Posted on 03/09/2017 7:28:42 AM PST by SeekAndFind
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, the first bill that has been unveiled is intended to be passed under the reconciliation process, which requires only a bare majority. Only Obamacare provisions that have a budgetary impact can be repealed in the reconciliation bill. Other measures will have to follow afterward. Peter writes:
Critics do have reason to complain and demand change, but the current response recklessly sets up the expectation of a full repeal among those in the conservative base, an expectation that Congress cannot meet. Upon failing to meet this expectation, the base may become needlessly demoralized and distrustful.
***
Republicans can repeal a substantial portion of Obamacare with a simple majority through the budget reconciliation process, but this process only allows Republicans to repeal those portions with a budgetary impact.Repealing just items with a budgetary impact leaves in place the insurance regulations that are presently driving up health care costs and spinning many state insurance markets into death spirals. Specifically, the reconciliation process can’t repeal Obamacare’s essential health benefit requirements that force people to buy very generous and, therefore, very expensive health plans. Most troublesome, reconciliation cannot repeal insurance regulations that force insurers to sell coverage to everybody, regardless of whether they responsibly maintained coverage. This allows people to wait until they are sick before gaining coverage.
***
A key problem is that repealing the individual mandate without repealing the requirement on insurers to guarantee coverage increases the incentive to wait to buy coverage until you need it. That’s why the House plan imposes a 30 percent penalty on people who buy coverage who failed to maintain continuous coverage. This penalty has been panned by critics, but anyone who studies health insurance markets will tell you something like this is necessary, so long as Obamacare regulations remain in place.
The good news is that the reform process is beginning, not ending. GOP leaders say there are two more bills yet to come, and we have a Republican president whose administration can reverse those portions of the Obamacare disaster that came into being through regulations. Which is many of them.
[A]nother point too often lost in the debate is the role the Trump administration will play in complementing Congress’s work. Though certain regulations cannot be immediately repealed, the Trump administration can modify regulations through the rule-making process. For instance, the Department of Health and Human Services (DHHS) can authorize a much more affordable set of essential health benefits. DHHS has already proposed important changes to stabilize individual insurance markets.
Peter thinks that the Medicaid provisions in the current bill represent a very important set of reforms, and will address that aspect of the legislation soon. In the meantime, conservatives shouldn’t be depressed over what we have seen so far:
Much of the rest of the bill is open for reasonable debate among conservatives—such as those refundable tax credits to buy health insurance—and critics are certainly entitled to their strong opinions and encouraged to share them.
But it’s dangerous if, to foment a public outcry to force changes to the bill, critics instill within the conservative base a sense that full repeal is possible if not for those weak-kneed Republicans elected to Congress. If conservative leaders set unattainable expectations, they will create a perception of failure in Congress that will deflate the conservative base.
Read the whole thing at the link.
It’s a dumpster fire that the GOPe cooked up.
The Democrats did not have 60 votes to pass it.
Use the same kind of underhanded skullduggery to repeal it.
If the entire Obamacare bill could be passed in a reconciliation bill why cannot the entire bill also be repealed in a reconciliation bill? If those parts that do not have budgetary impact cannot be so repealed those same parts should not have been able to be passed through reconciliation.
Does President Trump and his cabinet believe that all Americans should pay for “Gender reassignment surgery”?
“In particular, a full repeal of Obamacare must get through the Senate, which means it must get 60 votes.”
Which ain’t gonna happen.
So the thing has to be dismantled piecemeal.
Which is what they’re doing.
Everyone relax.
IT WAS NOT PASSED WITH 60
USE THE SAME TRICKERY TO REPEAL IT
It passed with 60 votes. What in the Sam Hill are you lying about now?
I’ve yet to see ANYONE who supports RINOCare. Not Ryan. Not the House. Not any conservative media. No one.
Except Trump.
And he is hedging his bets by allowing this is a step by step process.
But we must remember that Trump wants a replacement to ObamaCare so we must not be surprise when he signs off on some lame-ass version of ObamaCare 2.0
So the thing has to be dismantled piecemeal.
Nothing is being dismantled. It’s a total fairy tale. Rolling back medicare in 2020? During a POTUS election year? Nonsense. Never going to happen. This is Gang of 8 all over. We are being lied to.
Personally, I think there's a simple process for dealing with this disaster -- and this is a perfect time for it:
1. Let the GOP leadership in Congress do whatever the hell they want with their "health care reform." They can reform it, repeal it, sit on their @sses and leave ObamaCare in place, etc. It doesn't really matter.
2. Have some enterprising business and medical professionals -- you know, the kind of people who have been MAKING AMERICA GREAT for more than 200 years -- come up with a medical insurance or cost-sharing plan that is governed (or not) by the regulations in one or more states and saves its members a ton of money because it doesn't meet any of the ObamCare or RyanCare requirements.
3. Tell Congress, the U.S. Department of Health and Human Services, and the insurance industry lobbyists that own Congress to go f#%& themselves.
Ten bucks says Donald Trump would be 100% behind this alternative approach.
Go back and review the skullduggery used to pass it.
The author a friend of Ryan’s? Whatta load.
Repeal, tear, shred, mutilate, burn, hang, shoot, gas, drown, stab, then burn and drown it again for good measure.
RE: T WAS NOT PASSED WITH 60
USE THE SAME TRICKERY TO REPEAL IT
__________________________
Could you kindly remind us again how the trickery was used?
That's a little over the top.
It didn’t you dingbat. It passed with 60 votes. There was a small funding bill later that used reconciliation, which was allowed as it was a tax piece. But the O-care got 60. Read em and weep.
60-39 December 24, 2009
I don’t have to. I know what happened. You go review it. It got 60 votes in the Senate Dec 24, 2009 and was signed into law.
Up to a $14K subsidy to the upper middle class, including some of the subsidy reaching up to $290K in income?
It is a horrible new and newly expanded entitlement that will balloon the debt and deficit of the US guv, as well as a yet bigger wrench distorting and thus increasing the cost of what healthcare is delivered into the US. In that way, not too different from how the US involvement in student loans has bloated college costs while building an upper-middle-class entitlement monster.
The Affordable Care Act, deemed “Obamacare” by some, received no Republican votes in either the Senate or the House of Representatives. In the Senate, the bill was passed with a total of 60 votes, or 58 Democratic Party votes and 2 Independent Party votes.
They gutted a House bill that had nothing to do with healthcare so they could claim it originated in the House.
Skullduggery.
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