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You go to war against Obamacare with the President you have

You go to war against Obamacare with the President you have

There isn’t going to be another chance.

I haven’t had a chance to fully digest the House health care bill.  I’m just beginning the process of learning more.

Trump supports the bill broadly, subject to some negotiations. And is promising a round 2 and round 3 of more market-oriented reforms.

It appears that much of this procedure is driven by the desire to repeal Obamacare as a technical matter by the means through which it was passed — the “reconciliation” process. That avoids the possibility of a Senate filibuster by Democrats, but also limits what can be done.

I’ve seen many of the statements rejecting the bill, even if modified somewhat, from the conservative side (I’ve tuned out what Democrats are complaining about). The overall point, as I take it, is that the House bill institutionalizes the key concept of Obamacare – that the federal government not markets will drive health care.

I would have liked to see a truly conservative alternative. But in order to do that we should have elected a truly conservative president.

That’s not a knock on Trump — he is what he is, and as pointed out during the primaries he never has been an ideological conservative. There are many things he believes and already has done that are conservative, but it’s not his nature. He’s always believed in big government, but big government that seeks to make America great again, not big government that seeks to make America weak again.

Ideological conservatives had their chance in the primaries. They lost. We lost. I supported Ted Cruz, but he couldn’t pull it off.

It may be that we ended up with the most conservative candidate who could be elected president, as unsatisfying as that may be.

There is a chance to move the window of the health care bill towards conservatism and free market solutions. We should do that.

But I think it would be a mistake to jettison a version of repeal of Obamacare that does not fully meet our expectations just because it does not fully meet our expectations.

It’s said that you go to war with the army you have.

We’re going to war on Obamacare with the president we have. There isn’t going to be another chance.

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Comments

Close The Fed | March 8, 2017 at 9:37 pm

I understand the reconciliation factor, but am puzzled why they could pass that monster by reconciliation, but we can’t repeal and replace with our version via reconciliation. I haven’t read that deeply on it.

It’s troubling they’re telling insurers they can charge, I believe, 33% more to someone who doesn’t have insurance for 62 or 63 days. That will allow people to game it in a serious way. I far prefer allowing the insurance companies to charge whatever they deem actuarially sound.

I’m also sick and tired of the HSA thing. In comparison, if you don’t have an HSA, you can’t deduct a single medical expense until it’s over 7.5% of your adjusted gross income under their proposal. Obamacare made it 10%. If we are trying to encourage patients to spend their own money, and not filter it through insurance bureaucrats first, we should let people deduct every dollar.

I could just go on and on.. . . . . but the deductible part just kills me.

    One reason I went with a bronze/HSA compatible plan was that I don’t spend enough money to go over even a low deductible limit. I contribute to the HSA to have the cash for the deductible when I need it.

    The Dims had a 60 vote Senate majority when they rammed that fetid turd down the throat of the republic.

      Close The Fed in reply to Paul. | March 9, 2017 at 7:16 am

      No, they didn’t. Scott Brown from Massachussetts had just been elected to the 60th slot.

        Blueshot in reply to Close The Fed. | March 9, 2017 at 8:41 am

        The Democrats had 60 votes. They did some shenanigans to prevent Scot Brown from being seated for a few days. That’s the only reason they were able to get the 60 votes and get Obamacare passed in the Senate.

          MattMusson in reply to Blueshot. | March 9, 2017 at 9:10 am

          Don’t forget that a couple of hundred illegal votes by Felons in Minnesota elected Al Frankin to the Senate which allowed the Democrats to have the 60 needed votes.

          Milhouse in reply to Blueshot. | March 9, 2017 at 12:53 pm

          On which planet did this happen? On this one there were no shenanigans to keep Brown out. The senate passed its version of the bill on Christmas Eve, 60-39. Brown was elected on January 19th, and was sworn in the next time the senate sat, which was February 4th.

          That meant that if the house and senate went to conference as usual, the reported bill would not pass the senate. So the house passed the senate bill as it was, and then put the amendments it wanted into the reconciliation bill, which passed the senate 56-43.

          But because this was the reconciliation bill it could only include budget-related measures. anything the house wanted that wasn’t budget-related couldn’t go in it, which is why the final law ended up with a lot of things that the senate passed in the first place expecting to drop them in conference. Since there was no conference, they stayed in.

You have to take with a grain of salt any criticism leveled by Rand Paul or Lindsay Graham…Trump’s opponents in the primary season. I suspect they do not want Trump to succeed.

If Trump is OK with it, then go forward. He obviously has long-range plans. His record of success on many fronts is…impressive….most impressive.

    Close The Fed in reply to Leslie Eastman. | March 8, 2017 at 10:05 pm

    Rand Paul isn’t motivated by losing to Trump. He’s motivated by what has motivated his father and himself for decades: the knowledge that socialism is a way to impoverish Americans, and he doesn’t want any part of it.

    Not everyone is petty.

      Then, Rand should focus on making sure phase 2 and phase 3 are implemented, instead of interjecting himself so dramatically on all the talk shows. Just sayin’.

        Close The Fed in reply to Leslie Eastman. | March 8, 2017 at 10:38 pm

        Not if he thinks there’s a superior way. I trust he knows the process. We’ll see what shakes out.

        Blueshot in reply to Leslie Eastman. | March 9, 2017 at 8:44 am

        Phase 2 and 3 are going to take place during the 2020 election. Do you really think the Republicans, not known for being brave, are going to actually hold true to their word and carry out those phases?

        Remember this is a party that is notorious for not keeping it’s word to the voters.

Sundance over at the Treehouse has an excellent article titled “Why ObamaCare Cannot Simply Be Repealed…”

Those interested can Google it or find it on his site.

It is a good read. I am more hopeful after reading it but I am also unwilling to hold my breath.

Given that if Trump had not have won, we wouldn’t be having any conversations about repealing ObamaCare. If Rand Paul can figure out a way to repeal the mess without a single Democrat vote, I’d be glad to hear it. And don’t expect a single Democrat vote for anything related to repealing. They want the GOP to own the health care issue for while; it’s wiped out their party between the coasts.

Here is a good take on the issue, posted at Powerline, as to why we all shouldn’t be getting the vapors quite yet.

Read the whole thing, as well as the post on which it’s based.

Obamacare is essentially a tax on insurance premiums which is about as bad as you could make it. If they don’t remove that tax, then most people in Congress are idiots.

Obama can tax & borrow & spend whatever he wants and push the nation to the brink of bankruptcy, but if Trump cuts one penny from anyone’s “entitlements”, the Democrats and media de-evolve into howler monkeys.

Look, the blue social model has already fallen apart, and its not Trump & the Republican’s job to fix it. Just go on TV Ross Perot style with some charts and graphs and say that everything Obama promised you was a lie because we couldn’t afford any of it and thanks to his mistakes we have to play clean up for at least a year or two. The voters know that Obamacare is a dog with fleas and will be happy to see it taken out to the farm, never to be seen again.

Close The Fed | March 8, 2017 at 10:27 pm

Okay, I read the Treehouse article. Basically his position is we should keep the filibuster. I disagree with him that if we lose the filibuster we turn into a democracy and the Senate becomes worthless redundancy of the House.

However, aside from disagreement with his belief it would turn us into a “democracy,” I do agree losing the filibuster is a bad thing. He claims even Reid didn’t do that, but the fact is, Reid WOULD HAVE done that if that was the only way to get what he wanted.

The fallacy continues: everybody keeps using the word “healthcare” when in reality NONE of this is about healthcare.

Ahhh, forgive me if I am wrong (I’m not), but didn’t a full repeal bill land on President Obama’s desk last year that was passed under reconciliation through the Senate? So why all of a sudden is that not possible now?

    Liz in reply to iambasic. | March 8, 2017 at 11:29 pm

    The Rs knew it would be vetoed, so there was no problem with sending a simple repeal bill to Obama.Now that they have to do something, there are problems and it’s not as easy.

    I wonder how many of the regs that were implemented after OCare went into effect can be eliminated through a simple regulation elimination or defunding process? That may be part of the plan so the Ds cannot complain until it is too late. Trump seems to be the master of the “look a squirrel” method of changing the topic.

    I seem to remember that there were a few poison pills in the law that makes it almost impossible to eliminate once implemented like the death panels. Or maybe that was the Consumer Financial Protection Board or something else.

      iambasic in reply to Liz. | March 9, 2017 at 7:11 am

      Why is it that the automatic thought is that Republicans have to do something after a full repeal? Why do we need Republicans to have government control healthcare planning at all?

    Mac45 in reply to iambasic. | March 8, 2017 at 11:40 pm

    It was actually a defunding bill for some of the regulatory aspects of the ACA. It would not have repealed the provisions of the ACA itself. And, of course the Republicans knew it would be vetoed and that they did not have the votes to override a veto.

      iambasic in reply to Mac45. | March 9, 2017 at 7:09 am

      It seems to be the starting point conservatives and Republicans need. We need to defund it completely and let it die. Republicans are too afraid of giving up government control of things they think they can control better but that still allows government control and it is wrong.

There are only two significant changes to the ACA, which are present in the AHCA. The employer mandate and the personal penalty are removed from the law. That is it. Everything else remains in play. The funding for the expanded Medicaid is not only retained, but expanded. The insurance subsidy continues as a refundable tax credit. There is no change in the type of insurance plans that may be provided by private insurers. And, there is nothing which will stimulate premium reduction.

Now, being a job builder, the revocation of the employer mandate and the personal penalty appeals to Trump, as these changes are advantageous to businesses. However, all it really does is shift the burden for insurance, which is mandatory in this day and age for families and older residents, to the consumer. So, full-time employment will increase, but the cost for medical care and insurance will continue to climb for the consumer. And, in the short run, no one will lose their insurance coverage, such as it is.

Of course, as costs continue to climb [as they always do in a third party payer system] along with insurance premiums and out-of-pocket costs for medical procedures for the middle class, the healthcare system will eventually collapse. When it does, the government will de “forced” to step in and provide medical “insurance” which will also require price controls. Hello socialized government run health care.

So, whether ACA or AHCA [as currently written] is in effect the healthcare system will still collapse and be taken over by the government. It might just take a little longer under the AHCA, is all. That old saying “there will be grass growing in the streets in ten years, but the Republicans can do it cheaper” is no longer accurate. The healthcare system will still collapse, but it won’t be any cheaper if the Republicans do it. It might even be more expensive.

Subotai Bahadur | March 9, 2017 at 12:26 am

I am unsure on what basis that it can be believed that the Republican Congress will go on to the promised step 2 and step 3 or as yet unnamed further steps to finally kill Obamacare. Look at their performance over the last 10 years, and tell me why they can be trusted to keep their word on that. For that matter, they have not really given their word, its only a talking point. They DID promise explicitly and repeatedly to repeal Obamacare completely and immediately. Not happening. So what good is their word?

Then there is the fact that the GOPe does NOT want to repeal it. There are at least 4 nominally Republican Senators who have drawn a line in the sand over not reducing Medicaid. At all. Ever. Included in that group, sadly, is Colorado’s Cory Gardner, who really should switch parties.

This bill makes everything that happens to health care [real health care, not insurance] now officially the Republican’s fault and does not fix any of the built in poison pills that were in Obamacare.

If they blow this, there is no need for a Republican Party. A “Deplorable” Party should replace them.

    Blueshot in reply to Subotai Bahadur. | March 9, 2017 at 8:51 am

    Exactly. Phase two supposedly takes place in 2020. A POTUS election year. Are we to really believe the Republicans will be messing with healthcare during a presidential campaign? Given the GOP’s past I’d say they are going to suddenly forget that there was a phase 2 and 3 of this new plan.

    We should either repeal Obamacare 100% or leave it as is and let the Democrats continue to eat it.

    If the GOP makes changes to Obamacare without getting rid of it they will simply make it worse. The system will still crash and burn our economy BUT instead of Democrats taking the fall for it the Republicans will take the fall because the Democrats can say, “They are the ones that screwed it up by changing it”

    The GOP is run by idiots. They are about to take Obamacare, make it worse, and than put their names on it taking ownership. Damn fools.

Ryan’s bill simply Amends several of the most odious sections of Obamacare, then adds in some reforms.

It least the overwhelming majority of the PPACA intact. Literally thousands of sections completely untouched.

Worse, it creates a massive new federal entitlement – it creates “REFUNDABLE tax credits” to help pay for health insurance. The problem lies in the “refundable” part of this, which will result in the federal government simply paying for the health insurance of about half the population of the country. There is no funding mechanism to pay for this, and even if there were it would be an abomination.

    Ryan is an Obama in Boehner clothing.

    Off with his squeakership.

    Blueshot in reply to Aarradin. | March 9, 2017 at 9:05 am

    “Worse, it creates a massive new federal entitlement – it creates “REFUNDABLE tax credits” to help pay for health insurance. The problem lies in the “refundable” part of this, which will result in the federal government simply paying for the health insurance of about half the population of the country. There is no funding mechanism to pay for this, and even if there were it would be an abomination.”

    Essentially the GOP is setting up the country for single-payer healthcare because if the government is paying for everything that is what you have: single-payer.

You go to war against Obamacare with the President you have

You do indeed.

You also go to war with the Congress you have. And the same old tired political parties you have.

The unusual thing about the 2016 election was that we ended up with a President who isn’t already an entrenched part of the revolving-door system the professional politicians have imposed on the country. But that was the only unique feature. All the other players in the government game are the same-old-same-old, and the best we can expect from them is institutional inertia as only fat and comfortable pros can do it.

In this setting, anything useful the new administration manages to accomplish will be a bloody miracle.

buckeyeminuteman | March 9, 2017 at 8:32 am

The point of repeal is not to undo something simply because Obama signed it and it has his name on it. The point of repeal is to get the Federales out of healthcare and have a free-market, across state lines system. Trading one turd for a slightly smaller turd still leaves you with a turd. Although eating less crap is technically better…

    Ragspierre in reply to buckeyeminuteman. | March 9, 2017 at 8:37 am

    And changing the nomenclature of the turd is not an improvement.

    Which is all this does in many important ways.

    Blueshot in reply to buckeyeminuteman. | March 9, 2017 at 8:55 am

    I would argue that it’s not a smaller turd. The Republicans are taking the worst of Obamacare and adding on to it. The system will collapse even faster under RINOcare.

    This of course will cause the Democrats and their partners in crime, the media, to blame Republicans for the collapse.

    So I’d say the GOP took the turd and decided to up-size that turd to a large turd with everything on it.

      buckeyeminuteman in reply to Blueshot. | March 9, 2017 at 12:38 pm

      If RINOcare is enacted and inevitably crashes, Democrats will win elections and will come in to “fix” the mess.

      Obamacare -> RINOcare -> Single Payer

This is absolute garbage. This bill was hidden from public view because it was written by lobbyists.

It takes Obamacare and literally makes it worse. The system was breaking under Obamacare but the Republicans have decided to break the system twice as fast and sign their name on the dotted line and own that turd.

We will eventually be forced as country into single payer healthcare but it won’t be because of Obamacare. It will be because of the idiotic Republicans.

When the system collapses the Democrats/Media will slander the GOP every waking hour of the day for it and the Republicans will be unable to respond. How can they? They took a system that they said was bad, supposedly fixed it, and now it’s worse!

I could see the GOP taking a bloodbath in the 2018 elections if this passes. In the 2020 elections this may even result in the GOP losing the White House. Is this really what the GOP wants?

Either get rid of Obamacare or leave it alone and let the Democrats continue to eat it.

https://www.conservativereview.com/commentary/2017/03/20-ideas-to-crush-obamacare-and-cure-americas-health-care-crisis

You go to governance with the ideas you have.

AND you hold your elected SERVANTS to their promises.

I am trying to figure out why the Republicans don’t use Obamacare like a club on the Democrats. Pass a simple repeal in the house and send it to the Senate. If the Dim’s filibuster the bill and won’t let it be voted on use that club to have more R’s elected in 2018.

All they need is a simple talking point like the following:

We can’t move forward with a replace of Obamacare until it is repealed in full and the Dim’s won’t vote on the repeal.

Basically use the Dim’s playbook against them. Make them own Obamacare and club them with it until either they help repeal it or the voters send them packing in 2018.

    Blueshot in reply to gmac124. | March 9, 2017 at 10:15 am

    I think the Republicans think that won’t work because everyone will demand that they just use the nuclear option and break the filibuster.

    And they would be right.

    People are expecting them to use the nuclear option on filibusters for important stuff like SCOTUS picks and Obamacare.

      Ragspierre in reply to Blueshot. | March 9, 2017 at 10:21 am

      Truly two places where “Use it or lose it” fully applies. If the Republicans fail us here, we’ll fail them at the ballot box.

        buckeyeminuteman in reply to Ragspierre. | March 9, 2017 at 12:41 pm

        But then who do we vote for? Dems? No. GOP? No. Libertarians? Never going to win. The GOP is putting the very people that voted for them into a corner with no way out.

          Ragspierre in reply to buckeyeminuteman. | March 9, 2017 at 12:59 pm

          Vote FOR conservatives. If you don’t have one, make sure the puke you DON’T vote for knows why, and begin looking for their replacement.

    Mac45 in reply to gmac124. | March 9, 2017 at 11:27 am

    Most of the Establishment Republicans in Congress do not want to change Obamacare. Those that they are beholding to, not their constituents by the way, want to shift the burden of healthcare from the financial/big business sector to the populous while controlling that populous. This is best accomplished by making the federal government the primary payer for medical care. In that way, the people pay for their own healthcare through direct taxation and the government controls not only the medical profession but the people.

    There would be NO GOP Obamacare replacement bill at all, if those nasty deplorables had not continued to demand it after the elections this year. Two weeks ago, Ryan assured everyone that there was a bill. Unfortunately a large number of Congressmen were unaware that such a bill even existed. So, now there is a bill. And that bill does little to change the impact of Obamacare on individuals while granting breaks to small business, large investors and the states [continued funding of expanded Medicaid]. So, now Ryan is trying to sell it as phase one of a three phase “plan” to repeal and replace the ACA. However, it has not been explained why the initial phase of the plan requires that the existing ACA provisions actually be strengthened in order to repeal it. If this bill is enacted and the other two phases of the “plan” fail, we actually are in a worse position, healthcare wise, than we were before.

    All this “plan” does is to provide political cover for the establishment Republicans. It allows Obamacare to remain in place whether it is passed or not. It allows the Republicans to claim Democrat and GOP conservative obstruction for the failure of this bill to become law and/or for the failure of the second and third phases of the “plan” to be implemented. The things to remember are that the Establishment wants the ACA to continue and that in order to fix the healthcare system, some people are going to lose their insurance because universal health insurance is simply not possible unless the federal government IS the insurer AND controls healthcare pricing.

    gmac124 in reply to gmac124. | March 9, 2017 at 4:51 pm

    I had a couple additional thoughts about this fiasco. The first is why would you bring out a BB gun for your first shot. Even if this plan is what they eventually passed this is not even close to a starting point unless they didn’t want to get rid of Obamacare to begin with. Honestly they should be bringing out the cannon to completely repeal the entire bill as the first shot. Pass a repeal bill in the house send it to the Senate and than use it to whip the Dim’s for a time. Force them to either cave or compromise while you have the leverage.

    My next thought was that if they cave this quick they are not the opposition party. If the R party continues giving up this much ground while they have leverage and without opposition the party will be killed. I am going to write a letter and send it to all of my representatives basically telling them that if they pass this crap I will never vote for them again, EVER. I will vote against them if their is a primary and I will vote Democrat or third party if they win the primary. There is no reason to shoot for the least favorable outcome as your first shot. Shoot for the moon and expend your ammo before falling back to this position.

Government health care is government health care no matter how many times you rename it.

I’m reminded of “vapor-ware”, a marketing technique that does several things simultaneously.

In this context, it drains all the demand out of the issue without providing the expected and demanded product.

It further accepts a “deal” that cements a status quo in place for a promise of a product that has not (and never will be) produced in the future.

I remember it being used by Commodore Computers to accept deposits on promised computers which never materialized, but froze orders for actual computers into the future.

I was corrupt bullshit than and it is now.

It would matter a lot less about what obamacare/RyanCare provides if they would just add a simple provision to allow any state to completely opt out completely from all obamacare/RyanCare laws, taxes, regs, etc.