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Tuesday, April 25, 2017

Tilting At Healthcare



Josh Marshall asks why the Republicans don't just give up on the Obamacare repeal:

Even as they face an insanely busy week when a government shutdown will need to be averted and President Trump would also like to unveil a tax overhaul plan, some GOP lawmakers—perhaps at the behest of White House officials seeking to save face ahead of the 100-day mark—are talking up the possibility of a new deal to revive legislation to dismantle the Affordable Care Act.
Even as GOP congressional leaders tamp down expectations of any quick movement to resuscitate the bill, which was pulled from a House floor vote last month due to lack of support, the latest round of hype signals a longer-term problem for the GOP’s approach to governance. As long as Republicans can’t fully move on from Obamacare repeal, it stands to infect the other agenda items they seek to pass while they still have full control of Congress.
“The bills is undead. You can’t kill it, you can’t revive it,’ said Jonathan Oberlander, a professor of social medicine and health policy at the University of North Carolina-Chapel Hill.
This week, for instance, a potential government funding showdown has shaped up around threats from Trump to blow up the ACA’s individual market unless legislators fund his border wall, a political flashpoint that neither Democrats nor many Republicans want to hash out in must-pass spending legislation.
Trump’s apparent logic is that such tactics give him leverage to force Democratic negotiations on repealing Obamacare—a posture that doesn’t really make sense when grounded in both the political realities of who owns health care at this point (Republicans) and the GOP’s own moves to shut Democrats out of their legislative process.

There's just no way they can pass it. If they had had a bill ready in January (rather than just voting on a bill instructing Congress to write a bill), they might have gotten it done. But the fact that they didn't allowed the Democrats to change the conversation from "We'll replace Obamacare with the bestest thing you could ever imagine, and ponies!" to "How many people will the AHCA leave uninsured?" So the Republicans had to try to cobble something together that might work for Republicans who are spooked at the prospect of losing their seats because they've left their constituents uninsured, and those who really just don't care who's insured (or maybe want people to go insured) as long as the taxes in the ACA disappear. They couldn't do that a few weeks back, and there's no reason to believe they can now.

I see the Republicans as the guy at the bar who has nothing to say, so he keeps repeating the same conversation over and over. Aside from an Obamacare repeal and tax cuts (which, for budget reasons, likely can't happen before that repeal, there's very little they want to do that won't get by a Democratic filibuster in the Senate. Essentially, all they can do is use executive orders and wait for Trump's Cabinet appointees to blow up the government from the inside, and they're left with nothing left to do... If they don't tell the AHCA story, they've got nothing to tell. So they repeat that story.