The Republicans' Not-So-Secret Strategy to Pass TrumpCare

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Written by Ted Landau   
Monday, 13 March 2017 05:32

I have to give the Republicans credit for cunningness. In case you haven’t quite yet figured it out, here’s whats’ going with the GOP’s American Health Care Act (or AHCA, also known as TrumpCare, although some may prefer to give Paul Ryan equal credit):

• The GOP knows that any health care bill they come up with will garner zero support from Democrats. Given that any plan they come up will either cut benefits or increase costs — or more likely both at the same time — this is not a surprise.

• This means that the GOP cannot hope to get any “true” health care legislation through the Senate — as Democrats will filibuster it.

• The GOP’s only chance for success is to have this first iteration of TrumpCare be a reconciliation bill. Such bills get fast-tracked through the Senate without allowing for a filibuster, thus requiring only a majority vote to pass (rather than the 60 votes otherwise needed).

The catch is that reconciliation bills can only be “for legislation that changes spending, revenues, and the federal debt limit.” http://www.cbpp.org/…/federal-budget/introduction-to-budget… In other words, a reconciliation bill cannot introduce new programs or procedures. It can only modify the budget of existing programs.

• Somehow, the GOP has shoe-horned the AHCA to fit the constraints of reconciliation. This means the Democrats will be unable to filibuster it.

• The problem for the GOP is that this tactic comes at a cost. A significant part of what the GOP might have liked to include in a health care replacement bill is MIA. If they had put in everything they wanted, the bill would not be a reconciliation bill and would have been filibustered.

The result is a bill that even its most ardent supporters know is insufficient at best and a disaster at worst. Of course, they’re not marketing the bill to the public in this way, but it’s well understood.

• Assuming the bill passes, the true nature of the disaster will likely become apparent by early 2018. At this point, the Republicans WILL introduce non-reconciliation legislation, designed to “fix” the problems that they themselves caused. This legislation will be subject to a filibuster. However, the political calculus will be different from what it is now. If the Democrats block any and all Republican “fixes,” the GOP will attempt to blame the failure of health care reform on “obstructionist” Democrats.

In other words, the GOP strategy is to make things so terrible that Democrats have no choice but to vote for a change — even if it’s a change the Democrats don’t really want.

• This is why many in the GOP talk about the health care reform ultimately taking several years to complete. It’s not that the matter is so “complicated” (although, of course, it is complicated). It’s that they need to do it this way in order to sidestep a filibuster.

If the strategy succeeds, the Republicans will have implemented their plan to replace ObamaCare with something that may remain a disaster — and despite opposition by Democrats. After all, it still amounts to a half-baked plan put together in haste, despite the GOP having seven years to come up with something. It will still likely reduce the number of people covered and increase the cost of insurance. But it will be a plan that the GOP will be content to live with.

• The GOP is playing the long game here. If you oppose any GOP replacement to Obamacare because you see it as a step backward, and you thought that a Democratic filibuster would prevent it from passing, think again. The GOP is one step ahead of you.

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