Republicans claimed victory as their Obamacare-replacement bill that pundits pronounced dead a few weeks ago passed the House of Representatives.
Many conservatives say the bill is a step in the right direction, but they dispute the idea that is a true repeal of Obamacare, the GOP’s signature campaign promise for the last seven years. Although Obamacare is collapsing as premiums rise and insurers flee certain areas, it leaves much of the structure of Obamacare intact.
The legislation is a modified version of the measure that House Speaker Paul Ryan (R-Wisc.) dramatically pulled from the House floor on March 24. The House narrowly approved the legislation yesterday afternoon on a vote of 217 to 213. All of the 193 Democrats who showed up to vote, voted “no.” There were 20 Republicans voting "no."
Americans “suffered with Obamacare,” a triumphant President Trump said in the Rose Garden. “I went through two years of campaigning, and I’m telling you, no matter where I went, people were suffering so badly with the ravages of Obamacare.”
With the passage of the revamped proposed “American Health Care Act,” “your premiums, they’re going to start to come down,” he said. “Your deductibles … were so ridiculous that nobody got to use their current plan – this nonexistent plan that I heard so many wonderful things about over the last three or four days.”
After that, I mean, it’s – I don’t think you’re going to hear so much. Right now, the insurance companies are fleeing. It’s been a catastrophe. And this is a great plan. I actually think it will get even better. And this is, make no mistake, this is a repeal and replace of Obamacare. Make no mistake about it. Make no mistake.
Trump added, “very importantly, it’s a great plan. And ultimately, that’s what it’s all about.”
Now the legislation goes to the Senate where it faces an uncertain future.
Senate leaders don’t like that the measure has not been scored by the Congressional Budget Office, which means it isn’t clear how much it will cost. Nor are they happy that the bill was rushed – in their view – through the House.
Sen. Rand Paul (R-Ky.) praised the conservative House Freedom Caucus for improving the bill but said it’s still a bad piece of legislation.
But what I’m still concerned with is, this’ll be the first time that Republicans have affirmatively put their stamp of approval on a program where federal money, taxpayer money, is paid to insurance companies. … And it boggles my mind how that became a Republican idea.
As much as the former presidential candidate dislikes the current bill, he acknowledges it is salvageable.
It’s going to take a little bit of work to get me to a yes vote, but I do have an open mind. I mean, there’s not been a louder voice up here for repealing Obamacare. I really want to repeal it. I just don’t want to replace with Obamacare-lite, or another federal program. The programs they put in place will be there forever. So the refundable tax credit, which is a subsidy by another name, will be there forever. And this — these buying — these high-risk pools they want to create, Republicans used to hate the idea. They hated the idea when they were called risk corridors, and there were giving money to insurance companies. They were bailouts, when it was a Democrat idea. Now that it’s a Republican idea, they keep sweetening it up.
Democrats say that Republicans who voted for the bill just signed their own political death warrants, a prediction that is both premature and unlikely.
House Minority Leader Nancy Pelosi (D-Calif.) said lawmakers who voted “yes” were being made to “walk the plank” by President Trump.
"So if they vote on it — just bringing it up is not good — if they vote on it, the minute they cast that vote they put doo-doo on their shoe. A tattoo on their forehead," she said. "And they have to explain it to their children, at some point they have to explain to their children what they did to make America sick again."
"And then, say they pass it," she added. "Even worse, they really have to be accountable for it. And it's largely unpassable in the Senate, so they walk the plank for nothing. Thank you, Mr. President."
What’s in the bill that cleared the House? (ABC News has a helpful, if biased, analysis of the bill.)
Deal-sweeteners that helped get the bill passed include $8 billion to help subsidize people with preexisting conditions in state high-risk pools, and the creation of a "patient and state stability fund" to help low-income Americans.
The bill does good, patient-friendly things.
It expands health savings accounts, an unmitigated good that incentivizes personal responsibility. It eliminates the Medicare surtax on wages and the Medicare tax on investments.
The bill has elements of economic rationality about it. It allows states to permit insurers to charge more for covering preexisting conditions. It rolls back Medicaid expansion in 30 states and allows states to impose Medicaid work requirements. And it blocks Medicaid funds from going to Planned Parenthood.
The bill also does bad things.
Republicans claim the bill ends the individual mandate but in reality the measure merely puts a new gloss on it. It imposes a surcharge, i.e. a penalty, for coverage lapses, which is a mandate. This is the beating heart of Obamacare and it’s still in there.
It continues the grotesque market distortions that are part and parcel of Obamacare. It forces insurers to allow young adults to stay on parents' plans until age 26. It prevents insurers from imposing lifetime or annual limits on coverage. It ends Obamacare premium subsidies, a very good move by itself, but then offers refundable tax credits instead which are subsidies by another name, as Sen. Paul noted.
Getting rid of the communist Trojan Horse that is Obamacare is proving to be difficult.
The underlying political problem with any effort to gut Obamacare is that Republicans can’t be trusted to make the right arguments. They are surprisingly economically illiterate.
Most Republican lawmakers refuse to challenge the leftist argument, repeated many times by Barack Obama and other socialist levelers, that health care is a “right.”
The most glaring recent example of this kind of intellectual cowardice comes from so-called conservative commentator Ben Stein. Stein is a very, very intelligent man. He knows universal health care will destroy America, but he doesn’t care.
Stein appeared on Neil Cavuto’s show this week to discuss close personal friend Jimmy Kimmel’s heart-wrenching televised monologue the other night about his newborn son who was born with a dangerous heart defect and needed emergency open-heart surgery. No one with blood coursing through his veins who watched it could fail to be moved as Kimmel passionately discussed his personal anguish about a loved one.
But then Kimmel transformed into a leftist demagogue, as Charles Hurt wrote in the Washington Times. Kimmel raged against President Trump’s proposed cuts to the National Institutes of Health because somehow one day children might be affected.
“Let’s stop this nonsense,” Kimmel said, making a pitch for universal health care. “This isn’t football; there are no teams. We are the team — it’s the United States. Don’t let their partisan squabbles divide us on something every decent person wants.”
Yes, that’s right. He just had a kid and the kid nearly died and he wants you to know that if you are not for bloated federal bureaucracy, socialized medicine, higher taxes and tons of more debt piled onto your grandchildren, then you are not a “decent person.”
Stein picked up on Kimmel’s emotional blackmail and took it further.
It is a basic American right to have decent health care. That is a basic right. We’re in a very, very rich country. We have 650 billionaires. We have tens of millions of millionaires [sic]. We can take care of our own and the idea that any parent who sees his child born with a serious defect will think, my God, I might not be able to afford to keep my child alive, is abhorrent to everything it means to be an American.
As long as (real) conservatives fail to confront this ugly, un-American premise that your own personal misfortunes constitute an unlimited moral claim on the services and property of others, they will lose.
Leftists understand that morals-based, emotional arguments tend to prevail over bean-counting and abstractions.
Conservatives need to learn to say no to the endless demands to redistribute the wealth of Americans and back up what they say with the mountains of compelling arguments available to them.
If they don’t stand up now, we may be stuck with Obamacare or something like it forever.