That's It? We Only Had One Chance To Repeal?


The fait accompli that has encapsulated Capitol Hill since Friday afternoon suggests Obama and the Democrats have once and for all won and Obamacare is here to stay into perpetuity.

That had better not be the case. Does the GOP want to go down as having trumped Obama’s all time political lie about liking your doctor and keeping your doctor by claiming for seven straight years they would repeal and replace the Affordable Care Act, and then not do so?

No one ever said repealing and replacing Obamacare would be easy. While the Affordable Care Act was conceived as a health insurance bill it morphed into something much more complex with all kinds of taxes, differing cash flows, budget off-sets, and was passed through Congress by manipulation of the legislative rules and changes in the legislative process. When it comes to repeal and replace certainly efforts should be made to diminish budgetary impacts on yearly deficits and debt, to minimize the number of Americans who will not have government subsidies that make their monthly insurance premiums free or more affordable, and to plug cash flow and regulatory holes for insurance providers so that they can transition out of Obamacare and still remain in business and provide health insurance policies. These things can all be achieved while at the same time moving towards a more free market based health insurance system. There is and always will be a role for government in the health insurance market.

This process will be messy, and that is OK. The failure of the AHCA to reach the House floor for a vote does not mean the GOP is in tatters or in a catastrophe. The failure wasn’t stunning. What was stunning was how bad the bill was. Speaker Ryan’s failure simply means a sufficient number of Republicans didn’t like the contents and likely outcomes of the bill, or the manner in which it was cobbled together and presented to them.

The AHCA was a bad bill written behind closed doors and completely out of line with the campaign rhetoric of every Republican incumbent since 2009. Party loyalists, professionals, and the consultancy class were content with the bill given the circumstances and will lean on the realpolitik considerations of the risk to maintaining control of the House and the Senate when it comes to taking free health insurance away from voters (forgetting many getting free health insurance are on the Dem team anyway). The practical agnostic will explain the opportunity the reconciliation process offers for easier passage of legislation in both houses and so the need to act sooner rather than later. Plus, keep in mind, the political professionals and the elected officials they serve are already focused on re-election in 2018; it constrains risk taking.

There were only two good outcomes for the AHCA: voted down, or pulled from consideration.

Since Speaker Ryan pulled the bill from the floor on Friday talk has been of moving on to the next agenda item, that Obamacare is with us for the foreseeable future, and Trump’s claim he will be back to help after Obamacare collapses. Irresponsible, unprofessional, embarrassing are words that come to mind to this type of talk.

From there considerations of Congressional productivity and how little work our highly paid members of Congress do each day, week, month, year, or cycle must be addressed. Four hundred and thirty-five members of the House and there is no time to start again on repeal and replace? There is only time to move on the next agenda item? Talk about low productivity. There is plenty of time; they choose not to use it for the hard work of the people.

Why?

Fundraising and re-election is why. Most of a member’s time is spent fundraising for the party, themselves, or their preferred colleagues. Have a look at the legislative calendar for a good laugh. Monday’s and Friday’s are travel days.

The research on the health insurance industry is done to death. The research on why Obamacare is failing is done and evident to all who are willing to notice. Dozens and dozens of repeal and replace bills have been voted on and passed in the Republican controlled House. Another repeal and replace bill could be readied in days.

Stop the politics. Get to work!

There are dozens of hard working Republicans trying to do the right thing each day, who put in the hours, who vote for what is right regardless of political risk, and who I know are willing ready and able to put together another repeal and replace bill this week. Several members of the NC delegation would be on this list of dozens including Mark Meadows, Richard Hudson, George Holding, and Walter Jones. David Brat from VA is ready to work and lead as well. If the legislative calendar doesn’t allow for more time to be spent on repeal and replace, change the calendar.

Leadership and productivity; these two key elements of GOP success have been put in sharp relief this week. The GOP led house should do what it said it would and do, and do so in an efficient and productive manner now.

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