Posted on 03/22/2017 6:10:56 PM PDT by jazusamo
It's floor vote eve, and many creatures are stirring in the House. In a potentially dramatic eleventh-hour gambit, Republicans are considering pushing further than they initially thought possible to repeal additional Obamacare regulations within the American Health Care Act (AHCA). Remember, part of the reason that the current bill does not attempt to tackle certain issues is that under "reconciliation," all provisions must be germane to the budget. That's why buying insurance across state lines and tort reform aren't included, for example. For this same reason, unraveling some of Obamacare's "essential health benefit" regulatory mandates was seen as beyond the scope of Senate rules, and therefore relegated to phases two and three of the overall 'repeal and replace' strategy. But Utah Sen. Mike Lee tells the Washington Examiner's Philip Klein that the Senate Parliamentarian -- the official responsible for making the relevant determinations about various provisions' acceptability under the rules -- informed him that regulatory repeal would not necessarily be out of order :
Sen. Mike Lee, R-Utah, said on Wednesday that the Senate parliamentarian has told him that it may be possible for Republicans to push harder on repealing Obamacare's regulations than the current House bill, which contradicts the assertion by House leadership that the legislation goes after Obamacare as aggressively as possible under Senate rules. "What I understood her to be saying is that there's no reason why an Obamacare repeal bill necessarily could not have provisions repealing the health insurance regulations," Lee said in an interview with the Washington Examiner, relating a conversation with parliamentarian Elizabeth MacDonough about reconciliation he had on Tuesday...
Conservatives such as Lee have argued that Republicans should fight harder to argue that the regulations, which have a clear budgetary impact, can be passed through reconciliation. But House leadership and supporters of the bill have countered that the legislation already goes as far as possible. House Speaker Paul Ryan spokeswoman AshLee Strong, when asked about this by the Washington Examiner last week, said "We've worked closely with the Senate to carefully craft the bill to repeal and replace the law to the full extent allowed under the rules." But having met with the parliamentarian, who plays a key role in advising the presiding officer of the Senate over what's in bounds during reconciliation, Lee is more convinced than ever that this is not true.
Klein cautions that this isn't an indication that such changes would be permissible; only that they are not automatically out of bounds, depending on how they are written and presented. As a result of this new information (more on that in a moment), House leaders say they're open to amending the legislation further to strip out additional regulations that they previously thought could not pass procedural muster. If this happens, the House Freedom Caucus could be brought on board after all. Also via the Examiner:
Previously, House leaders have argued that the regulations could not be nixed, because doing so would blow up the bill in the Senate, where Republicans will have to pass the measure under restrictive rules to enable it to clear with a simple majority. But a House leadership aide told the Washington Examiner that on Wednesday, Republicans received new information from the Senate, indicating that axing the regulations wouldn't automatically doom the bill from being considered on an expedited basis...House Speaker Paul Ryan's office is now more open to nixing the regulations, known as "essential health benefits." Under Obamacare, all insurance policies must include ten categories of benefits, such as maternity care and preventive coverage, that make policies more comprehensive but also make it costlier for individuals who would prefer cheaper plans with fewer benefits.
A few thoughts: (1) How could Republicans just now be learning this? Either they didn't do their homework, which would be an astonishing dereliction, or this is a real procedural stretch. My suspicion is that the latter is the case, but even if that's so, it's still certainly worth exploring. (2) That House leaders are potentially moving in this direction tells me that President Trump and Speaker Ryan aren't confident that they have the requisite head count for tomorrow's scheduled floor vote. (3) Based on multiple conversations with top House sources in recent weeks, I can report that they really believed they were already pushing the edges of what they could accomplish within the Senate rules with the existing AHCA. Perhaps as a sop to Lee and House conservatives, they're willing to tack on these additional changes to get the legislation through the House with relative ease, then really buckle down with the parliamentarian to make sure that the legislation isn't ruled out of order on the Senate side. This very well may require stripping these new provisions back out, in addition to a host of anticipated amendments during the Senate process.
As such, if pushing as far as conceivably possible under the reconciliation framework on the House side won't endanger the success of the overall bill, why not go for it -- especially with this new, vague guidance from the parliamentarian? If the rule-enforcer reviews the changes as decides they're not kosher, fine. Take them out for the sake of saving the bill. But give it a shot. Repealing a number of Obamacare's 'mandatory minimum coverage' regulations through the legislative process, as opposed to through executive actions by the HHS Secretary ("phase two"), would almost certainly help reduce premiums even further. (4) If these non-trivial adjustments are being made tonight and tomorrow, wouldn't that render the forthcoming new CBO score of the bill basically useless? And if CBO needs to review yet another major iteration of the legislation, how can tomorrow's floor vote proceed on schedule? (5) How will the GOP moderates -- remember them? -- feel about all of this?
Urgent: Big meeting among House GOP moderates in the leadership suite right now on #healthcare
This is NOT WHAT WE WANT!! This is BS!!
I think this is just the beginning the real healthcare plan...it will be changed...
Well, it’s still has to go throught the Senate, then back through the House and then to reconciliation and to the House and Senate again.
But the irony IS a nice touch (or rather: Touche!).
I don't believe it! Postpone the damn vote, get the bill's language absolutely right, have it properly reviewed (with errors/shortcoming caught & corrected) AND THEN, AND ONLY THEN, HAVE THE VOTE.
People like Rove ridicule it because they can afford their premiums......no matter what they cost. Normal people don’t have that luxury. Until January when hubby turned 65 our premiums were more than our house payment. Not Obamacare, private. But when I checked Covered California Obamacare was the same price. Ridiculous.
the problem is not insurance. IT IS HEALTHCARE COST.
REMOVE THE SUBSIDIES . GO TO THE ER!! Save trillions! I don’t want to subsidize DOCTORS!!
Also true....
Trump has something up his sleeve on this. I can feel it.
He gets Ryan to introduce a bill that will get conservatives pissed and Democrats denouncing it as "Trumpcare."
OK fine...
Now the Dems have pissed away whatever chances they had at least getting RINOs on-board and splitting the House conservatives against Trump, thereby getting the base to be mad at Republicans and endanger their chances at holding Congress.
But read the piece in the NY Post. The Dems are so beholden to their left-wing kook base that they won't do anything to help or work with Trump.
Now Trump has been pushed to the right, he's free to work on (I hope) a conservative bill that repeals Obamacare but yet get the people who lost coverage immediate help.
Once Obamacare is repealed and more market-based options are available to healthcare, there's no stopping the economy. Because after that comes the tax cuts. More regulations reined in or repealed.
The answer to the problem is, and can only be, a return of the medical industry to its historical 3-4% of GDP.
How?
Enforce the damn law — specifically, 15 USC and State Consumer Protection laws. Enforce them in a simple fashion: Everyone must post a price and everyone pays the same price; any sort of hiding, collusion, cost-shifting or similar is met with indictments, prosecution and prison for consumer fraud and racketeering along with violations of the Sherman, Clayton and Robinson-Patman acts.
https://market-ticker.org/akcs-www?post=231928
The Freedom Caucus, by INSISTING upon doing the repeal & replace right, will be saving Trump & us from a 2018 ELECTORAL BLOODBATH that would result if the ABOMINATION KNOWN AS RYAN-CARE became law.
I hope President Trump can appreciate that.
I hope so too, that's what is desperately needed.
“Phase 1” MUST include provisions that actually give people the ability to reduce their insurance premiums as soon as possible — not at some time in the future.
Trump said he wasn’t going to let people die in the streets. I know he’s always said repeal and replace. So if he dismantles a little here while implementing a little there — It’s okay with me. If he’s setting up a long con to pin this on the house leader and he wants it to fail — well I’m okay with that too.
Trumps strategy is 2 magnitude higher then most of us. I gave up because he’s beaten my skepticism and doubt every time and came out FTW!.
You do realize that physician fees are a small part of the healthcare costs. Most of us warned about all this stuff. Liberal physician academic and national organizations are not representative of where most physicians.
1. He said the House leadership hasn't reached out directly to the Freedom Caucus members at all.
2. He gave Trump a grade of "A+++" for his work in negotiating with Ryan and the various House members.
It’s amazing what Hospitals have tacked onto my 2 operations I’ve had over the past 5 years. The tests they order and read is where they really like to screw people. You should be able to atleast shop hosptials for CT scans and stuff like that. So you just don’t get whacked with ridiculous bills .
I am adamant about implementing something that reduces premiums immediately (or no later than the 2018 renewals that come out in late 2017) because it will be a political disaster if they don't.
everything in the medical system is inflated by 80% or more than is should be in a free market. You can literally fly to japan to get an MRI cheaper then here for less than it will cost, possibly for less than your copay...
All that stuff they say cannot be done through reconciliation was put in using reconciliation.
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