On Obamacare, it is time to play hardball

Shockingly, Republican senators, having failed to pass any health care reform legislation, appear poised to leave Washington in August for an undeserved vacation.  Senate majority leader Mitch McConnell of Kentucky has decided to force them to vote on a repeal plan (thereby exposing their true positions), which cannot eliminate many of the worst provisions of Obamacare.  For example, this does nothing to block-grant Medicaid to control runaway costs, perhaps the best aspect of the failed second Senate attempt. 

A vote to repeal Obamacare will leave Republicans exposed to well deserved criticism as funding for the medical system becomes untenable.  If they could not agree on a repeal and replace bill, they will never agree to fully repeal Obamacare, despite years of promises.  Further, it allows Democrats, particularly New York senator Chuck Schumer, a greater hand in crafting a replacement, since there is no consensus among Republicans for replacement.  A standalone replacement bill will require 60 senators to pass a filibuster challenge.

President Trump is now trying the charm offensive by inviting Republican senators to lunch at the White House.  He may encourage a simple repeal vote as a way of gaining a compromise.  If this effort fails to reach a compromise that can pass, it will be time to use a more direct method.  The "mother's milk" of politics is money.  It is time for Republican senators to clearly indicate their frustration by their intent to withhold funds for future election campaigns. 

The Washington establishment sought to please the insurance, medical, pharmaceutical, and hospital lobbies, among the largest nationally, to ensure future campaign funding.  They crafted a hodgepodge package that left many unhappy.  Funds for opioid treatment were increased greatly.  McConnell offered goodies to Alaska senator Lisa Murkowski to no avail; he still could not secure 50 votes.  He had hoped to protect those moderate and liberal senators in his caucus, guaranteeing their votes for his leadership.  But he lacks the skill of his predecessor, the Democratic former Senate leader, Harry Reid.  This failure may take down the entire caucus and damage Republicans in 2018.

Perhaps McConnell's gambit to force senators to vote for repeal (the favorite plan of Kentucky senator Rand Paul, another "refusenik") will make a compromise more likely.  With any luck, Trump may be able to cobble together a successful negotiation.

Despite its faults, there were some good aspects of the failed legislative proposal.  Taxes were reduced, which would spur economic growth.  Reduced spending would free up as much as $1 trillion that would allow a more generous tax reform package.  It would have reversed some of the governmental growth into our freedom (a feat rarely accomplished).  It provided for block-granting Medicaid, allowing some fiscal control.  It would have given Trump another step toward a major legislative victory.  Repeal would save the private medical insurance system.  It would have given employers greater flexibility in hiring as businesses approach 50 or more employees.  It would lower the cost of all covered employees.  Most important, individual insurance purchasers would have more choices in policies that met their needs, the hallmark of capitalism (a Texas senator Ted Cruz compromise).

The worst provisions of the failed bill included subsidies to insurance carriers as a way of normalizing premiums.  Some of the taxes on wealthier wage earners were continued.  All of the regulatory mechanisms were not removed, a victory for the left.  This is the result of years of failing to defund Obamacare. 

Now the media and the left have managed to make the Republican plans appear worse than the Democratic plans.  But the fault falls on the Republican information machinery.  Republicans surrendered the narrative through naïveté, incompetence, and deception.  Some Republicans wish to continue with the march toward socialized medicine, thinking the money will be available for many years.  Dependence upon incorrect CBO scoring as cover for their activities has doomed citizens to poor decisions. 

The swamp is deep and murky.  Washington is full of these monsters.  This series of failures in the Senate exposes some of the Republican creatures.  Avoidance of a direct vote on repeal may force hesitant senators to compromise on a repeal and replace bill.  Such is the way sausage is made in Congress.  For the future of our health care system, Trump must finish the deal and find a compromise that secures 50 votes.  Then he must go on the road to educate the public and bypass the media.  This is not a job that should be left to his Twitter fingers.

Shockingly, Republican senators, having failed to pass any health care reform legislation, appear poised to leave Washington in August for an undeserved vacation.  Senate majority leader Mitch McConnell of Kentucky has decided to force them to vote on a repeal plan (thereby exposing their true positions), which cannot eliminate many of the worst provisions of Obamacare.  For example, this does nothing to block-grant Medicaid to control runaway costs, perhaps the best aspect of the failed second Senate attempt. 

A vote to repeal Obamacare will leave Republicans exposed to well deserved criticism as funding for the medical system becomes untenable.  If they could not agree on a repeal and replace bill, they will never agree to fully repeal Obamacare, despite years of promises.  Further, it allows Democrats, particularly New York senator Chuck Schumer, a greater hand in crafting a replacement, since there is no consensus among Republicans for replacement.  A standalone replacement bill will require 60 senators to pass a filibuster challenge.

President Trump is now trying the charm offensive by inviting Republican senators to lunch at the White House.  He may encourage a simple repeal vote as a way of gaining a compromise.  If this effort fails to reach a compromise that can pass, it will be time to use a more direct method.  The "mother's milk" of politics is money.  It is time for Republican senators to clearly indicate their frustration by their intent to withhold funds for future election campaigns. 

The Washington establishment sought to please the insurance, medical, pharmaceutical, and hospital lobbies, among the largest nationally, to ensure future campaign funding.  They crafted a hodgepodge package that left many unhappy.  Funds for opioid treatment were increased greatly.  McConnell offered goodies to Alaska senator Lisa Murkowski to no avail; he still could not secure 50 votes.  He had hoped to protect those moderate and liberal senators in his caucus, guaranteeing their votes for his leadership.  But he lacks the skill of his predecessor, the Democratic former Senate leader, Harry Reid.  This failure may take down the entire caucus and damage Republicans in 2018.

Perhaps McConnell's gambit to force senators to vote for repeal (the favorite plan of Kentucky senator Rand Paul, another "refusenik") will make a compromise more likely.  With any luck, Trump may be able to cobble together a successful negotiation.

Despite its faults, there were some good aspects of the failed legislative proposal.  Taxes were reduced, which would spur economic growth.  Reduced spending would free up as much as $1 trillion that would allow a more generous tax reform package.  It would have reversed some of the governmental growth into our freedom (a feat rarely accomplished).  It provided for block-granting Medicaid, allowing some fiscal control.  It would have given Trump another step toward a major legislative victory.  Repeal would save the private medical insurance system.  It would have given employers greater flexibility in hiring as businesses approach 50 or more employees.  It would lower the cost of all covered employees.  Most important, individual insurance purchasers would have more choices in policies that met their needs, the hallmark of capitalism (a Texas senator Ted Cruz compromise).

The worst provisions of the failed bill included subsidies to insurance carriers as a way of normalizing premiums.  Some of the taxes on wealthier wage earners were continued.  All of the regulatory mechanisms were not removed, a victory for the left.  This is the result of years of failing to defund Obamacare. 

Now the media and the left have managed to make the Republican plans appear worse than the Democratic plans.  But the fault falls on the Republican information machinery.  Republicans surrendered the narrative through naïveté, incompetence, and deception.  Some Republicans wish to continue with the march toward socialized medicine, thinking the money will be available for many years.  Dependence upon incorrect CBO scoring as cover for their activities has doomed citizens to poor decisions. 

The swamp is deep and murky.  Washington is full of these monsters.  This series of failures in the Senate exposes some of the Republican creatures.  Avoidance of a direct vote on repeal may force hesitant senators to compromise on a repeal and replace bill.  Such is the way sausage is made in Congress.  For the future of our health care system, Trump must finish the deal and find a compromise that secures 50 votes.  Then he must go on the road to educate the public and bypass the media.  This is not a job that should be left to his Twitter fingers.

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