Obamacare escaped assisted suicide at the hands of the so-called "united Republican government" of House speaker Paul Ryan and will now die a lingering and painful death. The American Health Care Act (ACHA), which proves the adage of a camel being a horse designed by a committee, imploded on the launch pad, abandoned by purists left and right, making the perfect the enemy of the good.
Arguing over who now owns this continuing Obamacare train wreck ignores that the American people are still tied to the tracks. While the Democrats celebrate the survival of the health care equivalent of the Hindenburg disaster, the GOP debate whether trying to get what they could through reconciliation was the best strategy.
The Democrats still own it. The Republicans didn't fix or replace Obamacare, but they didn't break it, either. It might have been a better strategy to repeal and replace Obamacare in one bill that would pass the House, leaving the Democrat senators up for re-election in 2018 to either join the replacement effort or filibuster it at their electoral peril.
The bottom line is, there's still hope and still a viable option. Don't go back to the drawing board; rather, simply reintroduce and pass 2015's HR 3762, theRestoring Americans' Healthcare Freedom Reconciliation Act. Introduced by then-Rep. Tom Price, now HHS secretary, the bill passed the House on October 23, 2015 by a vote of 240-189. The Senate, after making changes to make it more robust, passed their version on December 3 by a 52-47 vote. A vote to override President Obama's veto failed on February 2, but the onus was on him and the Democrats. Voters, knowing that a Republican president would have signed the bill, elected one, Donald J. Trump. So what's wrong with reintroducing a bill that passed both the House and the Senate?
Granted, it was not a full repeal and place, but it was a better starting point than the Rube Goldberg legislation that just died in childbirth, doing many of the things everyone, including the Freedom Caucus, said they wanted:
The House version of H.R. 3762 included repealing the individual mandate, the employer mandate, the medical device excise tax, and the "Cadillac tax" on expensive employee health insurance premiums.It also included a measure to eliminate federal Medicaid funding for Planned Parenthood for one year. But it called for increasing funding for community health centers by $235 million/year for two years (a 6.5 percent increase over the currently scheduled funding).
The House bill also allowed people to use their Health Savings Accounts to buy over-the-counter drugs. Outspoken AHCA opponent Rand Paul voted for the Senate version. Freedom Caucus members Rep. Mark Meadows and Rep. David Brat voted for the House version. Ironically, one of the poison pills in the bill was refundable tax credits, called an "entitlement" by the likes of Meadows today but embraced by GOP AHCA opponents in 2015 as a great conservative idea.
Meadows's hypocrisy as a co-sponsor of Rep. Price's Empowering Patients First Act of 2015 (H.R. 2300) has been duly noted by Quin Hillyer in the Washington Examiner:
The leading double-talker is Rep. Mark Meadows of North Carolina, chair of the House Freedom Caucus – a group even more hard-line than the longstanding conservative caucus called the Republican Study Committee. In multiple interviews, Meadows has repeatedly blasted the refundable credits for somehow amounting to "a new entitlement program."This is the same Meadows who just two years ago signed on as a co-sponsor of the Empowering Patients First Act of 2015, authored by then-Rep. Tom Price, who now is secretary of health and human services. The official summary for that bill starts with one sentence saying it would replace Obamacare; then the very next sentence – the first sentence explaining the actual substance of the act – reads as follows (my emphasis added): "The billprovides for refundable tax credits for health insurance coverage and health savings account (HSA) contributions." ...If the tax credits are such an obvious betrayal, why have solid conservatives supported them for so long? The House Freedom Caucus has yelled loudly against the leadership's replacement bill, but among the other caucus members who signed onto Price's tax credit bill two years ago were Reps. Jeff Duncan, Scott Perry,Trent Franks, Scott DesJarlais, Steve Pearce, Ted Yoho, Randy Weber, and Mark Amodei – along with noted budget hawk Mick Mulvaney, who now heads the new administration's Office of Management and Budget.
FreedomWorks' Jason Pye has recommended that the GOP in fact considerresurrecting the Restoring Americans' Health Care Freedom Reconciliation Act and sent a letter to Congress endorsing the idea:
FreedomWorks has long opposed ObamaCare and supported the effort to repeal the 2010 law, which is why we key voted in favor of the Restoring Americans' Healthcare Freedom Reconciliation Act, H.R. 3762, in the 114th Congress. This bill repealed ObamaCare's tax and cost-sharing subsidies, most of the law's taxes, and Medicaid expansion within two years. It also zeroed out the individual and employer mandates.The Restoring Americans' Healthcare Freedom Reconciliation Act passed both chambers of Congress with overwhelming Republican support. In fact, only five members–three in the House and two in the Senate–voted against it. All but three House Republicans voted to override President Barack Obama's veto of the Restoring Americans' Healthcare Freedom Reconciliation Act in February 2016.After President Obama's veto of Restoring Americans' Healthcare Freedom Reconciliation Act, Speaker Paul Ryan (R-Wis.) said, "We have shown now that there is a clear path to repealing ObamaCare without 60 votes in the Senate. So, next year, if we're sending this bill to a Republican president, it will get signed into law."
The Heritage Foundation, which had grave reservations about the AHCA, urged after Trump's election the re-passage of the 2015 legislation, suggesting that based on past support, it could have been on Trump's desk for him to sign on day one:
There are no more excuses to be had. The Republican-controlled Congress has every tool that it needs to overcome any and all obstacles that stand in the way of fully repealing Obamacare. Now that voters have given Republicans control of the House, Senate, and the White House, this campaign promise can and must quickly become reality and the American people should hold them, and President-elect Trump, accountable for delivering on that promise.In fact, it is entirely possible for the Republican Congress to have a bill fully repealing Obamacare on President-elect Trump's desk by the time he takes office on January 20. This memo outlines the path that Congress can take over the next two months to ensure a bill repealing Obamacare is the first thing President Trump signs – and that he signs it on Inauguration Day. ...In 2015 the House and Senate passed a reconciliation package (H.R. 3762) that repealed most, but not all, of Obamacare. During the process, Heritage Action argued that: "Using reconciliation this year is important because it should be a trial run for 2017, when we will hopefully have a President willing to sign a full repeal bill. If we are short of 60 votes in 2017, then we will need to use the reconciliation process to accomplish this. If we do it now and do it right, we can ensure full repeal is a fait accompli in 2017." While the initial, House-passed version of H.R. 3762 in 2015 fell far short of true repeal, the Senate amended the bill to make it a more robust repeal package.
Indeed , there are no more excuses to be had. I advise the GOP to learn from history and, in this case, try to repeat it. There is a Plan B waiting to be passed. Pass it.