Friday, May 05, 2017


Now that the House has passed one godawful version of Trumpcare, the battle now moves to the Senate, where Republicans say they're starting from scratch, even though they're going to try to include elements of the House bill:
Senate Republicans said Thursday they won't vote on the House-passed bill to repeal and replace Obamacare, but will write their own legislation instead.

A Senate proposal is now being developed by a 12-member working group. It will attempt to incorporate elements of the House bill, senators said, but will not take up the House bill as a starting point and change it through the amendment process.

"The safest thing to say is there will be a Senate bill, but it will look at what the House has done and see how much of that we can incorporate in a product that works for us in reconciliation," said Sen. Roy Blunt, R-Mo.
If the Senate bill includes any elements of the House bill it will be awful, because every element of the House bill is awful. And yet, because there's so much pressure on Republicans to score a win for the president and the party, and because the bill is a legislatively necessary precursor to the GOP's Holy Grail, a really huge tax cut for the rich (even though the health care bill itself gives a very large tax cut to the rich), I expect victory for Republicans in the Senate, probably on a 50-50 vote, with Susan Collins and Lisa Murkowski voting no and Mike Pence breaking the tie. In fact, I think Republicans will get through the whole process successfully -- Senate vote, negotiation of a reconciled version of the bill, revotes in the House and Senate -- despite what I expect to be sustained outrage from the anti-Trump resistance.

Why do I think they'll get a bill enacted? Precisely because whatever they come up with will be staggeringly awful.

It will be awful in so many ways that opponents will be unable to focus on a few aspects and build opposition to them outside the liberal realm. When we talk about it, we'll be describing a bill that sounds so horrific that seemingly persuadable middle-of-the-road listeners will assume it can't possibly be that bad -- they'll think it's just liberals proclaiming again that the sky is falling because we have a knee-jerk hatred for everything Trump and Republicans do.

Even the Washington Post editorial board can't decide which aspect of the House bill is the worst:
Betrayal, carelessness, hypocrisy: The GOP health-care bill has it all

WHAT A BETRAYAL: Republicans promise to maintain access to health insurance for people with preexisting medical conditions, and then on Thursday press a bill through the House that would eliminate those guarantees....

And what hypocrisy: House Speaker Paul D. Ryan (R-Wis.) claims to be restoring fair process to his chamber, and then orchestrates a vote on this hugely consequential bill before the Congressional Budget Office can tell lawmakers what it would cost or how many people would lose access to health care as it took effect.

Carelessly, the bill would threaten the integrity of even employer-based health-care plans in every state, apparently by accident. Recklessly, its drafters introduced just one day before the vote legislative language that an independent expert called “incoherent, arbitrary, and technically complex.” Tragically, the repeal-and-replace effort is causing so much uncertainty that, even if this bill dies in the Senate, it may unravel the existing health-care system....

Meanwhile, the bill’s sloppy drafting means that employer-based health-care plans might be permitted to impose annual spending limits and lifetime coverage limits — even if most states attempted to keep strong market protections in place. And do not forget that much of the bill is unchanged from March, when the CBO found that it would result in 24 million fewer people with health insurance. It would still roll back a Medicaid expansion for the near-poor and unlink federal health-care subsidies from income and region. The money saved would go to wealthy people in the form of tax cuts. Poorer, sicker and older people would feel the pain.
That's how we're all describing it: it's horrible in this way and this way and this way and this way -- and if we keep doing that, people in the middle are going to tune out. In fact, the more right-centrist of them will think, Boy, this thing must be pretty good if it's giving fits to the media and the liberals. Remember, that's more or less how Trump got elected.

Democrats took a long time to pass the Affordable Care Act, which gave opponents plenty of time to mount a series of focused attacks (death panels! read the bill! Cornhusker kickback!). Republicans are rushing this through, and opponents aren't focusing. So I think conservatives voters will close ranks around the bill and a lot of mushy-middle voters will start assuming it's okay. The poll numbers on it are likely to rise. And it'll pass.

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