Health Care

The GOP Health Care Bill Is Just Barely Alive

HuffPost: “A day after just about everyone on Capitol Hill declared the Senate health care bill dead, the legislation once again seemed to have the tiniest bit of life, with Republicans staying late into the night Wednesday to discuss whether there was a path forward.”

“If Collins is a no vote on any form of the legislation and Paul won’t support a replacement, and Capito and Murkowski won’t support the repeal-only approach, and Lee and Moran won’t support the replacement, and it’s unclear if McCain will be back next week … Republicans simply don’t have the votes throughout all the confusing scenarios. And that’s to say nothing of Dean Heller (R-Nev.), who has been cagey all along on any form of the legislation.”

Politico: “A harsh reality is setting in among Senate Republicans: they’re extremely unlikely to repeal Obamacare in the coming days.”

22 Million Would Lose Coverage Under GOP Plan

A new CBO report says that about 22 million people would lose health insurance coverage over the next decade under the most recent revision of the Senate’s Obamacare replacement bill, The Hill reports.

“The number is slightly less than what was predicted in the original draft of the legislation released last month, but still far more than the number of uninsured under the Affordable Care Act.”

“However, the CBO did not score an amendment added to the bill by Sen. Ted Cruz (R-Texas), which would let insurers opt out of ObamaCare regulations as long as they also sell ObamaCare-compliant plans.”

Senate Still Stalled on Health Care

“A key group of Senate Republicans met late into the night Wednesday to try to salvage their health care bill, but emerged without any breakthroughs and still appeared far from finding the votes to repeal Obamacare. Still, as GOP senators left the nearly three-hour meeting, they professed optimism,” Politico reports.

Said one former aide to Caitlin Owens: “They can’t accept they’ve been promising something that is undeliverable and a bad idea for seven years.”

Exchange of the Day

President Trump spoke to Maggie Haberman of the New York Times:

HABERMAN: “Am I wrong in thinking — I’ve talked to you a bunch of times about this over the last couple years, but you are generally of the view that people should have health care, right? I mean, I think that you come at it from the view of …”

TRUMP: “Yes, yes. [garbled]”…

TRUMP: “It’s been a long time. Nothing changes. Wait till you see what we’re going to do on trade.”

HABERMAN: “Sounds like it’s going to be very interesting.”

TRUMP: “Much more interesting than anybody would understand.”

Repeal-Only Would Cause 32 Million to Lose Insurance

The CBO estimates that the GOP repeal-only health care bill would increase the number of people who are uninsured by 17 million in 2018, compared with the number under current law.

That number would increase to 27 million in 2020, after the elimination of Medicaid expansion and the elimination of marketplace subsidies, and then to 32 million in 2026.

In addition, average premiums in the nongroup market would increase by roughly 25% in 2018. The increase would reach about 50% in 2020, and premiums would about double by 2026.

Freedom Caucus May Force Vote on Repeal-Only Bill

Politico: “Leaders of the hard-line House Freedom Caucus on Wednesday evening will jump-start a process intended to force the measure — a mirror of the 2015 repeal proposal that President Obama vetoed — to the floor as early as September.”

“Their effort is unlikely to result in a bill landing on Donald Trump’s desk — many Republicans have rejected calls to eliminate the core of Obamacare without having a comprehensive replacement plan ready. But if the group garners enough signatures to trigger the floor vote, it would force many mainstream and moderate Republican lawmakers into the uncomfortable position of rejecting a repeal measure they backed just two years ago.”

Bonus Quote of the Day

“I don’t think there are 40 votes to repeal and say to the American people, ‘Well, trust us to come up with something in the next couple of years.’ I don’t think that’s a good idea.”

— Sen. Lamar Alexander (R-TN), quoted by CNN., on the proposed “clean” repeal of the Affordable Care Act.

Lawmakers Still Don’t Know What They’re Voting On

Caitlin Owens: “It’s up in the air what Senate Republicans will vote on next week, following their meeting with President Trump on Wednesday. The goal seems to be to get something passed, regardless of whether it just repeals parts of the Affordable Care Act or tries to replace them.”

“It can’t be overstated how wild it is that Senate Republicans are planning to vote on a massive restructuring of the health insurance system next week, without knowing what it will look like. And though passage of anything seems unlikely, if they do manage to pass a replacement bill, it’ll be a patchwork of last-minute compromises on top of a bill that is already massively unpopular and hasn’t been thoroughly analyzed. And Republicans will then own whatever happens under their bill.”

GOP Health Bill Holdouts Will Meet Tonight

Axios: “All of the Republican senators who oppose the Senate health care bill are meeting tonight to work out their differences — after being told by President Trump this afternoon that they need to work late into the night to get a deal. The holdouts, including moderates and conservatives, are scheduled to meet in Sen. John Barrasso’s office at 7:30 pm Eastern with the goal of getting a deal to revive the shelved Affordable Care Act repeal and replacement bill.”

However, one senior GOP aide dismissed the chances for actual progress: “This is just the death rattle.”

Trump Calls Lee to Revive Health Care Bill

“President Trump has reached out to Sen. Mike Lee (R-UT), the conservative who helped deal what appeared to be a fatal blow to the Senate healthcare bill, as part of a last ditch effort to revive the legislation,” the Washington Examiner reports.

“Lee reiterated his position that he wanted to free the market from Obamacare’s regulations in an effort to drive down premiums and provide more choices. Trump, according to the spokesman, seemed receptive.”

David Nather: “This anecdote suggests that Trump will try to convince Republican senators to revive the broader Senate health care bill when they meet for lunch at the White House today. It suggests that Trump still hasn’t grasped the big reason why Senate Republicans are stuck: They want different things, and every time GOP leaders try something to please one wing of the party, it pushes away the other.”

Why Trump Can’t Convince Anyone on Health Care

Ezra Klein: “The core problem is Trump has no idea what he’s talking about on health care and never bothered to learn. ‘Nobody knew health care could be so complicated,’ he famously, and absurdly, said. His inability to navigate its complexities meant he couldn’t make persuasive arguments on behalf of the bills he supported, and he routinely made statements that undercut the legislative process and forced Republicans to defend the indefensible.”

“Because Trump doesn’t understand the legislation or the trade-offs it made, he can’t make persuasive arguments on its behalf in public or private, and so he mostly doesn’t try. Trump and his team are not frequent presences in the public debate trying to sell the legislation they’re so keen to sign. That’s one reason the various bills routinely polled around 20 percent — without Trump using the bully pulpit to argue on behalf of the legislation, critics, terrible Congressional Budget Office reports, and news of congressional infighting filled the void.”

“When Trump does weigh in, it’s often a disaster.”

Health Care Bill Enters Zombie Phase

Rick Klein: “The GOP health care proposals are now in their zombie phase, and the undead can be hard to kill off. Perhaps that’s why President Trump is responding to major setbacks by attacking just about everybody — Democrats, Republicans and even the people who depend on Obamacare for their health insurance — if he’s serious about letting insurance markets fail now. Where he’s not assigning blame, of course, is on himself: ‘I’m not going to own it,’ the president declared.”

“That – aside from being a stunning abdication of presidential responsibility, if he’s serious — means that the White House plan is that there is no plan. The president will lunch with all Republican senators today to try to change minds one last time. But in blaming basically everybody, Trump’s own actions have given those senators no real political wiggle room. Just because Trump doesn’t have a strategy, though, doesn’t mean Republicans in Congress can’t. A failed vote next week would free up lawmakers to go rogue, and even – gasp – talk to people on the other side of the aisle.”

Sam Baker: “It ain’t over until it’s over, and there’s still some chatter bouncing around Capitol Hill about last-minute shenanigans or a Hail Mary on the Senate floor. And President Trump is sure to put some serious pressure on the moderates this afternoon when all of the Republican senators lunch with him at the White House. But unless something dramatic changes, Washington appears to be about done with the repeal-and-replace phase of the debate over the Affordable Care Act.”

A Massive Defeat for McConnell

Politico: “The failure of Obamacare repeal marks Mitch McConnell’s lowest point as Senate GOP leader. Despite having a Republican in the White House, full GOP control of Congress, and seven years of campaign promises – ‘pulling out Obamacare root and branch,’ as the Kentucky Republican famously declared – McConnell acknowledged this week that that he didn’t have the votes to even start debate on replacing the 2010 Affordable Care Act.”

“It’s a serious defeat for McConnell, and one that leaves deep bitterness among rank-and-file GOP senators, as moderates and conservatives blamed each other over who is at fault for the setback. It’s also a blow to McConnell’s reputation as a master legislator and raises doubts in the White House about what Senate Republicans can actually deliver for President Donald Trump. McConnell, like Speaker Paul Ryan (R-WI), finds himself caught between the factions in his own party. And like Ryan, McConnell hasn’t demonstrated that he knows how to resolve the dispute.”