Those are the two options, huh? ObamaCare or ObamaCare Lite? Megan McArdle summarized the logic of the House bill this way last night: “Something must be done. This is something. Therefore, this must be done.”
Pence wants “something” done.
“If you like your Obamacare you can keep it,” Pence told Republicans at a closed-door meeting Tuesday. “But the American people want change.”…
The White House on Tuesday cast the GOP bill as a “work in progress,” a sign that changes may be necessary in order to move it through the House. Pence acknowledged that reality by saying as the legislative process goes forward, the GOP plan “is the framework for reform and we are certainly open to improvements and to recommendations in the legislative process.”
But he also warned the GOP, “this is the bill” backed by President Trump.
When are these improvements and recommendations happening, exactly? McConnell’s ready to ram it through the Senate as soon as the House passes it. The slower Ryan moves and the more the bill is rewritten, the greater the risk it’ll stall and that already wavering pieces of the GOP coalition in the House will break off. Doesn’t sound like Trump is keen on improvements and recommendations either:
Whip sources tell me Trump agreed with their argument that this is binary choice: either u back a replacement that can pass or u keep Ocare.
— Rachael Bade (@rachaelmbade) March 7, 2017
Kevin Brady, head of the Ways and Means Committee, also said Trump sounded urgent in their meeting: “The president made it very clear that this is his bill and there are no excuses — it’s time to act now. It is clear he is putting his presidential weight behind [the measure].” One thing that might get the caucuses in both chambers excited to pass it would be a provision authorizing insurance to be sold across state lines — but right now that’s slated for “phase three” of the legislative process. Which means … I’m not sure what:
Moving across the Capitol, Pence and Price worked Tuesday to sell the proposal to House lawmakers — arguing to reluctant Republicans that the repeal-and-replace measure was one of a three-part plan to reform health care.
The second phase involves Price, the former House Budget Committee chairman who as HHS secretary has the power to repeal hundreds of Obamacare regulations as well as the ability to reshape or replace them with a patient-centered and market-driven outcome Republicans are seeking. The third phase will involve taking up additional health care legislation that would improve the insurance market, including a measure allowing consumers to purchase plans across state lines.
It may be that they have to separate the provision regarding selling insurance across state lines because that’s non-budgetary, which means that reconciliation can’t be used in the Senate to enact it. The plan seems to be to pass all the budgetary measures right now via reconciliation (which requires only 51 votes, of course) and then, once that’s done, to tackle the state-lines bill in the hope that red-state Democrats might be willing to join the GOP on it at that point and help defeat Schumer’s filibuster. The left won’t let centrist Dems like Joe Manchin vote for anything that repeals ObamaCare, but if the GOP manages to get repeal done first on its own, Manchin might feel comfortable enough to vote with them on additional reforms later on the theory that O-Care is gone and he might as well make the best of a bad situation. (Or, of course, the GOP could always follow this strategy to force him to.) And if Democrats stand firm and refuse to vote for that bill too, it gives the GOP something to run on in 2018. “Help us free the insurance market by electing more Republicans to the Senate!” Just one wrinkle: If the House bill ends up getting enacted and it’s a bust — ahem — it’s likely to mean a bluer Congress in 2019, not a redder one. And a bluer Congress will be in no mood to help the GOP pass “phase three” of TrumpCare or whatever.
Two other points. One: I don’t understand why they let Ryan and the House leadership roll this out instead of making Trump himself the face of it. Conservative groups and activists were far more likely to RINOize a bill that has Ryan’s fingerprints all over it than Trump’s. Granted, Trump isn’t able to field questions on the nuances of the bill with anything approaching the dexterity that Ryan or Tom Price has, but no one was asking him to. He could have simply called a press conference last night with Ryan at his side and run through some scripted shpiel about it. The fact that he didn’t makes me wonder if Trump and Bannon knew that the bill wouldn’t be well received on the right and insisted upon Ryan being the lightning rod for it. Bannon’s a Ryan critic from way back, remember; if he has his own vision of health-care reform in mind, step one is to have the congressional GOP’s plan be swept away and the party be left scrambling for an alternative.
Two: Rand Paul and Jim Jordan are preparing to introduce a “clean” repeal bill that would, apparently, largely duplicate the 2015 repeal bill passed by Republicans and vetoed by Obama. That seems like a tough vote potentially for Republicans if it makes it to the floor. On the one hand, every Republican would/should want to be on record as voting for repeal; on the other hand, it’d be risky to pass the Paul/Jordan bill so long as the House GOP’s bill is in doubt. We could end up in a situation where the latter fails and the only thing left for Trump to sign is the former, which would risk chaos in the insurance industry without a replacement system ready to go. What does Trump do then? Does he ask the caucus to vote no on the clean repeal bill to avert that scenario?
Here he is today talking up the bill, followed by Sean Spicer emoting over the fact that the GOP’s plan is only a fraction of the size of Obama’s bill. Er, yeah, buddy. That’s because it’s basically just an amendment to ObamaCare
WATCH: White House Press Sec. Spicer uses stacks of paper to make his argument about health care bills and "big government." pic.twitter.com/niVTuGBfJL
— NBC Nightly News with Lester Holt (@NBCNightlyNews) March 7, 2017