Ah, that special moment when the negotiation stage moves to the threat stage.
How scared should Mark Meadows be of being blamed for killing a bill that’s as popular as asbestos?
— Michael F. Cannon (@mfcannon) March 23, 2017
Credit where it’s due: Whatever ends up happening, the president, the speaker, and the Freedom Caucus have made this one highly entertaining intraparty sh*tshow. If this day doesn’t end with Trump threatening to find a primary challenger to Meadows next year, I’ll be disappointed.
Speaking of sh*tshows, CBO released its score this afternoon of the amended version of the House bill, one which lowered the threshold for Americans to deduct medical expenses on their income tax returns and which tweaked Medicaid in certain ways. Result: Instead of reducing federal deficits by $337 billion over 10 years, the amended bill would reduce them by only $151 billion. The bill got more expensive due to the adjustments, in other words, a new Democratic talking point against it. And it might get more expensive still if Ryan ends up agreeing to repeal some of the regulations governing ObamaCare’s “essential health benefits,” as the Freedom Caucus has demanded. Philip Klein:
The problem comes because the bill [without the mandates for “essential health benefits”] would then still leave in place not only the requirement that insurers cover those with pre-existing conditions, but also the restriction against charging more based on health status, a regulation known as community rating.
In such a market, healthy people would have every incentive to purchase the cheapest plans possible, knowing that they could always upgrade to more comprehensive plans if they get sicker, since those will be community rated. Also, insurers could reduce the number of sicker people on their rolls by offering slimmer coverage options. This exodus of healthy people could put comprehensive coverage out of financial reach for sicker individuals.
With the EHBs repealed, there’ll be less revenue for insurers as healthy people downgrade to cheaper, less comprehensive plans and there may be fewer plans with robust coverage available to the sick. Put all of that together and some people with preexisting conditions might not have the coverage they need and insurers might not have the revenue they need to cover them. You can’t just repeal the “essential health benefits” to make conservatives happy without solving that problem, as Justin Amash (a Freedom Caucus member) pointed out last night. But this is what the House might be poised to do, purely in the name of throwing together a bill — any bill — that can pass.
Exit question: Er, how are moderate Republicans handling these endless efforts to make Meadows happy by making the bill more conservative?
Source tells me the GOP moderates "are freaking out right now" on health care bill. "We'll get them. But they are nervous."
— Chad Pergram (@ChadPergram) March 23, 2017