Friday, January 27, 2017

GOP Looking For A Healthcare Strategy

The Washington Post has obtained a secret recording of a closed-door meeting between Republican lawmakers – and it reveals them expressing serious doubts about how they are going to live up to their promises to the American people of getting rid of Obamacare, while at the same time initiating a replacement without creating chaos.

In the recording, a number of concerns were raised, but chief among them was how they were going to do this in a way that wouldn’t hurt them when the next election comes up.

What’s most striking about the conversations, however, was that key Republicans admitted that they didn’t know what to do as far as a replacement plan is concerned.

They discussed how to prepare a plan – a plan that they should have already figured out. Keep in mind – they have been talking about repeal and replace for quite a long time now, but they still don’t seem to have their agenda sorted out.

According to the Post, they are still determining how to avoid damage to the health insurance market, how to keep premiums affordable, and how to get away with defunding Planned Parenthood without it hurting them politically. Congressman John Faso (R-N.Y.) touched on this latest point:
“We are just walking into a gigantic political trap if we go down this path of sticking Planned Parenthood in the health insurance bill,” he said. “If you want to do it somewhere else, I have no problem, but I think we are creating a political minefield for ourselves — House and Senate.”
The recording took part during a Republican Party policy retreat in Philadelphia. It’s not sure who sent the recording to the Post yet. It was sent to several news outlets from an anonymous email address. The Post took the extra step of confirming the recording by calling their offices, though, and it is legit.
“The fact is, we cannot repeal Obamacare through reconciliation,” said McClintock in the meeting. “We need to understand exactly, what does that reconciliation market look like? And I haven’t heard the answer yet.”
Rep. Tom MacArthur even expressed Democratic sentiment, and agreed with the notion that the GOP’s plan would eliminate health coverage for 20 million Americans, even those covered under Medicaid:
“We’re telling those people that we’re not going to pull the rug out from under them, and if we do this too fast, we are in fact going to pull the rug out from under them.”
Republicans promised their voters that they would replace Obamacare immediately and are trying to take steps to do that – but the truth is they can’t. Speaker Paul Ryan has already stated that they won’t repeal without a replacement plan. This recording proves they aren’t even close to establishing a way forward yet.

The Washington Post also reported:
Seven years after unruly [Tea Party Republicans attending] Democratic town halls helped stoke public outrage over the Affordable Care Act, Republicans now appear keen to avoid the kind of dust-ups capable of racking up millions of views on YouTube and ending up in a 2018 campaign commercial. Only a handful of GOP lawmakers have held or are planning to host in-person town hall meetings open to all comers — the sort of large-scale events that helped feed the original Obamacare backlash in the summer of 2009. …

… Instead, lawmakers are increasingly turning to more controlled forums like telephone town halls, as well as Facebook Q&As and smaller, unpublicized personal meetings that cannot so easily be filmed.
Ed Kilgore wrote about the first two days of their “retreat”–and a retreat it was!–at New York:
The congressional Republican retreat in Philadelphia this week was supposed to foster highly efficient private discussions and briefings, and let the solons emerge from their labors revealed as a lean, mean, legislating machine. From reports at the end of the first day, however, they looked more like lost sheep, disappointed at the inability of their leaders to provide clear direction on how they would negotiate the tangle of health care, budget, and tax legislation they’ve committed to enact. There is particular anxiety about the very first item on everyone’s agenda: the repeal and replacement of Obamacare.

“Exact, specific and detailed — that’s what people want,” said Rep. Pete Sessions (R-Tex.), the chairman of the House Rules Committee. “We’re going to own this stuff, and we better be able to explain it.”

They sure didn’t get that kind of guidance. Here’s an example:

“I don’t think you will see a plan,” said Rep. Patrick J. Tiberi (R-Ohio), chairman of a key subcommittee on health care. “I think you will see components of a plan that are part of different pieces of legislation that will make up what will ultimately be the plan.”

That’s clear as mud, isn’t it?

Mitch McConnell and Paul Ryan tried to generate a sense of decisiveness and momentum by talking about the timetable for one reconciliation bill to repeal (and replace?) Obamacare, another to cut taxes, and additional actions required on appropriations. But the content of all this frenetic activity was left maddeningly vague.

The big problem Republicans face, of course (beyond the unpopularity and the fiscal unfeasibility of much of what they want), is that they’ve chosen a partisan strategy to enact their agenda, which means precision timing and, most of all, advance assurances their own president is onboard are critical. Nobody wants to be halfway through an amendment vote-a-rama on a budget-reconciliation bill repealing Obamacare to find out via Twitter that Donald Trump has changed his mind or finally understood some key issue thought to be long resolved. So the Republicans in Philadelphia expected some guidance and feedback from the president, scheduled to address them on the second day.

Instead, Trump gave them a ton of headaches even as they arrived in Philadelphia, with a bunch of executive orders on hot-button issues. It was painfully clear nobody at the gathering had been given a heads-up on what he planned to do while they were away from Washington, and new issues to grapple with were absolutely the last things they needed.

But the senators and congressmen dutifully cheered the new boss during his pithy remarks today, even as many inwardly cringed at his cavalier disregard for their needs, and his insistence on pursuing entirely imaginary priorities like “voter fraud,” a reminder that he is still upset about losing the popular vote last November.

What they did not get from Trump’s speech was even an ounce of guidance. His comments on tax reform amounted to one vague sentence. On Obamacare, he spent most of his time making the strange and incredible claim that he had thought seriously about letting the present system stay in place until it collapsed, but instead decided to “help out” Democrats by putting it to the sword. He did mention his interest in a big fat infrastructure spending binge, which most Republicans, worried about the red ink he seems determined to spill, would love just to go away. All in all, it was a sort of unplugged version of a 2016 Trump campaign speech.

Sure, Trump or his underlings could convey more concrete hopes, wishes, and instructions informally whenever they wanted. But listening to Republicans in Philadelphia and elsewhere, it sure sounds like that’s not happening, at least not yet. And so they rush toward the deadlines they’ve set for themselves, without the slightest assurance any of their complex legislative maneuvers will turn out well.

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