Health/Medical
See other Health/Medical Articles
Title: Abandon ship: [4 major] Conservative groups turn on House GOP’s ObamaCare bill
Source:
HotAir
URL Source: http://hotair.com/archives/2017/03/ ... -on-house-gops-obamacare-bill/
Published: Mar 7, 2017
Author: Allahpundit
Post Date: 2017-03-07 15:01:55 by Tooconservative
Keywords: None
Views: 3078
Comments: 9
Here’s the statement from Heritage, which Matt Welch describes as the “in-house think tank for the Trump administration.” “Many Americans seeking health insurance on the individual market will notice no significant difference between the Affordable Care Act (i.e., Obamacare) and the American Health Care Act. That is bad politics and, more importantly, bad policy. “Rather than accept the flawed premises of Obamacare, congressional Republicans should fully repeal the failed law and begin a genuine effort to deliver on longstanding campaign promises that create a free market health care system that empowers patients and doctors.” I don’t believe I’ve seen one major Republican player outside the congressional leadership say they support the House GOP bill this morning — with one very important exception, and even he’s sufficiently nervous to have framed the bill as a mere starting point for “negotiation”: — Donald J. Trump (@realDonaldTrump) March 7, 2017 The whole point of this rollout, though, is that there’s not going to be negotiation. McConnell made that plain this morning in saying that they’re going to vote ASAP. The bill wouldn’t survive a free-for-all in which the disparate centrist and conservative factions within the GOP are suddenly making demands for amendments. The only way this has a chance of getting passed is via a gut check, with McConnell and Ryan practically daring the critics in their caucuses to vote no and kill the GOP’s first, and maybe best, chance at repeal. That’s why the statements from Heritage et al. are so important: Activist groups are showing wary Republicans in Congress that they’ll have some grassroots support if they defy Trump and the congressional leadership by voting this thing down. It’s the first major rebellion on the right against the administration since Trump was sworn in. And it makes his reaction important. If conservatives end up muscling him into turning against the House plan, it’ll be taken as evidence that they can do it on other policies if they act in concert. In fact, Trump’s already signaling that revisions, in the form of another “phase” of the process, might be in the offing: — Donald J. Trump (@realDonaldTrump) March 7, 2017 You can’t get to phase two unless phase one passes the House and Senate, and right now it sure looks as though the votes aren’t there. Rand Paul has already pronounced the bill “dead on arrival” and it’s hard to disagree given the volume of attacks. How do Trump and Ryan turn the momentum around amid an avalanche of criticism from both the left and right? At a minimum, Paul and Mike Lee sound like firm “no” votes in the Senate, leaving McConnell with no margin for error with the rest of the caucus. (Your move, Ted Cruz!) Health-care wonks like Peter Suderman have described the bill as a purported solution to ObamaCare that doesn’t solve anything but really just tinkers with the O-Care framework already in place to produce different winners and losers. Insurance expert Bob Laszewski, a longtime critic of ObamaCare, elaborates that the bill isn’t so much a policy solution as a political solution: Republicans know that there are no Democratic votes for it so they’ve thrown something together which they hoped might be able to draw enough votes from their own caucuses to get it through Congress. But it won’t work politically (the law overcompensates for how ObamaCare favored the poor at the expense of the middle class by favoring the better off) or as policy (the GOP’s “soft” mandate isn’t punitive enough to avoid adverse selection problems). And it doesn’t make enough Republicans happy to skate through the Senate given the GOP’s very narrow majority there. So what’s left? I think it was conservative wonk Philip Klein who got to the heart of the problem for right-wing groups like Heritage. By merely fiddling with the controls of ObamaCare, writes Klein, the GOP has conceded that liberalism won the argument on health care: It still rests on the premise that the federal government should play a significant role in subsidizing and regulating insurance markets in an attempt to ensure broad coverage. Thus, despite the political failures that resulted from Obamacare, the clunky legislation still moved the ball ideologically to the left. The argument isn’t over whether the government should require all insurers to cover people with pre-existing conditions. The argument is about whether the government should pay for it by forcing healthy people to purchase insurance under the threat of a penalty, as Obamacare does, or by threatening anybody who doesn’t maintain continuous coverage with a 30 percent late fee, as the GOP prefers. Liberals, in other words, have won the central philosophical argument, and Republicans are reduced to fighting over the mechanics. Two great mysteries remain. One: How long will Trump continue to support the bill as the outcry grows on the right and left? The only hope it has of passing is if he goes all-in and demands that congressional Republicans pass it, but even that probably won’t work to scare Paul and Lee back into line in the Senate. (They were both reelected just a few months ago, remember.) All it’ll take is one more defector and Trump will have suffered a humiliating loss. That being so, how much does he really want to invest in selling this thing? And what happens if CBO comes out with a score showing that the bill would reduce coverage while increasing the deficit? That’s a steep political price for the White House to pay for backing a bill that probably can’t pass. Two: If the bill goes down, what replaces it? Conservatives want a clean repeal, but I think they’re kidding themselves. The public doesn’t like that idea; returning to the pre-ObamaCare status quo, even temporarily, may be a harder sell for the GOP than the new bill is. Another alternative is to back the Cassidy/Collins bill, which would let Democratic states keep ObamaCare if they like, but if you think Trump and Ryan are getting grief for their new plan today, imagine the grief they’d get from the right for a bill that explicitly preserves O-Care in some jurisdictions. Update: Hoo boy. Now Tom Price is calling the bill a “work in progress”? Wasn’t supposed to be. — Manu Raju (@mkraju) March 7, 2017 Update: Here’s Paul declaring the House bill DOA. Heritage Action and the Club for Growth and Americans for Prosperity and FreedomWorks are all thumbs down? Who said conservatives don’t stand up to Trump anymore? “In many ways, the House Republican proposal released last night not only accepts the flawed progressive premises of Obamacare but expands upon them. Ronald Reagan once said, ‘Government’s view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it.’ The AHCA does all three. Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster – is imploding fast! Don't worry, getting rid of state lines, which will promote competition, will be in phase 2 & 3 of healthcare rollout. @foxandfriends Ultimately, it doesn’t do much to foster the development of a free market system. Under GOPcare, individuals would not be able to take insurance with them from job to job, because tax credits would not be available to people who have an offer of job-based insurance. They would not be able to purchase whatever plan they want, because the federal government will still be dictating what has to be in insurance policies, making insurance more expensive then it needs to be. If this bill passes, everybody would have to get their insurance either through government, their employer via tax subsidy, or be left to purchase government-designed health policies using federal subsidies… Tom Price calls health care bill a "work in progress" and "an important step" but won't say it's the "administration's bill"
Post Comment Private Reply Ignore Thread
Top • Page Up • Full Thread • Page Down • Bottom/Latest
#1. To: Tooconservative (#0)
Of course not. They're waiting to see how much pork Trump is going to offer them for their vote. They're in for a surprise.
Sen. Rand Paul Says GOP Healthcare Plan is ‘Dead on Arrival.’ And Maxine Waters will praise Rand Paul as she gains another ally against Trump.
Rand Paul is right.
You are incorrect. They are not supporting it because of the new entitlements. The democrats are the ones who want the pork. At least that is about 96 percent true. My take. Rand Paul isn't looking for more pork. Maybe your representative Mcasshole is.
Rand Paul is right. On Wednesday, Politico reported that the House Freedom Caucus, an influential group of House conservatives, was considering whether to give its official endorsement to Sen. Rand Paul’s Obamacare Replacement Act (S. 222). The report indicated that word from the Freedom Caucus about an endorsement could come as soon as next week. To this conservative health policy analyst, this development raises some serious concerns. Although not as objectionable as the Collins-Cassidy Patient Freedom Act, Paul’s legislation contains several features that, if widely embraced by conservatives, could lead to strategic and policy missteps going forward.1. Doesn’t Repeal Obamacare While the Paul bill provides an alternative vision for health care, it does not repeal most of Obamacare. The bill does repeal virtually all of the law’s major mandates: the individual and employer mandates to obtain insurance, the guaranteed issue and community rating regulations, the essential health benefits, and other various insurance mandates that have raised premiums. However, the bill does not repeal either of Obamacare’s new entitlements—the subsidies for exchange health insurance, and the massive Medicaid expansion to the able-bodied—leaving in place nearly $2 trillion in spending over the coming decade. Likewise, the bill does not repeal any of the Obamacare taxes used to fund that spending, except those associated with the individual and employer mandates. Paul’s office may view the bill as a successor and complement to the reconciliation bill that Congress passed, but President Obama vetoed, in 2016. That bill would have repealed the law’s entitlements (after two years), and its tax increases (effective immediately), but not its regulations. Paul’s office might argue that his bill repeals the critical portions of Obamacare not included in last year’s reconciliation bill—the major insurance regulations—while providing a replacement vision to go beyond repeal. But that position assumes last year’s reconciliation bill will be the starting point for this year’s discussion—and it may not be. Politico reported Tuesday evening that Republicans were having difficulty figuring out how to square Medicaid reform with Obamacare’s massive Medicaid expansion. Likewise, some Republicans have discussed not repealing the law’s tax hikes. On these controversies, the Paul bill, by omitting any provisions relating to the entitlement expansions and tax increases, contains a deafening silence. Paul’s bill repealed the individual and employer mandates, even though last year’s reconciliation measure also effectively repealed them. Why didn’t his bill repeal all the other tax hikes and spending increases as well? Is it because Paul, whose home state expanded Medicaid to the able-bodied under Obamacare, wants to avoid taking a position on whether to keep that expansion?2. Tax Credit Slippery Slope The Paul bill does provide tax credits for health coverage, but largely of the non-refundable kind, an arcane but important difference. Paul’s bill provides a $5,000 tax credit to individuals who contribute to Health Savings Accounts (HSAs), but only to the extent such individuals have income tax liability. The Paul bill does include a refundable tax credit for health insurance premiums, but the refundable portion of the credit only applies up to the limit of an individual’s payroll taxes paid. Many Republican health reform plans would offer refundable tax credits to individuals in excess of tax liabilities, which represents pure welfare/outlay spending—the government issuing “refunds” to people with no net income or payroll tax obligations. By contrast, the Paul bill would ensure that credits only apply to individuals with actual payroll and income tax obligations. However, this critically important distinction will likely be lost on many members of the press—and perhaps members of the Freedom Caucus themselves. “House Freedom Caucus Endorses Tax Credits” will blare the headlines. Having endorsed tax credits once, the pressure on Freedom Caucus members to then go further and endorse the House leadership plan for refundable tax credits will be immense. Put simply, the slippery slope to endorsing a major spending package in the form of refundable tax credits starts with the Paul bill.3. Budget- Busting Health Care Giveaways While the Paul bill includes no outlay spending— its incentives all come via tax cuts—those incentives are numerous, and costly. The legislation would supplement the current, uncapped exclusion on employer- provided health insurance with a new, uncapped deduction for individual-provided health insurance. It would eliminate contribution limits to HSAs, and introduce a new federal subsidy (via the tax credits) of up to $5,000 for HSA contributions. Apart from the fiscal implications of the tax incentives, are these tax cuts smart tax cuts? Evidence suggests they may not be. Economists on all sides of the political spectrum believe that the current uncapped exclusion for employer-provided health insurance encourages over-consumption of health insurance, and thus health care. Rather than reining in this tax incentive as one element of pro-growth tax reform, Paul’s bill goes in the other direction, creating two new uncapped tax incentives for health insurance. As a medical doctor, Paul has shown little inclination to rein in health care spending. He voted for budget-busting Medicare physician payment legislation in 2015 that raised the deficit by more than $140 billion in its first decade alone, while failing to solve the long-term problems it purported to address. He has also previously proposed budgets that included minimal savings to Medicare, despite long-running deficits within Medicare. But with health care already consuming nearly one-fifth of our economy, and our national debt approaching $20 trillion, does the solution to these problems really lie in creating new, uncapped incentives for tax-free spending on health care and health insurance? Therein lies but one of the Paul bill’s problems. While ostensibly promoting market-oriented solutions, the legislation contains several strategic trip-wires that could contaminate any attempt to repeal Obamacare, or enact a conservative alternative. Members of Congress should tread cautiously.
What entitlements? A tax credit? Conservatives have been saying for decades that individuals who purchase health insurance should get the same tax credit that corporations do. You don't support that?
Just relevancy.
I read about the new healthcare bill, but I still don’t know much about its complexities and fine points. I do know that Trump likes it and fully supports it. That’s good enough for me….and therefore, I am sticking with Trump. You can stick with Rand, if you like….that’s okay by me. I will still call you, friend …
"I don’t believe I’ve seen one major Republican player outside the congressional leadership say they support the House GOP bill this morning"
#2. To: Tooconservative (#0)
#3. To: Tooconservative (#0)
The D&R terrorists hate us because we're free, to vote second party
"We (government) need to do a lot less, a lot sooner" ~Ron Paul
#4. To: Gatlin (#2)
#5. To: misterwhite (#1)
Of course not. They're waiting to see how much pork Trump is going to offer them for their vote. They're in for a surprise.
#6. To: A K A Stone (#4)
Sen. Rand Paul Says GOP Healthcare Plan is ‘Dead on Arrival.’
He could very well be right, I will not argue that….this whole Republican healthcare appears to be turning into a fiasco. Even Rand Paul’ own proposed bill is challenged:
What do you think about this?
#7. To: A K A Stone (#5)
"They are not supporting it because of the new entitlements."
#8. To: A K A Stone (#5)
"Rand Paul isn't looking for more pork."
#9. To: A K A Stone (#4)
Rand Paul is right.
Top • Page Up • Full Thread • Page Down • Bottom/Latest
[Home] [Headlines] [Latest Articles] [Latest Comments] [Post] [Mail] [Sign-in] [Setup] [Help] [Register]