The "American Healthcare Act 1.0" Needs an Upgrade

The "American Healthcare Act 1.0" Needs an Upgrade
 03/10/2017 04:00 PM

The American Healthcare Act was rolled out for examination earlier this week.  It is being called the first of three “phases” of the 'repeal and replace' Obamacare program, which was a key promise of President Trump's campaign.  The response has been twofold.  There has been the expected opposition by the Democrats, and by the newly named “opposition party” aka, the main stream media.  There was also the unexpected opposition by certain people in the Republican majority, most notably Senator Rand Paul (R-Ky),  Senator Mike Lee (R-Utah), and Rep. Jim Jordan (R-Oh)as part of the House Freedom Caucus.

Senator Lee weighed in on the objections to the new bill on “The First 100 Days” program on Fox News a few days ago.  While the Democrats objections were summed up as saying they thought this bill went way too far, the conservative Republicans seem to be saying that the bill doesn't go far enough.  Jordan says this is just “Obamacare in another form,” and Paul says it is “Obamacare light”.  They point out, for example, that this new bill doesn't stop the expansion of Medicaid until 2020, and adds a new entitlement in the form of refundable tax credits.  Lee agrees with this but he added something that I did not know, and seems to me to lend powerful support to he and his colleagues. During the interview, Lee said that Jim Jordan was going to reintroduce his bill from 2015 which passed and President Obama promptly vetoed.  What I didn't know, and Lee stated,was that Jordan's original bill was not only a straight repeal of Obamacare, it included a period in which Obamacare would still be in effect concerning those currently covered,in order to provide time to pass the best legislation possible addressing the health care issue.  This seems to address the concern that if Obamacare were repealed without a replacement ready, millions would be without insurance immediately.  Additionally, the replacement part of the process would then be handled in another bill introduced at the same time.  In fact, Senator Paul has done this in conjunction with the reintroduction of Rep. Jordan's bill. 

This is just the beginning of the legislative process.  Yet I am becoming more and more confused as I learn more about this.  I am confused by the unwillingness of Congress to even consider Jordan's reintroducing his previous bill as sufficient.  I am confused by the of those such as Speaker Ryan who make statements like these: “This is our one chance” to repeal and replace Obamacare, and “We would need 60 votes to pass” a repeal bill like what passed in 2015.  These are nonsensical statements, at least to me.  How can this be the one chance to get rid of the monstrosity of Obamacare?  Is the Speaker seriously saying that if this doesn't pass, they won't ever try again!?  Why do they need 60 votes in the Senate?   The objection that the “Byrd rule” on reconciliation would require 60 votes with anything other than fiscal issues doesn't hold water.  If they are so worried about a democratic filibuster, they can use the so-called 'nuclear option' that former Senator Harry Reid invoked a few years ago, and they would then just need 51 votes.  In fact, when the Jordan bill was passed, they didn't have 60 votes, just 51.  Of course, with Obama's guaranteed veto at hand, the Republicans on the Hill didn't have to be concerned about defending and implementing it.  It seems cowardly to put forth a bold proposal when you know it won't be implemented, and yet reject the same proposal when it is virtually certain it will pass and be implemented.  

I am also confused by the support the President himself has given this bill.  One of the reasons given is that this must get done fast and,more importantly, before they can proceed with tax cuts that were promised by the President during the campaign. The administration claims this is necessary because we must know first what effects the new health care bill has on the tax allocations before we can work on tax cuts.  I get the idea.  One should know what something will cost before you “buy” it. However, that is a false dichotomy.  One buys what one can afford. Therefore, why not make the “repeal and replacement”fit into the tax cuts and the budget!  A straight repeal, with the features outlined in Jordan's bill, would seem to already “fit” into such a budget structure.  

Perhaps the Congress will happily surprise me this time.  Perhaps the finished product “AHA version 2.0” will be a real upgrade.  If it isn't, there might just be a few GOP high fliers being given the 'heave-ho'out of D.C. by some very upset voters in 2018.


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