Jennifer Rubin describes my ambivalence about the House bill to destroy the Affordable Care Act pretty well. The political consultant in me can see no more optimal result than one in which the bill passes the House with the bare minimum of votes and then dies in the Senate. So, should I root for passage?
To begin with, I see what the House leadership is trying to do. They’re desperate to get this off their plate and put the blame for inaction on the Senate. They’re going to their members and making the following case: “We voted to repeal Obamacare dozens, hundreds of times, and now that we have the chance, we’re going to fail to pass anything? The base will go nuts! The senators are laughing at us. They’re treating us like we’re idiots. And they’re going to shift all the blame on to us. How much better it would be to just send them something, anything, and let them be the ones who fail! Now, here’s what you do. When they accuse you of screwing over people with preexisting conditions, you tell them that you voted against that version of the bill and you only voted yes once we put this amendment in with a few billion for high-risk pools. Tell them this version of the bill protects people with preexisting conditions. Go ahead and add your name as a co-sponsor of the amendment. That way, you don’t have to hear about how we did nothing and you have an answer when you get hit from the other side!”
It’s a pretty compelling argument, and it may carry the day. But, as a political consultant, I still think it’s suicidal. The public isn’t as likely to make fine distinctions as this strategy assumes, so if there is no ultimate repeal and replace, the blame will fall on the president and the party broadly, with few allowances for anyone no matter how they voted on an amendment. In truth, even voting no is a bit of a disaster. Just being a Republican is a disaster in this scenario.
Probably the worst outcome for the GOP would be to actually succeed in kicking tens of millions of people off their health insurance, but failing to do anything at all isn’t a whole lot better for them. And, in the context of failure, voting for something that would have been really unpopular is probably worse than having voted against it.
They’d really like the issue and all their promises to disappear, but the best facsimile of that outcome for the House is to punt the debate to the Senate.
That all makes the case for wanting the House to succeed, since it would create infighting and a huge pile of blame to spread around. But I also have a lot of experience working in the recovery community where the protections for preexisting conditions and the mental health provisions of Obamacare have been hugely beneficial lifesavers for countless people trying to stay sober and for their families who struggle to pay for their treatment. I don’t like to see them yanked around like this and put under so much stress. They don’t know that this is all a Kabuki Theater blame-shifting exercise. They’re worried, and if the bill proceeds they will get more worried.
And, of course, what if I am wrong and the bill doesn’t die in the Senate? I think that’s a very small risk, at least in anything like its current form, but why root for an outcome that creates that risk?
So, part of me just wants them to pull the bill and for this issue to die for good, at least for this year.
Someone ought to be demanding a CBO review, yet it’s gone unnoticed. That should have been a requirement before this shitmess ever got to a vote. The Republicans are always squalling about the bottom line, except when it applies to them.
G-dammit! This makes me furious! I am sick and tired of being jerked around by this adminstration! They are quietly writing in a clause that protects their insurance from being changed. They are rushing this through for the simple reason of crowing that they can too pass legislation. It’s obvious that this is nothing more than Trump winning, no matter that it would be devastating to millions of Americans.
I hate this crap.
Lots of people – almost everybody who isn’t a Republican Representative – were asking for a CBO review, and the rules of the House required both a waiting period and a CBO review. The House rules committee actually voted to change the rules to pass this piece of garbage.
They were smart – they didn’t let on that they were close until a week ago.
The opposition didn’t have time rally. Hell was there a FP post here about over the last week?
With the added bonus that a House death of the bill would be more painful for Trump.
Wanting this to pass seems just like hoping Trump wins the nomination. Perhaps good on paper, but there’s an awful downside.
No More Mr. Nice Blog makes a pretty compelling case that this bill actually can pass the Senate. I was worried before; now I’m really worried.
While your argument may make sense to a rational person, the Republican base is not rational. They are emotional. Seeing the ACA go down will make them feel great. There will be high fives all around. Once the affects hit them, they will feel angry, and blame the government for making their lives worse. But they won’t see it as a Republican thing. The Republicans have been trying to screw over the country for decades, and yet people keeping voting for them. They will just fall back into a government sucks attitude. And then they will fall for an even worse person than Trump that promises to save them. A downward spiral into who knows what hell.
“…with few allowances for anyone no matter how they voted on an amendment…”
Why would there only be few allowances? The House constituencies are famous “they’re ALL CROOKS!!!! Except for mine …”. I don’t see the supreme blowback from voting no. The real danger is being primaried, but realistically, any congress person who WOULD vote no on this has already been primaried by the TP’rs with cries of “RINO”.
As for wishing it would pass? In my opinion, if this thing passes the house, it passes the Senate.
Look at the R senators under the gun in 2018: Flake(AZ), Wicker (MS), Fisher(NB), Heller(NV), Corker(TN), Cruz(TX), Hatch(UT),Barrasso(WY). Which of these are going buck McConnell? Possibly Heller. That’s it.
The rest of them? In this day and age, 2020 is a lifetime away. Any vote taken now will not resonate supremely negatively in 2020 unles the entire R party is blasted out of the water … in which case, any given vote taken now will not matter.
It will take 5 R defections to defeat the bill in the Senate. I’ll give you Heller, Collins, Murkowski. Finding the other two could be tough.
“It will take 5 R defections to defeat the bill in the Senate. I’ll give you Heller, Collins, Murkowski.”
If all the Democrats and Independents hold together, that will be enough. Your analysis presumes that wouldn’t be the case. Who do you think will cave? Manchin and Heitkamp?
Actually, Neon, I think you’re right. I forgot about the King and Sanders (I).
Ok.
Let’s hope Murkowski and Heller can’t be bought off.
It only takes 50 votes from regular members to pass this thing, not 60 because they are going to use reconciliation or blow up the filibuster all together.
That means we need at least 3 Republican defectors of the 52 Repubs while holding all of ours to avoid Pence breaking the tie. I don’t think we get them and hold ours. Manchin and Heitkamp are almost certainly going to vote for this POS. That leaves us right back with your original 5.
Collins and Murkowski aren’t going to buck McConnell unless they know they are going to win. Heller might, but it’s not likely.
I just don’t think the Senate can save the ACA at this point.
Don’t care if they vote or not. I will not consider either result a win. I have made my sign and plan to demonstrate.
Setting aside our political calculations, the Repubs have clearly concluded that passing this absurd legislative turd is the only option for them, whatever the ultimate fallout may be. It’s the best of a bad lot of options.
They long ago backed themselves into a corner on this and they now either deal with obvious political failure (can’t pass anything after 7 years of denunciation) or a deferred policy failure (passing an absurd can’t-work bill that doesn’t take effect for years). Since they can always spin a future policy failure as a complete victory today, their course seems clear. He who lies and runs away, lives to lie another day….the Repub credo!
If Ryan’s Reprobates pass it, at least they and Trumper have something to say at 5 pm, which for a 100% cynical party, is as good as it gets. As for the prospects in the senate, the script writes itself: “The senate Dems blocked making America great again, we need more Repubs!” You can always claim the answer is more Repubs…one can never have enough! And the can is kicked. Or else a (somewhat less) terrible repeal bill comes back to them sometime down the road. They can cross that bridge when they get to it.
Hoping that they pass the turd is probably a reaction to the fact that it now looks like Ryan’s Randians got their act together enough to pass something, anything. Dem reps can’t do anything about it (it’s completely a Repub show), so Dems are left with hoping it’s a great political mistake to pass it.
To an party of almost complete political cynicism, led by an ignorant sociopathic narcissist, passing any turd anywhere is the end of the story. They can “govern”; Der Trumper can “win”; Spicy can bloviate; the corporate media can obfuscate. This about all that can be expected in a failed state.
There’s a low below the low you know.
No. Why would I want to risk something like that over political calculations? You fight for legislation you want and go to the ballot box to rally the people behind you with that vote. If it ends well and doesn’t pass the Senate, then good — but it isn’t the scenario to actively cheer for. Just like flirting with fascists for political gain ain’t worth it.
We are talking about a radical change to Medicaid.
And we are worth risking that over a political calcuilation, when everyone’s political calculations over the last 18th months have sucked.
I find it incredible that people are saying that.
And the GOP House is incredibly insulated. and most of the Senate Seats that are up are Democratic Seats.
90% of the House knows this won’t hurt them. If you give the Dems a 10 point Generic Ballot advantage, the STILL hold the House.
How is it possible that normal humans can actually vote for this sort of thing? How do they keep them. Are they all just this stupid?
It has a huge tax cut for those making over 250K.
That answer your question?
This is about money for the rich.
Evil fuckers aren’t they. Money talks and to hell with everything else.
I presume you are referencing the 3.6% tax on investment income and .9% medicare tax. All of that proves why one should not target special taxes on special income or people. If you need more tax, increase progressive tax rates and forget taxes on stock transactions and this kind of tax. All that does is incentivize those people affected, i.e. singled out, to find a way to eliminate it. If that seems to imply the whole insurance company scheme, well yeah, it does. Health care is a right and should be universal. Period.
I refuse to allow this community to be talked into the idea that nothing can be done. It’s going to be extremely difficult. Our entire movement, from stem to stern, needs to learn and grow.
The philosophies of the John Birch Society have taken over the conservative movement. Supporters of Birchism have been extraordinarily well-funded for a half-century, and they have finally achieved their breakthrough. The election of an African-American President helped their movement enormously. 9/11 also provided Birchers a crucial assist.
We will have to be just as determined. This will be a multi-decade fight. I am disappointed by those who believe our difficulties will begin to end when the DNC selects their preferred Chair, or when the Green Party becomes viable. These people are not figments of my imagination. They’re online, they’re in my community, they’re in and outside of my Party.
I desperately want the Occupy and Bernie movements to grow and learn how to win at electoral politics. If we are to declare the Democratic Party wholly or primarily responsible when their candidates lose elections, we must also hold the Occupy and Bernie movements responsible for their broad failures at electoral politics so far. These movements are fairly new and must be built, but their supporters would be well advised to stop blaming others for their failures. Unfortunately, blaming others is often an animating principle for many in these movements.
Well the bill just passed the house, so now on to the Senate. I hope you’re right and it dies there, Booman. It’s sickening to me to see the R. party gleefully applauding passage of a bill that will end up killing thousands of Americans each year, if enacted.
Martin, you will have to pardon me for my vulgarity, but I wish I could just shove a red hot poker up the asshole of every Republican in the House right now.
I saw your comment, which I block-quoted, and as I am reading this post my wife and I are in the process today of opening up our home to her sister, who is being booted this afternoon from her in-house rehab for addiction because the very short coverage period for that type of treatment has run out. She is being released way too soon, into our custody, with the promise that she will attend several weeks of daily out-patient sessions at the same facility where she is now housed. The responsibility will be on us to insure that she makes these sessions. And it will also be our responsibility to make sure that she stays away from all the people who helped drag her down her disastrous road.
I told my wife when her sister first went into rehab that she should steel herself for dealing with a whole bunch of very dedicated people in the mental health community who are forced to work within the most fucked up system imaginable. I have been down this road before with my brother. I told my wife that in this country, the only people who get the real treatment they need are the mentally ill who are in the criminal justice system, and those who have the tens of thousand of dollars to pay for their treatment directly. And my prediction turned out to be 100% correct. Her sister could continue to get the in-patient treatment that is helping her so much, for just a meager $18,200 deposit. She is already on the hook for a $2000 deductible for her current week of in-house treatment. This will most certainly never be paid. She has less than nothing right now.
The fact that we treat our mental health system for non-criminals as a for-profit enterprise is nothing short of a moral abomination. Your treatment is fully dependent on how much money you have. And if you can’t afford it, you are essentially given, at best, a bare minimum of follow up treatment, and then thrust out into the world, with the hope that you have family and/or friends who might help you.
I am so fucking fed up with the self righteous bastards in the GOP, and all their bullshit of feigned caring for the least among us. If there were actually a just god in this universe, they would all die slow, painful and merciless deaths. And that same god would allow me the privilege to laugh in their faces as they breathe their last breath and as a final act allow me to piss on their graves.
Fuck all of them. Fuck them all the way to hell.
Brother, any time you want to chat and get any support or advice, drop me a line.
Thanks, man. I am trying to keep a positive spin on this. My wife and I are the best support system her sister has in her world. My concern right now is for my wife and her emotional state. She just lost her baby brother unexpectedly on Tuesday. He was 54. So she is dealing with that, too. She has been riding this roller coaster with her sister for at least a couple of years, and is the only one in the family who seems to give a damn about saving her sister’s life. Things are piling up on my wife. She’s tough, but all these things are taking their toll. I just have to keep an eye on her and try to make sure she’s okay.
I have a lot of experience with how your wife (and you) can manage these challenges. There are things that work and things that don’t.
I’ll see how things go as we move into this new phase with her sister living with us. I might reach out to you as we go along. My biggest challenge is going to be handling the emotional aspects of all of this with my wife. For the last two years she has gone to bed every night worrying about whether her sister is okay, who is she with and what is she doing. Communications were often few and far between at times, so the pressure of worry was constant. So her imagination would eat at her. And the lies. Soooo many lies, about everything. Those constant lies just eat at her gut 24-7. You’re desperately trying to save someone’s life, and they just won’t tell you the truth, even about the simplest damn things. And we don’t know for certain whether that is going to change now that she is in rehab. Things seem better now, but she has been in a controlled environment. That is about to change.
Sorry, I could sit here and type for hours about this. We are just swept up in the vortex right now.
I know all of it too well. The story is being lived out by literally millions of people right now all over the country. The key for her (and for you) is to access the wisdom of the people living through the same thing and have them become part of your support network. And, most likely, the therapeutic part of it that will get you through will come in helping the next person in line after you. This is a key insight of 12-step therapy, that only through service do you gain strength to soldier on. It is equally true for the loved ones.
She has sessions M-F from 8-5. It is a continuation of what she has been doing. She is here at the house now and is in good spirits. We are hopeful. We’ll just have to wait and see. First, we have to get through the grief of losing their brother this week. It’s been a shit-pot full of stuff hitting all at once.
Life is what happens to you when you’re busy making other plans.
I have represented the Mentally Ill for years. The lack of resources available to them is a scandal.
I have little doubt that this MUCH worse for them.
This. 1000x over. I would be happy to work the bellows and make sure that red-hot poker is near melting before you insert where it will do them the most good.
Even if this dies in the Senate, what this does to families currently in the throes of dealing with active addiction and early recovery in terms of increasing their stress levels even further is cruel and inhumane. Many, many people only have had access to treatment because of the ACA provisions.
I am so angry I could slap those asshole GOP reps from here to Kentucky.
Just adding that your point about effective, long-term treatment only being available to the wealthy and in some cases, those within the judicial system where there are drug treatment courts is also a major problem with how we approach substance abuse.
My brother is currently in the criminal justice system, and you are correct. While he is getting “treatment”, the lack of long term care available to them once they are back out in the world is an absolute fucking joke.
We have a treatment court program here that is very structured, with steps down in supervision and testing, and it is highly successful for people who complete the 2-year program. In some cases, entry into the program is preceded by a 3-6 month residential treatment program (if your attorney is savvy enough to negotiate that as part of the plea). For people who only get 12 step groups in jail and minimal followup after, not so much.
I have very much the same feeling about the fuckers. Good luck with your sister. Health care should be a human right for people in our country. It is not bc of the aforementioned fuckers.
Roll call.
Issa and those CA republicans in districts Clinton won need to go ASAP.
No dems on the list.
CNBC piece on preexisting conditions. The bill may only protect 5% of those with chronic preexisting conditions. Where’s that hot poker?