Trumpcare Declared Dead But GOP Not Finished Screwing America

Ken AshfordCongress, Health Care, Trump & AdministrationLeave a Comment

So this happened:

Republican senator from Kansas and his Republican colleague from Utah said “no” to the GOP plan to replace Obamacare. This comes even before the CBO had scored it, but it would have resulted in tens of millions losing healthcare and higher premiums. That doesn’t include all those who would get crappy healthcare that is useless when they actually have a catastrophic illness.

The Senate vote was supposed to be this week and it was right on the edge. Only one more Republican Senator (besides the two nay-sayers already) needed to step up and say “no” and the thing was dead. Senate Majority Leader McConnell put off voting until August while Senator McCain had some pretty nasty eye/brain surgery which apparently accounted for his odd behavior recently at the Comey hearing.

It was thought that key swing-votes were Rob Portman of Ohio, Lisa Murkowski of Alaska, Jeff Flake of Arizona, or maybe Cory Gardner of Colorado.

But Lee and Moran stepped up and killed this. They joined Maine Sen. Susan Collins and Kentucky Sen. Rand Paul in opposition, denying GOP leaders the support to even bring the bill to the floor and upending Republicans’ seven-year goal of repealing Obamacare.

But apparently McConnell had a backup plan: he announced that the chamber would vote to take up a House bill from 2015 that repeals the Affordable Care Act and then provides for a two-year delay while the Senate develops a plan to replace it.

“[I]n the coming days,” McConnell said in a statement Monday night, “the Senate will vote to take up the House bill with the first amendment being what a majority of the Senate has already supported in 2015 and that was vetoed by then-President Barack Obama: A repeal of Obamacare with a two-year delay to provide for a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.”

This is a terrible idea. Repealing Obamacare without implementing a replacement would have even more devastating consequences than Trumpcare. It would result in 18 million people losing their coverage the first full year after the bill’s enactment. That number would rise to 32 million by 2026, according to the nonpartisan Congressional Budget Office, which scored the repeal and delay plan when it was proposed in 2015.

Repeal and delay would also significantly increase premiums, the CBO said. In the first year following enactment of the law, premiums purchased through the marketplaces or directly from insurers would increase 20 to 25 percent relative to projections under the current law.

In the year following the elimination of the Medicaid expansion and subsidies provided by the ACA, that increase would reach about 50 percent, with premiums doubling by 2026.

The widespread confusion that repeal and delay would create would be detrimental even as the current law stays in place during the proposed two years the Senate would have to develop a replacement.

Insurers use projections to set prices, and knowing the industry is going to dramatically change but not knowing how is expected to cause insurers to pull out of the ACA marketplaces. This means higher premiums and, ultimately, a death spiral that would result in Americans losing their health insurance.

But the two defectors from last night are for repeal (right now), and so is this guy:

Trump clearly doesn’t care what the bill is.  He just wants to declare a “win”.  But this repeal-and-replace-later is a non-starter. I don’t think anybody thinks Congress will come up with a better idea in two years.  Plus, repeal will be hard since part so it require a 60-senator vote.

So the watch word on the left is: “Yay for us, but remain vigilant”.

UPDATE:  Yeah, it might be dead before this morning is out.