D-Day for ‘Obamacare’ repeal aka Trumpcare bill in the House

It is decision day (D-Day) in the House.

The radical far-right GOP House Freedom Caucus is making eleventh-hour demands for more draconian measures to the GOP’s “Obamacare” repeal bill aka “Trumpcare 2.0” (soon to be 3.0?) ahead of the vote scheduled for today, only because it is the anniversary of President Obama signing the Affordable Care Act into law. The post-policy nihilists of the GOP only do propaganda, not policy.

The New York Times reports, Key to Health Vote, Hard-Line Conservatives Push New Cuts:

Hard-line conservatives in the House will meet Thursday morning with President Trump to hammer out changes to the House bill to repeal the Affordable Care Act, pressing to eliminate federal requirements that health insurance plans provide a basic set of benefits like maternity care, emergency services and wellness visits.

What the Freedom Caucus wants in the GOP health-care bill, and why it’s not getting it:

The Congressional Budget and Impoundment Control Act of 1974 dictates that not just anything can be passed by the “reconciliation” process; matters that are “extraneous” to the budgetary nature of the bill are excluded.

House leaders, including Speaker Paul D. Ryan (R-Wis.), are insisting that any provisions rolling back the ACA’s essential health benefits are indeed extraneous. And not only are they extraneous, Ryan argued Wednesday, but if the House adds them to the bill, the Senate couldn’t just strip them out — it could no longer consider it as a privileged reconciliation bill needing only a simple, Republican majority to pass.

Translation: the Senate cloture rule requiring 60 votes to end debate and advance to a vote on the bill will apply, and Democrats could comfortably filibuster this bill in the Senate.

[A]ccording to several Freedom Caucus members and GOP aides, what Ryan and White House officials — including Vice President Pence — have offered the Freedom Caucus is a commitment that the Senate will seek to add a repeal of the essential health benefits to the House bill once it arrives in that chamber. If at that point the Senate parliamentarian rules that the provision is extraneous, it will simply be dropped and the rest of the bill will remain. (So the Freedom Caucus goes along with this charade and does not get what it wants in the end. These guys are losers).

More: Health-care overhaul faces an even bigger challenge in the Senate. Why should any House member go out on a limb to vote for this terrible bill when they know it is certain to be defeated in the Senate? They will hang Speaker Paul Ryan and Donald Trump out to dry to preserve their own seat.

Back to the Times:

House Republican leaders called off a meeting with all members of their party earlier Thursday at the Capitol, placing their faith in a House Freedom Caucus negotiating session at the White House with President Trump. If the president and the conservatives can reach an agreement, a vote on the House floor, still scheduled for Thursday, can move forward.

“My party intends to bring forth an agreed-to bill that we will be able to show to the American people, and we will own it,” said Representative Pete Sessions, Republican of Texas and the chairman of the Rules Committee.

* * *

But the prospect of a vote on Thursday on a newly revised bill exposed Republicans to criticism that they were moving recklessly in a desperate bid to get their plan passed. Representative Jim McGovern, Democrat of Massachusetts, pleaded with Republicans to slow down.

“This health care repeal affects millions upon millions upon millions of Americans,” he said. “Don’t jam a disastrous bill through the House with patched-up fixes.”

The emerging power of the Freedom Caucus, a group that has been historically marginalized in policy-making but a thorn in the side of leadership, is one of the surprises of the rushed health care debate. The Freedom Caucus has been empowered by the addition of one of their own, former Representative Mick Mulvaney, to the senior White House staff as budget director, and Mr. Trump’s disengagement from policy details coupled with his intense desire to score a win after a rocky start to his presidency.

* * *

But in trying to satisfy conservatives, the Trump administration and House Republican leaders risked jeopardizing support for the bill among more moderate Republicans.

Mr. Obama stepped into the fray on Thursday with a lengthy defense of his signature domestic achievement — and a call for bipartisan improvements.

“I’ve always said we should build on this law, just as Americans of both parties worked to improve Social Security, Medicare, and Medicaid over the years,” he wrote on the seventh anniversary of signing the measure into law. “So if Republicans are serious about lowering costs while expanding coverage to those who need it, and if they’re prepared to work with Democrats and objective evaluators in finding solutions that accomplish those goals – that’s something we all should welcome. But we should start from the baseline that any changes will make our health care system better, not worse for hard-working Americans.”

As the crucial vote approached, party leaders appeared to be short of a majority, as moderate Republicans continued to move away from the bill.

Representative Jaime Herrera Beutler, Republican of Washington, said Thursday that she would oppose the bill. “We can do better than the current House replacement plan,” she said.

And late Wednesday night, Representative Charlie Dent, Republican of Pennsylvania and a leader of a moderate bloc of lawmakers known as the Tuesday Group, said that he would oppose the bill.

“I believe this bill, in its current form, will lead to the loss of coverage and make insurance unaffordable for too many Americans, particularly for low- to moderate-income and older individuals,” Mr. Dent said. He added that he hoped that the House could “step back from this vote and arbitrary deadline to focus on getting health care reform done right.”

* * *

The tenacity and persistence of the conservatives appeared to give them outsize influence as Mr. Ryan struggled to round up votes for the repeal bill, which faces solid opposition from House Democrats. Supporters of their bill have put their faith in Mr. Trump, whose young presidency could be badly damaged by a public and consequential loss.

“When the president calls someone and says, ‘I need your vote on this,’ it’s very hard to say no to the president of the United States when this torpedoes our entire conference, Trump’s entire presidency, and we end up losing the Senate next year and we lose members in the House,” said Representative Chris Collins, Republican of New York and a top Trump supporter in the House.

But conservative opposition was over substance, not politics. Conservatives are upset by the failure of the House bill to repeal a set of regulations in Mr. Obama’s signature health law, which require insurers to cover a base set of benefits, like maternity care, preventive services, wellness checkups and rehabilitative services. These “essential health benefits” raise the cost of insurance and prevent companies from offering stripped-down options, the conservatives say.

“How can you talk about repealing the Affordable Care Act, Obamacare, without repealing the essential health benefits?” asked Representative Scott Perry, a Pennsylvania Republican who attended the meeting with Mr. Pence.

Oh sure, they want to gut essential health care services, but these radicals are OK with this: Late G.O.P. Proposal Could Mean Plans That Cover Aromatherapy but Not Chemotherapy, and this: A winner in GOP plans to repeal Obamacare: tanning salons (got to maintain “The Donald’s” orange glow).

And how about those “white working class” voters living in poverty who voted for Trump?  The “Trumpcare 2.0” (3.0?) screws you “bigly,” as Trump would say.

“An average family making more than $200,000 a year would gain $5,640 while a family making less than $10,000 a year would lose $1,420 if Congress passes the health care plan proposed by House Republicans, according to a new analysis from the Urban Institute. How the Rich Gain and the Poor Lose Under the Republican Health Care Plan.

Screen Shot 2017-03-23 at 8.48.49 AM

The Republican plan eliminates taxes Obamacare imposed mostly on the rich, including taxes on investment income and wages above $200,000. (Cuts to other Obamacare taxes, including ones on medical devices, prescription drugs, and indoor tanning, benefit the population more broadly.)

More than 70 percent of the tax cuts, however, would go to families with incomes above $200,000 a year, and more than 46 percent would go to those making more than $1 million a year.

And then there is this: GOP health-care plan analyses: Higher deductibles, more uninsured and millionaire tax breaks:

The Center on Budget and Policy Priorities has looked repeatedly at the likely effects of the AHCA’s passage, including an earlier determination that states most likely to have backed President Trump in last year’s election would disproportionately see a reduced benefit in the form of tax credits.

On Monday, the CBPP offered further analysis using data from the Tax Policy Center. As it turns out, repealing two taxes that are part of the Affordable Care Act (Obamacare) would offer no benefit at all to people making less than $200,000 a year — and would offer the bulk of its benefits, 79 percent of the total cut, to millionaires.

3-20-17tax2-f2

Writing for Axios on Wednesday, the Kaiser Family Foundation’s Drew Altman outlined another bit of math from the Republican replacement bill. According to his organization’s calculations, average deductibles from the AHCA would be $1,550 higher than under Obamacare, an increase of more than 60 percent.

Screen Shot 2017-03-23 at 9.42.35 AM

Finally, there continues to be opposition to the GOP bill from the conservative PACs who are scoring this vote, in particular the “Kochtopus.” (Looks like our Rep. Martha McSally may get primaried for supporting Trumpcare 2.0). Koch-related groups pledge millions of dollars in help for GOP lawmakers who reject health-care bill, and Healthcare fight pits Trump against Club for Growth. Club for Growth “is letting millions of constituents know that their Representative should reject RyanCare Trumpcare.”

There is literally no good reason for anyone to support this terrible bill. The latest whip counts all show there are not enough votes to pass this terrible bill.

Call your member of Congress and senators today and tell them to oppose this terrible bill, or you will vote them out of office.

One Response to D-Day for ‘Obamacare’ repeal aka Trumpcare bill in the House

  1. NPR reported that the Freedom Caucus wants to eliminate the basic benefit package to “save money”. The basic benefit package is the guarantee that preventive services– like women’s health check-up, mammography, colonoscopy, basic physical, etc.– would be free. Encouraging prevention– instead of encouraging people to lope along with untreated symptoms — saves money and lives in the long run.

    Scrimping on health insurance and whining about the cost to keep Americans healthy– which marching forward on wasting trillions on an absurd wall– is surrealistic.