Yesterday, I wrote that I was surprised that the Senate Republicans agreed to bring up the health care bill because “losing this vote would have been the most painless way to end their agony.” A reader of mine reacted with some confusion, asking me, “Agony? Show me the agony.” And he followed that up with an astute observation: “It is beginning to become somewhat evident to me that there is not really a significant amount of agony among Republicans at all. I think that deep down, they really want this win more than they fear the results of actually doing this.” In this assessment, he is joined by many others. I think James Hohmann put it best because he backed up my reader’s point while also doing a decent job of explaining my own:
“It’s hard to overstate the degree to which White House officials and Senate GOP leaders just want to pass something — really, anything — to show the base that they are keeping their promise to roll back Obamacare. They would happily portray even most modest tweaks to the Affordable Care Act as major successes to save face. As far as they’re concerned, whatever gets passed will be the basis for negotiations with the House. So this is not even a final product.”
“Opening floor debate may be a Pyrrhic victory for the GOP: Democrats are going to force Republicans to cast some uncomfortable votes in the coming days as part of the freewheeling amendment process. Regardless of whether a bill ultimately passes, and how they try to spin it, every senator who voted for the motion to proceed just gave years of fodder to Democratic admakers.”
For one thing, the agony comes from an inability to reach consensus within the party which has imperiled their entire legislative strategy for the year. At a certain point, it’s just embarrassing and a huge time sink, and the best thing to do is to cut your losses and stop humiliating yourself. This has the advantage of letting you move on to things their either need to get done or at least have some prospect of getting done in a satisfactory manner.
But Hohmann points out something additional, which I have also mentioned before. And this is the fact that the Democrats can now offer one brutal amendment after another that will before fodder for running against Republican senators for years to come. Even the vote that happened yesterday on McConnell’s bill was brutal. Why do you think senators like Capito and Heller and Portman voted for a bill that they said they would never vote for? It’s because they want to minimize how many times they have to vote no. They don’t want to hear the criticism from the base, but they’ve opened themselves up to the most accurate charges of hypocrisy and cowardice. I’d add McCain to this list, but he’s not likely to be worried about reelection. I don’t know what he is thinking.
Republican senators didn’t need to be taking these votes that will nail them coming and going. I referred to this process as McConnell trolling his own caucus either out of spite or because he’s too weak to stand up to the president and protect his members.
Yet, the other motivation is a kind of desperation to pass the buck. The House passed an unworkable bill to the Senate to get the heat off themselves. The Senate can’t quite reciprocate, but they can at least pass some kind of skinny repeal and bounce it back in the House’s lap for a while.
If they do this, it will be one of the most irresponsible things our government has ever done because they’ll remove the employee and individual mandates (along with a medical device tax that is important for revenue) simply because they’re unpopular measures, without the slightest regard for what this would do the insurance markets that would be crippled with overly sick pools of customers. I do not doubt that the Republicans in the Senate will succeed in this if for no other reason than almost none of them have any courage.
This would not solve their problems. It would exacerbate them badly because they’d now own the resulting damage. It’s like trying to kick your prescription painkiller addiction by taking up a needle and shooting heroin into your veins. It solves the pains of withdrawal by making it even more painful to quit.
As disastrous as this now likely outcome would be, it would still represent a victory of sorts for ObamaCare because it would keep the Medicaid expansion in place and the regulatory scheme. What would be left is a collapsing individual marketplace and a political party and administration in charge with no ability, knowledge, or willingness to fix it.
The sheer self-injurious stupidity of this move might prevent it from happening. It will only take the courage of three Republican senators, after all, and there are two who have already shown that they have a little courage. It’s depressing that even with these seemingly good odds, I can’t express optimism.
If they had any sense, they would have cut bait long before now.
Gulp.
Protects Medicaid and allows him to say yes.
Or is a trojan horse that allows for more mischief in conference committee.
Multiple members of Senate Republican leadership have confirmed that the skinny repeal bill is a Trojan Horse which will be changed in conference committee. They’re openly admitting this is the strategy- it’s not secret.
To complete the open mockery of an honest process here, multiple GOP House members were reported to be on the Senate Floor today, telling people that the House would not pass a skinny repeal Bill that the Senate may pass to them, guaranteeing that the Bill worked out in conference committee would be closer to the ACHA.
The moderates have nowhere to hide here. People are paying attention, and are motivated to do something if Republicans rip health insurance from tens of millions and drive up the out of pocket costs for tens of millions more.
Sounds about par for the course. The so-called “moderates” have no cover if they pursue any plan that explicitly harms millions of fellow Americans just so a few rich folks can have their fancy tax cut. They own the consequences, lock, stock, and barrel.
Yes, they do.
Yes, but on the other hand, the moderate Senators still have to vote for the conference report, and if the conference report touches Medicaid, they’re back at square one.
What I believe you are discounting here is how beholden the GOP is to big money, that is the Kochs, Sheldon Adelson or Robert Mercer. Dean Heller’s vote for YES, despite the fact that it would assumed to be political suicide, is simply because Steve Wynn compelled him to do so.
The GOP is counting on the twin bill of voter surpression and its twin, voter apathy. I was with you Booman until very recently; I think, however, that the U.S. is entering a state of apartheid where the 30 percent will rule the 70% and the healthcare vote is the bellweather event.
It’s starting to look that way to me. As you say, the GOP Pols are bought off by various members of the .1%. So what if Heller loses? He’ll be handsomely rewarded in various ways, I’m sure.
Sad to say that I think you’re correct about the apartheid situation. And sadder still is that a significant portion of the 70% who are ruled by the 30% – and who lose out on health care and other rights – will happily imbrace their situation as long as they can be insufferable racist, bigoted, sexist, homophobic, xenophobic, judgemental, gun-humping, ignorant jerks. It’s amazing how smugly satisfied a lot of citizens are with this very very thin gruel, but there you have it.
I get the sense that most of them just want this thing off their plate and into the House/Senate committee where it will essentially be entirely rewritten.
The sausage making will be done in secret where it won’t have their fingerprints on it. Stealing all the money from Medicaid will go back in, but hey, “The committee did it. Who could have known?”
Both houses would have to vote on the bill again, but they’ll have some distance between themselves and its creation.
No, no distance. They vote for a Bill which takes health insurance from tens of millions, we must make sure no distance is provided to them.
We’ll just have to overcome the money, now and in the future. Don’t stay in despair, don’t give up.
I would use another analogy to describe them.
If they don’t repeal the ACA, they look like a feckless bunch of incompetent losers, and they are screwed. But if they DO repeal or gut the ACA, and 20+ million people lose insurance, they are screwed even worse.
So basically, their party is trapped in the 20th floor of a burning skyscraper. And they are agonizing over whether they want to burn to death or jump.
It’s not a pretty picture for them, and it will, indeed, make you act in a highly inconsistent manner, because the outcome is horrifying no matter what you do.
The question is, which ones in particular are screwed in primaries if 20+ million people lose their insurance and the rightwing media raises the question of high-risk poYOUR BABY DAUGHTER IS TRAPPED IN A BATHROOM WITH A CHILD-PREDATOR WEARING LIPSTICK.
Correct. Some of them are not screwed at all by having millions of people lose health coverage. Some of them are DEEPLY screwed. At the same time, they have to weigh the relative danger of primary challenges vs. general election opponents. From a purely strategical perspective, it is an ugly place to be.
The guy in the worst position is Heller, though I think he really got his out, and he needs to use it: Gov. Sandoval. He needs to reaffirm, as he did at the outset, that he is not going to agree to Medicaid cuts, under Gov. Sandoval’s advice. Sandoval is really popular, and that should cover him from a primary challenge. And voting against Medicaid cuts is his only hope to keep his seat. That’s his path, and if he doesn’t see it, he doesn’t deserve to continue in the Senate. (Though we’ll all pay for it.)
For Flake too this is a nearly-impossible vote. Rumors were that McCain, who knew and cared little about health care policy, was opposing these bills to take one for Flake. Maybe he will continue to do that now?
Meanwhile there are people like Gardner and Tillis who need to worry about 2020. I haven’t heard Tillis worrying, but he damn well should. Gardner is gonna seriously hurt himself if he votes to slash medicaid in a blue state. People will remember this.
As a Coloradoan I can assure you we won’t forget or forgive Gardner. But he’s in tight with the Koch Bros and their ilk and appears to have hitched his political ambitions to them.
…one possibility is they are negotiating over who will fall on the sword to be the third No.
Collins has branded herself a moderate apostate. She’ll probably cash in the good will with indies by running for governor.
Murkowski already lost her primary and won the general as a write-in. She doesn’t need to fear her party.
Who else can afford to buck the party and its big donors? Maybe, McCain after all? I don’t know.
Forget McCain. He talks maverick, then falls in line to vote.
Maybe Rand Paul. Because skinny repeal doesn’t go far enough?
From CNN on the failure just now of repeal don’t replace:
So (R)’s want to end the employer mandate as well as the individual mandate, thus driving millions more to the Exchanges. Seems counter-productive if you hate Obamacare exchanges.
This will cause a collapse. Young people will not buy it meaning costs on the older less healthy population will increase.
Of course, but the collapse mechanism is soaring premiums to be blamed on Obama of course.
Within two years the blame will be irrelevant if the collapse happens as fast as I think it will.
I don’t think it will. The misery will, but humans have an enormous capacity to endure misery. Look at Russia in the Stalin Era or China during the Cultural Revolution. Vietnam between 1965 and 1975. Pol pot’s Cambodia! Our own Civil War and reconstruction. The Great Depression. Those are the relatively recent examples. The Black Death. The Viking incursions. da capo
The collapse will come from people walking away from medical debt because they cannot pay it. People will forgo insurance and be caught in large medical debt. Hospitals will go bankrupt. (Likely some of the for-profit hospitals first.)
That’s your collapse and it will shrink the supply of working providers as others cannot afford to keep practicing. And rural and low-income urban are already gone; the rot will spread to the next more middle class and more urban areas. And rapidly through retirement homes and nursing homes dependent on Medicaid.
Young people will not be able to buy it even if they are prudent; it will be too expensive for too little.
Most everyone will start going bare of insurance coverage, which will tank the employer-based market.
What was about to happen in 2008 but was forestalled because of the ACA will now happen and more rapidly.
Essentially we will be going back to pre-Obamacare without the crap policies. That is, for skinny repeal. For the original bill that “loosened requirements on coverage”, I read that as bringing back crap policies full of loopholes and exclusions. Then we will be back to pre-Obamacare.
It is an imperative for Trump to repeal Obamacare. It’s his vindictive personality. Anything Obama did needs to be eliminated. So hang on to your hats; he will threaten all of them until he gets it done. Any republican who votes against it is in for some serious shit. Move on over Beauregard.
Sadly I believe you have divined the whole of the strategy at this point; self-destructive.
Reading the small print of Narcissistic Personality Disorder these days is like watching Air Crash Investigation while flying. BLUF; if Trump faces humiliation (destruction) then we all do. Hang on to your hats.
Do you not understand that undoing the Obma administration’s accomplishments so that the black man will be a failure like unto the conventional story of Reconstruction is the whole point of the Trump administration and what his base expects.
And until there is a opposition with power in Congress that will be how it will be played.
I think it’s so the “Liberal” is seen as a failure. I don’t color is a major factor. Not around here anyway. Your mileage may vary.
Oh sweet cheeks! How adorable! Trying to convince us that 8+ years of “kenyan” and “muslim” and all the rest didn’t happen. Really, you deserve a trophy for Effort!
Imbecile. Of course it was his color, you Putin-felcher.
FOAD!
This is a fine example of Arhur Gilroys” The War at Booman Tribune, interjecting oneself into a polite thread purely for the purpose of disruption, deliberately using “fighting words” and insults instead of reasoned objections or even just polite dissent. A response designed to cow the opposition or just to stroke the ego of a worthless loser that has no other satisfaction in his worthless losing life.
He could have posted something like: “No, 8+ years of “kenyan” and “muslim” convinces me that race is the only thing involved here”, inviting polite rebuttal. But instead proceeded with insults and ad hominem attack, closing off dialogue because dialogue and the exchange of ideas is not what he wanted. Just another jackbooted thug intent on squashing all dissent and getting his rocks off at the same time. His parents, if indeed he ever knew both of them, should have taught him better manners, but no doubt they are pond scum like himself.
Things you dont like are neo-centrist, which is an expression used for things you dont like?
Interesting non sequitur. I never once used the term neo-centrist. Did you bring it up just to change the subject?
I guess Fuck Off And Die is totally fine when fighting the neo-centristsTM
No, just when addressing insulting trolls.
Thats such a brilliant way of dealing with trolls.
It is extremely notable that the community members here who proclaim themselves progressively holier than thou are rarely present on comments threads about health care policy or defending the ACA. We hear the calls for single payer from many of them, but defending the ACA’s major transference of wealth from the rich to the poor and provision of health insurance for over 20 million Americans appears to be beneath them.
OK, I’ll clap louder and talk to deaf ears. What will the Democrats in Congress do?
Framing the financial mechanism as a transfer of wealth from rich to poor was counterproductive. It makes the poor seem like moochers off of the decision-makers who ensure that that wealth in society gravitates to the top.
And when will the nickle-and-diming of deductibles, co-pays and medical debt end? Are most “practical Democrats” so affluent that they don’t experience these things?
Interesting who you think is not getting the realities.
Lovely.
Over 20 million Americans’ health insurance is at stake, and this literally regressive carping is what we get. Single payer/Medicare for All would have to be financed through a progressive taxing structure, I hope you agree.
The ACA is now more than twice as popular than the high water polls for the Republicans’ Bills. The passionate demonstrators are all on our side.
Good Lord, you’ve got a Democratic Governor and recently had a Democratic Senator, and you’ve decided Senator Tillis isn’t worth talking to?
Keep sitting on your hands then, if you think that decision is defensible and you’ll be proud of what you did when the chips were down. We’ll soldier on.
I’d ask you to think of all the people you know who have been helped by the ACA. It’s likely you know some.
No. I don’t. I think it could be financed by a flat tax on employees and employers as it is now. A progressive income tax increase would be nice, but not necessary. It may even be politically untenable. A German citizen told me that in Germany, employers pay the whole premium for the employed and the government pays the premium for those that are not employed. That could be a hybrid system. Employers pay a flat premium per worker and those not employed are paid for by general revenue which is progressive income tax.
Medicare provides great savings. I get a lot of EOB’s from Blue Cross that say things like:
Your provider charged $100
Our negotiated rate is $70
The Medicare approved rate is $20
Medicare paid $16
BCBS paid $4
You owe $0.00
Medicare is primary, BCBS is secondary.
Notice how much BCBS saved becaus4 Medicare is primary? Much as we hate them, the Inscos need to be part of Medicare-For-all. They own too many politicians to be frozen out. And as my example shows, they can still make out like bandits.
You’ve not watched Sen. Tillis closely, have you. Or Burr. Nor do you understand which GOP Senators polling can affect.
Who exactly are you soldiering on with? Feinstein and Harris? Schumer and GIllibrand? Manchin and Capito?
I was on the phone a lot during 2009 and 2010 to Democrats and Republicans. The Democrats sort of made it clear long before 2010 rolled around that the fix was in. Competitive pharmaceuticals for Medicare pricing was the first to go to get it out of a a Democrat’s subcommittee of the House.
Shaming doesn’t work as a motivating tactic in whipping votes because it often misses the point. Voters are not peforming pets that must do their act before the Democratic member of Congress does the right thing. If there is a Democrat in Congress who doesn’t know what the right thing is in this vote on repealing the ACA, heaven help the party.
So touching of you to soldier on. That doughboy helmet must look swell on you.
More than 20 million Americans’ health insurance is at stake. All Americans’ health care is at stake. Crashing the Obamacare markets doesn’t just affect the insurance markets, it affects the viability of hospitals and providers’ practices.
But whipping the vote has become so much about shaming that no one is bothering to describe the actual effects on the market of a repeal without replacement. As I have mentioned before, the political driver of Obamacare came out of the employer-subsidized market that most middle-class people were in in 2006-2007. For two decades, that insurance pool, even with those with pre-existing conditions excluded, was inflating rapidly with higher premiums, employers shedding their subsidies, and poorer care and business practices. That situation as only gotten worse even as Obamacare has created a safety net for 20 million people. Repeal will accelerate that return to trend.
No one is effectively arguing those effects in the media — all of those supposed defenders of Obamacare are failing at some of the critical practical arguments. No one is educating the public on what insurances is about, what health insurance is about, and why it’s not an individualized savings account. No one.
But you are going to soldier on calling Senators who have been determined to undermine the ACA from the day it was introduced. Senators who did not even play coy like Susan Collins or talk a good game like John McCain.
You are not soldiering on; you are merely going out for the good old college try before the predicted and pre-exonerated failure.
And you most likely will be among the first to proclaim once Obamacare is repealed that healthcare as an issue is dead for a generation or more. It’s not politically practical. Anyone who says otherwise, especially who says that single payer is more politically acceptable that any pseudo-market half measures is being holier-than-thou. All the while working to prevent the political viability of single payer from ever being tested.
This is a politician’s fight, not a voter’s fight. Sad that the politicians don’t even now realize that and that they have to have their ego’s massaged by compelled phone calls.
You see, I didn’t see any movement in the Senate move-to-proceed vote over what could have been predicted last November. It’s good that the frustration of phone calling might change a few votes of the callers in 2018. But I’m already there. Have been there for some time, for all the good that my yellow dog Democratic votes have done.
No, Thom Tillis is not worth talking to. Like Steve King and Louis Goehmert in that respect although he is currently lying low as a backbencher. Only hears money talk.
Maybe some of those big-money double-party donors could financially convince some Republicans to give up their seven-year-long dream of sticking it to the “Kenyan Muslim Socialist”. Too bad there was not enough money and organization in 2016 to put Deborah Ross in the Senate.
I do agree that health care should be financed by progressive taxes but only because any other method – like the ACA taxes on investment income and higher medicare on the elite – put a target on repeal.
I also agree that the ACA has helped a lot of people through the Medicaid expansion and the employer mandate. And for now we need to save it as best we can.
But I think ultimately the ACA needs to go in favor of medicare for all. It is the only way to achieve affordable universal health care and eliminate the “holy shit” when the medical bills come in.
One more thing. When you add up all the money spent today on health care and recognize the very high price we pay, I doubt – though I can’t prove – single payer will be anywhere close to what we as a whole pay today for health care. But the issue needs to be studied and I wish we were more serious about it. It will never come to fruition without a careful analysis of the cost and benefits and where the money comes from. The net savings will accrue to all or nearly all our people and become a net plus to GDP.
Oh, I agree some form of a a single payer/Medicare for All program would be less expensive and far superior for the vast majority of Americans.
What I find frustrating about the discussion many of us on the Left have about the subject is an unwillingness to acknowledge that not enough of the American people share this view yet. They’re getting there, but the polling on it is notoriously soft, and every time a State puts single payer to a referendum of the voters it gets utterly smashed.
And the discussion goes from frustrating to debilitating when people on the Left call politicians from the Democratic Party corrupt if they’re not down with trying to force through single payer tomorrow. It would be an unproductive kamikaze mission for them to attempt to do so.
Democratic Party leaders must lead on the issue and continue to build public support for it, but deciding to hate on anyone who isn’t hot to make single payer happen right now now is proving hurtful to our movement.
Who are you talking about? I don’t recognize anyone like that here. Name names, just don’t refer to some nebulous strawmen.
>> community members here who proclaim themselves progressively holier than thou
pre-emptive insults directed at anyone to your left who might disgree are dickish. Don’t be a dick.
The lemmings will jump.
(1) They are high on their own supply of eight years of anti-Obama propaganda.
(2) They are high on their supply of believing that a market solution can make better health care outcomes. It can’t.
(3) They don’t care about people who can’t afford health care and think they are failures who deserve to die–even the “moderates” do.
(4) The “leadership” can only stoke the hate in order to motivate the base in the 2018 midterm.
(5) The GOP narrative will eventually racialize healthcare and frame the problem as “bad behaviors”. Even the “moderates” will parrot this narrative; even some on the “moderate Democrats” will parrot this narrative as will “moderate African-Americans”. It’s worked on criminal justice and education, why not health care. “It’s yer own damned fault.” individual responsibility sort of narrative, ignoring the personal irresponsibility of lots of people who can afford their own healthcare and the role of physicians and other health care workers in changing individual behavior.
What is this debilitating trip you’re on? If the things you’re asserting here were universally true, Congress would have passed an ACA repeal bill in February, instead of running themselves through the extremely bloody and politically damaging gauntlet they are going through right now, right now, while you’re trying to convince us to all become Eeyores throughout the Trump Presidency. No thanks.
Increase your pressure on the Senate, everyone. We can win this. If a greatly watered down Bill limps over the finish line, there will be a thousand opportunities to come for us to stop them on all the issues we care about. The only way these radicals win is if we give up and stop organizing.
So much easier to sit back, wring one’s hands, and blubber with self-pity at having to “clap harder”, doncha know.
What defeats this bill is Democrats standing 100% together and 25 GOP members of the House crossing over and 3 GOP members of the Senate crossing over.
A full-court press of all House members was a good starting tactic. It now works only for those who are not resistant but still open to breaking with the GOP.
Who might those House members and Senators be now that the motion to proceed has clarified the current voting positions. The No votes for GOP were split between Medicaid preservers and tax cut promoters.
Maine, Alaska, and West Virginia voters could still have an effect on Collins, Murkowski, and Capito but that efffect is diminishing as the status of the bill winds toward some consensus or another.
More likely way of stopping it is through the three-way GOP division under Ryan’s leadership.
And delay is as good at the moment as outright defeat. There are lots of other items backed up in the delayed legislation. There is a legislative jam-up between October and January that Democratic unity can use effectively if the leadership can hold it and push for maximal positions.
As long as folks are proposing junk amendments to the bill, here is one. Repeal all of Title 26 of the US Code (Internal Revenue Code of 1986) and replace it with the statement that the Internal Revenue Service will collect taxes and that the rates will be those set by the marginal tax rate of the Internal Revenue Code of 1954. And then request a CBO scoring of the amendment. That scoring, if honestly carried out, will be very instructive for future legislation.
they are so phucking spiteful.
make an improvement, rename it Republicancare and take the win.
but, the bottom line is…they really don’t believe in healthcare for the masses.
and, they need the Medicaid decimation for their tax cuts for the rich.