump acquiesced in the decision. “‘We just pulled it,’ he said.” Inevitably, commentators will play the perceptions game: »

Trump demands Friday vote on Obamacare

Featured image My mantra on health care reform has been that it’s more important to do it right than to do it fast. President Trump disagrees. He insists that the House vote on Speaker Ryan’s (and his) flawed legislation tomorrow. After negotiations broke down today, Trump delivered an ultimatum: Pass the bill tomorrow or I’m moving on from Obamacare repeal. Congress can repeal and replace Obamacare even if the president moves on. »

Trump and Ryan still coming up short on AHCA [UPDATE — vote canceled]

Featured image Normally, when a new president and a House Speaker engage in heavy-duty arm-twisting over a piece of legislation, and they have a big enough majority to withstand 21 or 22 defections, the legislation passes the House. That’s all the more true if the legislation pertains to a vital issue and the president and the Speaker reasonably perceive that its defeat will have major adverse political consequences for them and their »

Tom Cotton nails it on the AHCA

Featured image Sen. Tom Cotton announced today that he will not vote for the American Health Care Act in its present form. He released the following statement: Despite the proposed amendments, I still cannot support the House health-care bill, nor would it pass the Senate. The amendments improve the Medicaid reforms in the original bill, but do little to address the core problem of Obamacare: rising premiums and deductibles, which are making »

Can Obamacare be killed?

Featured image Can an entitlement program be killed? That seems to me the question implicit in the unfolding drama over the repeal of Obamacare. With their majorities in Congress and Obama in the White House, Democrats forced the passage of Obamacare without a single Republican vote. The party discipline they displayed was impressive to observe. In the style of the Roman captives paying their respects to the emperor Claudius, the Democrats who »

Ryan ready to alter repeal plan, but in which direction?

Featured image Speaker Paul Ryan acknowledged today that his health-care proposal must change to pass the House, and said he is prepared to change it. As the Washington Post points out, this seems like a departure from Ryan’s earlier position that his proposal presented lawmakers with a “binary choice” and could not be altered significantly. According to the Post, Ryan did not say what changes to his plan are under consideration. Nor »

Tom Cotton rejects the parliamentarian dodge

Featured image I have written about how congressional Republicans are subscribing to the view that key parts of Obamacare cannot be repealed through “reconciliation” — i.e., without 60 votes. This view — reflected in the House “replacement” legislation — holds that the GOP cannot repeal the price-hiking, competition-destroying regulations that form the core of Obamacare because the parliamentarian, pursuant to the Byrd Rule, won’t allow such repeal through the budget reconciliation process. »

The limits of Speaker Ryan’s high-mindedness

Featured image Yesterday’s CBO report on the House GOP Obamacare replacement plan caused me to wonder: What kind of a political party front-loads reform legislation with pain — in this case, higher premiums — and backloads it with benefits — here, lower premiums and budgetary savings? The answer is, a political party led by Paul Ryan. The Speaker believes in legislating to fix problems in the long-term and, while waiting for the »

Tom Cotton sees through GOP wishful thinking on Obamacare replacement

Featured image Sen. Tom Cotton continues to speak more sensibly about Obamacare repeal than any legislator I knew of. Last week, he argued that the GOP is moving too fast on the matter. He stated, “I would much sooner get health care reform right than get it fast.” Considering the stakes for the country and for the Republican Party’s future, it seems difficult to disagree this common sense proposition. Today, Sen. Cotton »

CBO analysis suggests GOP “replacement” plan is politically unsustainable

Featured image The Congressional Budget Office (CBO) has issued its cost and coverage estimates for the House Republican Obamacare replacement legislation. CBO estimates that the bill would raise the number of people without health insurance by 24 million within a decade, but would trim $337 billion from the federal deficit over that time. The report is here. This passage (at page 3) jumped out at me: Starting in 2020, the increase in »

The parliamentarian dodge

Featured image I wrote here about how congressional Republicans are subscribing to the view that key parts of Obamacare cannot be repealed through “reconciliation” — i.e., without 60 votes. This view holds that the GOP cannot repeal the price-hiking, competition-destroying regulations that form the core of Obamacare because the parliamentarian, pursuant to the Byrd Rule, won’t allow such repeal through the budget reconciliation process. I took issue with that view. First, the »

Speaker Ryan vastly overstates his case

Featured image Speaker Paul Ryan says his proposal to repeal and replace Obamacare is “what good conservative healthcare reform looks like.” He adds: It repeals Obamacare’s taxes; it repeals Obamacare’s spending; it repeals Obamacare’s mandates. It creates a vibrant market where insurance companies compete for your business. Where you have lower costs, more choices, and greater control over your healthcare. And it returns power—this is most important—this returns power from Washington back »

One family’s Obamcare tale — mine

Featured image My wife is French. She has French health insurance. However, because health care is so expensive in the U.S., the French insurance now covers only about the equivalent of $300,000 in treatment and services rendered here. After that, my wife would have to go to France to continue being covered. The insurance policy will pay the cost of getting to France, but who wants to be shipped overseas, while suffering »

Will the House GOP Obamacare replacement accelerate the death spiral?

Featured image Sen. Tom Cotton says “I think we’re moving a little bit too quickly on health care reform.” He explains: This is a big issue. This is not like the latest spending bill that gets released on a Monday night, [passed] on Wednesday and everybody goes home for Christmas, and we live with it for nine months. We’re going to live with health care reform that we pass forever, or until »

Is GOP Health Care Bill a Disaster? No

Featured image Peter Nelson, my colleague at Center of the American Experiment, is one of the country’s leading experts on health care policy. On the Center’s web site, he urges conservatives to take a deep breath and understand the constraints that Congressional Republicans are working under. In particular, a full repeal of Obamacare must get through the Senate, which means it must get 60 votes. There are only 52 Republican senators. Therefore, »

Who will own the Obamacare “replacement”?

Featured image If you answered “the Republicans,” you are right. If you answered the Senate parliamentarian, you are crazy. It makes no sense, therefore, for the Senate parliamentarian to have a say in the replacement of Obamacare. Yet, congressional Republicans are effectively granting the parliamentarian a veto. In so doing, they are ensuring that the Obamacare replacement will be sub-optimal at best and, more likely, disastrous. Here’s the background. Republicans won’t have »