In the New York Times, reporter Alexander Burns does a nice job of detailing how a bipartisan group of governors, led by Republican John Kasich of Ohio and Democrat John Hickenlooper of Colorado, teamed up to kill (for now, at least) Mitch McConnell’s effort to pass a health care reform bill that would cripple Medicaid and leave tens of millions of Americans medically uninsured. The most significant thing I learned in reading the piece is that the governors hatched their plot way back in February, long before they had any way of knowing the details of what would be in the House or Senate versions of the bill or how the process would proceed.
Mr. Hickenlooper said in an interview that he and Mr. Kasich had agreed to team up after a February meeting of the governors’ association in Washington, where state leaders heard an alarming presentation about the potential consequences of a federal pullback in health care.
Within weeks, Mr. Hickenlooper said, both Mr. Kasich and Mr. Sandoval had sought his help in taking on their own party. Mr. Kasich, the Colorado governor recalled, expressed confidence that he could find other Republicans who would “take a pretty strong stand that coverage shouldn’t be rolled back.”
A tentative game plan emerged: They would assemble a nimble, informal group of governors, from the right and left of center, who would publicly express concern about health care legislation drafted in the House and Senate. The governors would press for a slower, less disruptive and more public legislative process, and insist on protections for states that had greatly expanded their Medicaid rolls.
Joining Mr. Kasich and Mr. Sandoval on the Republican side was Mr. [Charlie] Baker [of Massachusetts]. On the Democratic side, Mr. Hickenlooper recruited Steve Bullock of Montana, John Bel Edwards of Louisiana and Tom Wolf of Pennsylvania.
Whatever was in that presentation must have been compelling, and it must have been easy even in February to read that Medicaid would be on the chopping block of any foreseeable bill. Therefore, before anything really happened in Congress, the governors already knew that they’d be able to criticize both the House and Senate versions of the bill, and to criticize the secretive and hasty process.
What’s also interesting is that this bipartisan group of governors is united in thinking that the Democrats ought to be central to any reforms.
John Weaver, Mr. Kasich’s chief political adviser, said Mr. Kasich had spoken recently with other Republican governors, including Mr. Snyder, Doug Ducey of Arizona and Larry Hogan of Maryland, who have publicly criticized the Senate proposal. “He has worked it on the phone,” Mr. Weaver said of Mr. Kasich. “There are a number of Republican governors who he spoke to and didn’t want to sign the letter, but came out on our position.”
Mr. Weaver said the group hoped its appeals would put political pressure on the Senate and serve as a model of bipartisan action that Congress could copy in a more protracted negotiation.
Now that Senate Republicans have balked, aides to several of the governors said they hoped lawmakers in both parties would craft a different measure focused principally on stabilizing insurance markets. It is unclear whether the Senate might consider that approach…
…Mr. Kasich, who said he had spoken with [Republican Sen. Rob] Portman [of Ohio], said that Democratic senators should volunteer to cooperate on a negotiated solution, and that Republicans who campaigned on a root-and-branch repeal of the Affordable Care Act should be “big enough” to say they changed their minds.
This is, of course, what should have happened from the outset, but it won’t be possible until the congressional Republicans exhaust every effort to pass a bill without asking for or relying on a single Democratic vote.
Whenever they realize the situation they’re actually in, they’ll also have to figure out how to get President Trump and his hardline advisers to see the light. Every single step they’ve taken so far has been premised on the idea that they will never need a Democratic vote for anything, ever. They have no idea how to pivot off that presumption, nor the faintest clue how they might convince the Democrats to forgive and forget everything they’ve experienced since Election Day.
Still, the exchanges aren’t going to fix themselves. At some point, the Democrats will have to fix them. If they ever get the chance, the governors will be their best allies.
The exchanges are by far the less important component of ACA. The Medicaid expansion is by far the more important, and more progressive, component. No “compromise” should ever be entertained by Democrats if it in any way rolls back the latter as the price for stabilizing the former.
Yes, keep Medicaid and Medicare and expand it to more people. It is at least a start at single payer. Hey, I can dream can’t I?
They’re much more important than they look, though, because there’s at least 12 or 13 million people who should have signed up for them and haven’t, partly because even though IRS hasn’t acted on Trump’s executive order to stop enforcing the tax penalty, they still haven’t seriously been enforcing it either (it was finally about to become significant money this year); and partly because of the success of Republican propaganda in stopping them from trying. That adds up to a much bigger percentage of the population, though still not as many as Medicaid.
As companies try more and more to avoid paying benefits and self-employment and the gig economy become more prevalent, moreover, the problem solved by exchanges will become more and more important, too.
Not saying it’s not important, but preserving the Medicaid gains is vital.
… Mr. Kasich, who said he had spoken with [Republican Sen. Rob] Portman [of Ohio], said that Democratic senators should volunteer to cooperate on a negotiated solution, and that Republicans who campaigned on a root-and-branch repeal of the Affordable Care Act should be “big enough” to say they changed their minds.
Kasich is still delusional. The only reason Kasich, and other Trump-brained idiots like Doug Ducey, is/are doing this is because of the huge hole destroying Medicaid would put in their state’s budget. Not to mention they seem more susceptible to pressure from hospitals in their state. It’s a small victory but it still won’t stop DC Republicans. Yet.
More accurately, Kasich is still disingenuous. As are the rest of the GOP governors. In theory they’re fine with massive upwards redistribution of wealth but as you point out, they are the ones who would be paying for that with the lost Federal dollars. No state could make up that short fall and even if many said “screw the poors, they deserve to get sick and die so we’re not finding money for them” as the associated costs, loss of medical industry jobs, etc., would fall directly on their states. To say this scheme would be catastrophic to them politically is an understatement.
Whereas your average wingnut congressperson in his or her comfortably gerrymandered district is far more immune to the electoral consequences of this.
True.
I think Kasich wants to be the standard bearer for the Romney wing of his party.
Ah, saved by the Repub governors of some Blue/Purple states, eh?
Forgive me if I simply cannot imagine a DC Repub who will support the envisioned “Obamacare Improvements Act”, ha-ha. A recipe for a primary from the right. Talk about eatin’ some crow.
There is no way forward on health care for the Repubs if Master of the Senate Addison cannot bribe his purported senate holdouts. Repubs have no coherent “plan” to advance the nation’s health insurance or health care markets, that’s abundantly obvious. They have done nothing but devise a plutocrat tax cut and an a decades-old “conservative” device to wreck Medicaid. Nothing new here at all.
This does nothing to solve a single problem (which they may or may not be aware of) and in any event Repubs could not care less. If Addison cannot prevail with this cruel mess, they will drop this tar baby, advise Trumper do what he can to fester the health care abscess they have enabled, and move on their next “budget reconciliation” tax cut gambit, the Plutocr…er, sorry, “Job Creator Relief Act”.
The whole nauseating affair derives from the plain abuse of these arcane budget reconciliation rules, which are simply inscrutable, but which almost certainly should not be the basis of advancing what is obviously not primarily (or even secondarily) a “budgetary” matter—by its very terms it purports to be a health care bill, repealing Obamacare! And where exactly are the two “budgets” it is supposedly “reconciling”? Did I miss their passage by Repubs?
The entire spectacle is a sham and charade, which is all that is left of our vaunted institutions. “Master of the Senate”, indeed. Captain of a Ship of the Damned is more accurate. Mitch McConnell is in fact the principal architect of the failed and shipwrecked US Congress, that is his true historical legacy.
The next fight:
GOP Freedom Caucus who I think want to let Obamacare crash versus
Govs and House/Senate who would like to fix things.
The question is whether there is a Dem/GOP compromise that leaves the Freedom Caucus out and whether GOP leadership is willing to ignore the Freedom Caucus in the final solution.
FWIW, a trip down memory lane.
Price will implode the exchanges as well.
Schumer/Dems need to start a lawsuit against Price/Trumper alleging that HHS is intentionally failing to “take care that the laws be faithfully executed” in violation of Art II.
Lawsuits have been the standard Repub tactic and creates something new for media to cover. An offensive strategy is needed, since all Dems are currently doing is reacting to Repubs/Trumper.
The insurer payments are already tied up in appellate court. The district court ruled against the Obama administration (Republicans alleged that the insurer payments were unauthorized under the statute) and it is now on appeal. Trump hasn’t taken an official position on whether he will continue to appeal, but if I recall correctly several states/individuals have moved to intervene.
Well, the first step is for Schumer/Pelosi to unveil the “Obamacare Improvements Act”, which addresses and moots all the phony lawsuits filed by Repubs seeking absurd interpretations of various statutory provisions (which should have been fixed before passage but that Repubs refused to countenance in 2009), reverses “Justice” Roberts’ intellectually dishonest and perverse ruling on Medicaid expansion by making ALL of Medicaid a take-it-or-leave-it proposition for a state, and then lays out some changes to the exchanges to make them operate better, as well as introduce a new 55+ Medicare program available on the exchanges. No changes to the provisions regulating basic coverage or preexisting conditions.
Tell “the people” this fixes most of the problems with Obamacare that Repubs have engineered and that you look forward to working with Repubs that want to advance the ball as opposed to throwing everything into the toilet as RyanCare/Trumpcare essentially does. Then ask the corporate media every day why they refuse to cover or explain the Dem reform plan.
One must have a point from which to compromise.
Sorry, but there is no time for a counter offer. There is no normal process in congress now. The GOP plans a vote next week and if they don’t have the votes they move on to tax cuts. Then it will be time for the budget. A budget that will make ACA an unfunded mandate. I do not know what the Dems should do….but proposing policy solutions to people who do not believe that government has roll in healthcare is low on the list.
Democrats should not be offering anything.
An actual negotiation focused on improving the performance of the exchanges where both sides make some concessions is completely reasonable. I’m skeptical the Republicans are capable of abandoning their role as vandals to do it though.
There is no such thing as a good faith negotiation with the Republicans in Washington.
Obama never realized that or only way too late.
Not publicly.
And even privately it should all be bait and switch – if you make these changes, I might vote for it, then repudiate it later.
They should listen to offers and no more.
” and insist on protections for states that had greatly expanded their Medicaid rolls.”
Ah, self-interest, ain’t it grand?
Democrats need to remain snipers in this battle.
Or they can do the Republican strategy of pretending to compromise and not give one freaking inch. Or ask for changes, get them and then not vote for the final bill anyway.
Do not give them an escape hatch. Don’t let some horrific (that’s the only possibility from Republicans) legislation get a single Democratic vote or endorsement.