Here we are today; the AHA has seemingly crashed and burned because some Republicans were too afraid -- most are always afraid -- while others were just too pure of heart -- they would rather accept defeat than vote for something that was merely an improvement and not the whole ball of wax.
The frightened balked at the block-grant formulas for Medicaid, while the indomitable ideologues objected to the preservation of the 3.8% net investment tax on passive income, capital gains, and dividends as well as the 0.9% Medicare surtax on income and wages for couples making more than $250 thousand a year or singles making more than $200 thousand per annum.
Medicaid was originally designed as a program to guarantee healthcare for the poor. ObamaCare was in reality, mostly an expansion of Medicaid. After the passage of the ironically named Patient Protection and Affordable Care Act (PPACA) most of the boasted increase in those with coverage ended up in Medicaid metamorphosing the program into healthcare for the poor and non-poor alike. Along with this came the establishment of one-size-fits-all insurance policies. In other words, policies that were designed to include Democrat politically perceived universal exigencies instead of individual healthcare needs.
This made purchasing health insurance in America like buying cable where people are not allowed to pay for only the channels they want to watch. They have to pick from definitive “plans” offered by the cable companies. Hence, viewers always find themselves with a plan including things like the Sudanese State Channel and badminton from Suriname. The plans even have similar names. Silver, gold, and platinum are appellations liberally attached to plans offered by both health insurance and cable industries. With respect to healthcare, people are often forced to buy much more coverage than what is wanted or needed.
The bill that failed (ostensibly) in the Senate would have kept the 3.8% tax on investment income and the 0.9 payroll tax. Still, it was also an attempt to “transition the [Medicaid] program to per capita block grants and equalize payments for the poor and the disabled compared to ObamaCare’s Medicaid expansion population of able-bodied adults. The revision is too generous in the early years and has a long runway to give Governors time to plan and adjust, but it shifts to a budget growth rate in a decade that is fiscally sustainable,” a change that over the next decade will save $772 billion, according to a recent editorial in the Wall Street Journal.
That same Journal article also said that the bill would have provided for a “modest expansion of Health Savings Accounts and a version of Ted Cruz’s ‘freedom option,’ which would allow insurers that sell ObamaCare-compliant plans to also sell deregulated plans. Combined with state waivers, this could lead to significantly lower premiums for most consumers.” In other words, it was a halfway measure to eliminate the law’s requirement to buy more coverage than desired or required.
This wasn’t good enough for some Republicans and too much for others, and the result was legislative failure (supposedly). None of that matters at this point, because prospects for the passage of any bill on the subject of healthcare in the Senate, while not dead, are not particularly bright despite some late-inning arm-twisting by the president.
Yet, you never know. Repeal and replace, which had become partial repeal and repair at some point may become simply repeal -- or perhaps, some Republican senators may surprise us all by showing some spine and others, a willingness to accept limited victory instead of total victory and AHA will breathe new life. Trump’s working them, so we shall see.
Senator Schumer, one of the oiliest of the Democrat contingent, has complained bitterly about his party not being afforded the opportunity to write the legislation to accommodate their predilections as well as the use of Reconciliation for the passage of any bill. An outright liar or senescent scoundrel with memory issues, he acts as if he doesn’t remember how Democrats used legislative trickery to give us ObamaCare, not only without any opposition input but also without a single Republican vote.
Brian Sussman explains what happened succinctly:
“Nancy Pelosi’s Democratic majority in the House of Representatives was unable to pass their version of a healthcare law. Because all revenue bills have to originate in the House, the Senate found a bill that met those qualifications: HR3590, a military housing bill. They essentially stripped the bill of its original language and turned it into the Patient Protection and Affordable Care Act (PPACA), aka ObamaCare.“The Senate at that time had 60 Democrats, just enough to pass ObamaCare. However after the bill passed the Senate, Democrat Senator Ted Kennedy died. In his place, Massachusetts elected Republican Scott Brown. That meant that if the House made any changes to the bill the Senate wouldn’t have the necessary number of votes to pass the amended bill (because they knew no Republicans would vote for ObamaCare). So Senate Leader Harry Reid cut a deal with Pelosi: the House would pass the Senate bill without any changes if the Senate agreed to pass a separate bill by the House that made changes to the Senate version of ObamaCare. This second bill was called the Reconciliation Act of 2010. So the House passed PPACA, the Senate bill, as well as their Reconciliation Act. At this point PPACA was ready for the President to sign,” after the Senate passed the Reconciliation Act.
To sum up, they wrote and passed a million-page bill (hyperbole) that admittedly, no one had read, without opposition input or votes, in the dead of night, on Christmas Eve, using legislative trickery. It has failed spectacularly, and now, it's everyone else's fault.
According to Valerie Jarrett, all it needs is more money to tell everyone how great it is. I'm sorry, but no!
Enough with these people. What happened to leaving office with dignity and letting the next administration have the benefit of doing the things the people elected them to do?
Jarrett and her ilk are graceless autocrats who think Americans are morons with absolutely no memory of what went on with this abomination while having no idea of how much their healthcare costs have increased -- in some cases, astronomically.
Yet, I’m not sure passing anything would have any benefit to the nation. The way I see it the Republicans have two options:
- Pass AHA and then Republicans can claim victory and gather momentum, which they will need to pass tax reform, comprehensive or partial, whatever is doable. After passing tax reform and as the economy begins to pick up they can more fully concentrate on total repeal and replace.
- Forget about ObamaCare for the moment and let the Democrats own the monster as it collapses all around them while Republicans concentrate on tax reform, which in my opinion, should have come first anyway. As above, they can circle back later when tax reform begins to lift the economy, employment and wages.
Newt Gingrich made a good case for the first option when he said:
“When I worked with President Reagan, he had a constant desire to force a successful negotiation, get as much as he could, and then come back another day for another step forward.Reagan understood that dismantling the big government system was like eating an elephant -- you must take one bite at a time to succeed.”
Myself, I’m leaning toward the second option because clearly, the Democrats have not forced Americans to suffer enough for Republicans to have sufficient political capital to get a more comprehensive repeal and replace through both houses of congress. AHA doesn’t really matter because short of a full repeal of ObamaCare it will remain brimming with provisions that hurt the economy, employment, and wages. This will give license to the Democrats to blame ObamaCare’s inevitable death spiral on Republicans by saying it was perfect before they touched it -- all it needed was a little more money (Doesn’t everything?). Let’s face it; Republicans do not have a reputation of either willingness or ability to fight back against bad mouthing by the Democrats in the media.
It might be better to let the program fail, with full Democrat ownership and after tax reform, charge in and address healthcare then.