Shrouded in secrecy, GOP health plan finally unwrapped; governing crisis now on full display

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Steve’s Take:

The healthcare goals Pres. Donald Trump articulated in his address last week to a joint session of Congress marked a new record high for policy specifics. But as was been pointed out by the mainstream media, he had set the bar awfully low.

Since his address, the GOP began playing hide and seek with a draft of the healthcare bill, inviting everyone to wonder: what are they hiding, and why? Why the information vacuum after months of GOP promises from the White House and Congress for specifics.

Monday (March 6, 2017) arrived and for most of the day we still didn’t know whether Obamacare would be repealed entirely, repealed and replaced with an entirely new “Trumpcare,” or molded into something resembling an “Obamacare-Lite.”

Then that evening arrived and Paul Ryan finally unlocked the door to the House Ways and Means Committee and the Energy and Commerce Committee’s secret vault somewhere in the basement of Congress and unveiled the House GOP’s bill to repeal and replace the universally detested Affordable Care Act.

Until today, top Republicans opted to keep the bill “under lock and key.” The bill, styled as the “American Health Care Act,” is actually a pair of bills that, if passed, includes proposals to eliminate mandatory health insurance for all Americans and defund Planned Parenthood, just for openers.

Literally minutes after it was released from bondage, Rep. Justin Amash (R-MI) attacked the bill from the right, calling it “Obamacare 2.0,” according to Mother Jones–a certain and ominous sign of big governing problems the White House and Congress face in undertaking the mammoth task of providing healthcare for all Americans with a substantively new, alternative program.

Here are a few of the bill’s crucial elements:

  • Insurers still won’t be able to discriminate against people with pre-existing conditions, so long as they maintain continuous coverage.
  • The Medicaid expansion would continue until 2020, when enrollment would “freeze,” and states would be barred from adding new, low-income Americans to the rolls. Medicaid would also include per capita funding limits.
  • The bill would replace all Obamacare subsidies with age-based tax credits. However, those earning above $75,000 annually wouldn’t be eligible for them.
  • Those people with little or no income subject to federal or state tax would qualify nonetheless for tax credits and receive a “refundable tax credit” they could use to buy health insurance.

The unmasking of the bill sets the stage for a vicious intra-party debate with momentous consequences as far as many political careers are concerned at the polls two years from now. As The New York Times points out, even after Trump’s election in November, it’s far from certain that Republican lawmakers will be able to get on the same page and repeal the Affordable Care Act, passed back in 2010.

Pres. Trump, a newcomer to the American legislative process, recently remarked that, “Nobody knew that health care could be so complicated.” And on another occasion he told GOP governors he may have “underestimated Obamacare.”

Here’s a taste of what Trump, Paul Ryan, and Mitch McConnell are up against in their various roles if they are to succeed in governing wisely and effectively in this monumental task.

New polling Monday showed that most Americans want to fix the Affordable Care Act, rather than gut it, as Republicans have long promised, says The Los Angeles Times. Fully 68% of Americans want to keep what works and fix the rest, while just 32% preferred the GOP’s repeal and replace approach according to polling from Hart Research. In addition, the polling shows most Americans–including 54% of Pres. Trump’s voters–have a favorable view of the Medicaid system, which would face steep cuts under the Republican plan.

At the same time, the powerful Koch conservative faction has unleashed a huge advertising campaign to encourage Republicans to keep their promise of “full repeal” of Obamacare. And “You promised” is the slogan of the group Americans for Prosperity, said to be hosting a rally Tuesday (March 7, 2017) outside the Capitol to pressure GOP lawmakers.

On the other hand, and typical of the intra-party GOP debate, on Monday, four Republican senators–Rob Portman of Ohio, Shelley Moore Capito of West Virginia, Cory Gardner of Colorado and Lisa Murkowski of Alaska–signed a letter saying a House draft that they had reviewed did not adequately protect people in states like theirs that have expanded Medicaid under the Affordable Care Act.

Three conservative Republicans in the Senate–Mike Lee of Utah, Rand Paul of Kentucky and Ted Cruz of Texas–had already expressed reservations about the House’s approach. In combination, the conservatives and moderates have more than enough votes to bring it down in the Senate, according to The Times.

Then there is the role of the White House, with Mr. Trump expressing only fuzzy goals for how to repeal the ACA and improve the nation’s healthcare system. On Capitol Hill, lawmakers and their aides are waiting to see whether he uses his platform, still chiefly his Twitter account, to press hesitant Republicans to back the House plan.

For the most part, analysts remain skeptical about the GOP’s goal of repealing Obamacare and replacing it with a new healthcare system that costs less but provides just as much coverage. Most expect millions of Americans to lose insurance under the GOP plan, according to The Times.

Meanwhile, Democrats are rather enjoying what at times resembles a flying circus act, with GOP career politicians taking turns doing their high-wire, high-stakes best to reach the other side of this legislative mess unscathed.

Steve's Take: #Democrats are enjoying the #GOP #Obamacare high-wire act Click To Tweet

Whether it’s the Dems pointing to the millions of Americans likely to lose their health insurance under Trumpcare or lobbing Russian intrigue bombs on a daily basis, somewhere in their new abode in DC, I’m willing to bet that Mr. and Mrs. Obama are watching and shaking their heads in eye-watering disbelief.