The great compromiser: Health-care amendment that may unite GOP moderates and conservatives offered by ... Ted Cruz

Well, he did campaign last year on his ability to make the best deals, really fabulous deals.

That was Cruz, right?

Vox notes that the man most famous for filibustering ObamaCare and deriding Mitch McConnell may have hit on something that bails McConnell out of a seemingly unbridgeable gap within his caucus on O-Care’s replacement. Earlier this year, Susan Collins and Bill Cassidy proposed a compromise: Why not give states the option of whether to keep ObamaCare or not? Blue states could retain it, red states could opt for waivers that let insurers offer cheaper plans with less coverage. Cruz’s plan is an intrastate variation of that hybrid approach. Instead of letting each state decide whether to opt in or out of ObamaCare, he proposes letting insurers in each state offer whichever plans they like so long as they offer at least one ObamaCare-compliant plan. If you want to pay more for a plan with all the bells and whistles that O-Care requires, go nuts. If you want something less expensive and less comprehensive, that’s on the menu too. People with preexisting conditions could choose the bells-and-whistles plan, healthier folk could choose the skimpier fare. Win/win!

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That may make Republican moderates and conservatives happy enough to get McConnell 50 votes. Just one question: Who’s going to cover the revenue shortfall for insurers when healthy consumers start swapping their expensive ObamaCare plans for cheaper Cruz-enabled ones? The money to pay for treatment of people with preexisting conditions needs to come from somewhere. If it ain’t coming from healthy people, and if hiking premiums on the sick is too politically unpopular, where’s the money coming from? According to Cruz, it may need to come … from you and me:

“It’s not fair to a working-class person who’s struggling to put food on the table, for the federal government to double their premiums trying to work an indirect subsidy for others who are ill. Far better to have it through direct tax revenue,” Cruz told me.

So it becomes a question of the federal government’s willingness to pay that bill, indefinitely into the future…

“If those with seriously illnesses are going to be subsidized, and there is widespread agreement in Congress that they are going to be subsidized, I think far better for that to happen from direct tax revenue rather than forcing a bunch of other people to pay much higher premiums,” Cruz said.

Ted Cruz, blessing (reluctantly) higher federal spending on health care. Man, we’re a long way from the tea party’s salad days. Lefty Eric Levitz accuses him of supporting the basic logic of single-payer here, which isn’t quite true: The point of Cruz’s amendment is to give people more options in coverage. But the right wing of the GOP embracing greater federal subsidies for the very sick does feel like a significant step ideologically towards single-payer eventually. Relatedly, if the feds are going to be picking up (much of) the tab for people with preexisting conditions, those ObamaCare taxes suddenly become much harder to get rid of. Especially if McConnell also has to bend towards the GOP’s moderates on more robust Medicaid funding:

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The word late last night was that McConnell was preparing to put $45 billion in funding for opioid treatment programs back into the bill to attract holdouts like Rob Portman and Shelley Moore Capito. (Other reluctant moderates are reportedly being bribed with, ahem, larger numbers of H-2B visas for their states.) By the time this is over, the GOP might end up just re-passing ObamaCare and calling it “repeal.” Oh well. Cruz warned us we’d end up here, and now here we are.

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David Strom 3:20 PM | November 15, 2024
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David Strom 12:40 PM | November 15, 2024
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