Trump demands Friday vote on Obamacare

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. However, the ultimatum looks like it will have its intended effect — or at least half of it. It looks like there will be a vote on Friday.

To be fair, passing the Ryan-Trump measure doesn’t preclude doing repeal and replace right. The Senate can pass its own measure, after which the House will get another crack at the matter. Something good might still emerge, especially if Vice President Pence blows off the Senate parliamentarian.

Still, the better starting point the House comes up with, the better a final product is likely to be. Passing a placeholder may be better than passing nothing, but it’s hardly ideal.

Is the bill that will be voted on tomorrow better than a placeholder? It’s hard to say. I know the bill has been improved in an attempt to placate the Freedom Caucus. The “essential benefits” mandate has been eliminated, for example. This means insurers can offer policies that don’t include mental-health treatment, wellness visits, and maternity and newborn care, etc. That’s an improvement.

But I can’t tell from the reporting I’ve seen which mandates remain. I know that the one requiring coverage of individuals with preexisting conditions is still in the legislation, but apparently others remain as well.

Presumably, House members will get a handle on what’s in the new legislation before they vote tomorrow, if they do vote. But they won’t have enough time to make a realistic assessment of how the legislation likely would affect premiums and deductibles, which I think is the big question.

In the end, the vote would more likely to come down to whether the Republicans want to appease President Trump and Speaker Ryan and keep the repeal and replace process moving, or whether they want to take a time-out from health care and hope that the issue can be revisited later on in a more thoughtful manner.

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