The Republican Party’s long-awaited plan to undo ObamaCare will finally emerge this week, according to Reuters. Two months into the new session of Congress and their first real opportunity to make good on promises to repeal the Affordable Care Act, the legislative language will get published for debate in the House and Senate. An agreement between Capitol Hill and the White House on the finer points of the plan makes this possible now, Reuters reports:
Republican U.S. lawmakers expect to unveil this week the text of long-awaited legislation to repeal and replace the Obamacare healthcare law, one of President Donald Trump’s top legislative priorities, a senior Republican congressional aide said on Sunday. …
The aide cited progress in meetings and phone calls starting on Friday and lasting through the weekend involving House of Representatives Speaker Paul Ryan, Health and Human Services Secretary Tom Price, White House budget chief Mick Mulvaney, Trump domestic policy adviser Andrew Bremberg and others.
“We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week,” said the aide, speaking on condition of anonymity.
The aide called the expected bill a “consensus Republican plan,” but offered no details.
The new timeline doesn’t just come from Capitol Hill — it’s also coming from the other end of Pennsylvania Avenue. Hugh Hewitt spoke with OMB director Mick Mulvaney this morning, who told Hugh that we can expect the parameters around repeal and replace this week, including what can be accomplished through reconciliation:
HH: I’m a believer, Director Mulvaney, in passing a, Obamacare is repealed by August 31st of 2018, period. And if we can come up with a replacement, great. What is the strategy here, because I do not understand standing halfway up the mountain taking fire from both sides?
MM: Strategy is to try and get a bill that does what the President wants, which is to repeal and replace that is different than what passed the House and Senate in 2015, which was just mostly a repeal bill. But the President gets a say, and I respect that. In fact, he should have a say, and he wants to repeal and replace. When we talk about reconciliation, and I know that’s getting deep down into the weeds, but you and I both know how critical that is. What does that mean?
MM: Reconciliation means it only needs 50 votes. Keep in mind, we’re trying to undo a bill that was written when the Democrats had everything they wanted. They had 60 votes in the Senate, and this was their dream bill. They didn’t have to work through reconciliation to begin with until Scott Brown won. And they didn’t have to work with Republicans at all. So you’ve got a hard-wired bill in the system that came up with 60 Democrat votes. Undoing that through reconciliation is very difficult, because the reconciliation rules are limited. You can only effect spending in a reconciliation bill. So we are somewhat limited, but we are fighting a battle with 50 votes that they, you know, that they passed with 60 votes. So it’s sort of an un-level playing field to begin with. But the idea is to do exactly what the President talked about on the campaign – repeal it and replace it with something even better. That means something that is really affordable. One of the things that just struck me about the Affordable Care Act was how is not really affordable and didn’t really provide that much care. But we are coming up with something that is better, fairer and more likely to save the health care system in this market in the long run than Obamacare is, because as I think the President said one time, the politically smart thing to do is just let Obamacare go, let it run, and prove what a dismal failure it was. The problem is that’s terrible for the country, so that’s not what we’re doing. We’re working on stuff, and I hope to have something out here in the next couple of days.
HH: Most people, though, heard the President say erase the lines and repeal. And so to me, you can use reconciliation to say the 2,000 page bill is gone, and we are replacing it, and then, with a single national market. So very specifically, will there be a single national market where one policy available, whether or not you want to buy it, is available anywhere in the United States?
MM: And keep in mind, as much as I want that to happen through reconciliation, I don’t think it can. It doesn’t affect spending. So I don’t think you can erase the lines through reconciliation. You can repeal all the taxes. You can repeal all the subsidies. You can create new tax credits, because all of this deals with spending. But when you start driving things that are purely policy, the better example, the one that, not better example, but another example is malpractice reform, medical malpractice reform, not suitable for reconciliation. Keep in mind, reconciliation is part of the budget process. It is a budget tool. It’s sort of an anomaly within the Budget Act, and it must be budget-driven in order to be reconcilable. And creating a national market for insurance, which we want desperately, doesn’t seem to be subject to the reconciliation rules in the House and the Senate. So we will be limited on what we can do. That doesn’t mean that we stop pushing for it. It means that we…
HH: It does me, though, that the administration put out what it’s going to do. It’s going to have to have its five points of what it’s going to get done through reconciliation.
HH: When do we see those five, or seven or ten points of the reconciliation possible?
MM: This week.
Curiously absent from the meeting list that produced the new timeline: Senate Republicans. That may not matter too much at first, given the current outsider status of the House Freedom Caucus on the new plan. However, Mulvaney hails from that end of the House GOP caucus, and his sign-off might mean that the final House plan will be more tilted in their direction than first thought too. Senate Republicans have made it clear that they’re not interested in Freedom Caucus proposals on ObamaCare repeal.
Getting a passing vote in the House might be tricky, but it should be doable. As Allahpundit wrote on Friday, Trump’s backing will put a lot of pressure on House conservatives to play along. The real trick will be in the Senate, where Republicans can do most of the repealing on their own through reconciliation, but not the replacing. Mulvaney explains this in his conversation with Hugh — anything with a budgetary impact can get addressed through reconciliation, which would be all of the taxes, subsidy payments, and mandates. After that, though, Senate Republicans will have to put together a plan that will get at least eight Democrats without losing any Republicans — and then return it to the House for a new vote.
Perhaps this process might offer a chance to renew a long-ignored tradition in Congress: the conference committee. Thanks to the budgetary brinksmanship of Harry Reid, conference committees have been abandoned for all-or-nothing votes from one chamber to another. Repeal can take place with Republican-only votes, but perhaps after that is accomplished, the messier but usually productive conference process could result in a quiet, somewhat bipartisan effort to replace ObamaCare once it has been well and truly rooted out. Until it’s rooted out, though, Democrats have little incentive to cooperate on whatever comes next.