The TrumpCare comes back from the dead (...and lives!) thread

[The_Doctor]

I thought Classic Conservative didn't like the bill? I could be mistaken.

A flip side to everyone cheering how do you feel about preserving 80% of ObamaCare? You know the exchanges, subsidies, and the mandate is all still there right? The expansion will be moved leftwards in the Senate as well.

You do know that for all the changes we're still to the left of 2009?

Not exactly. The subsidies have been replaced with refundable tax credits that are mostly based on age, not income. The employer mandate has been repealed. The individual mandate has been replaced:

You must be logged in to read this quote.

http://money.cnn.com/2017/05/04/news/economy/obamacare-republican-health-care/

The next Democratic White House is going to push for significant changes and the basic structure is there and remains there. THIS is a shift from the pre-2009 situation.

Note that subsidies, the exchanges, Medicaid expansion, and so on all will continue in some form and will be there in 2025. That's now a matter of settled and important precedent.

You'll note that the mandate that they imposed is similar to Obama's mandate in terms of forcing coverage. The Republicans have implicitly accepted the concept of a mandate.

Do you think this is the final iteration of healthcare reform? Hardly. These same Republicans will be back here screaming in 4-8 years as the Democrats get a second crack through reconciliation. (They have the upper hand as reconciliation expires after ten years)

CC and people like Krazen don't think beyond 5 years. They think of the now. The problem is that we face either doing healthcare through conservative market based ideas or the Democrats act more radically when they win back power.

[The_Doctor]

So Portman, Heller, and Capito, and Collins have major issues with the bill in the Senate. That, combined with 48 Democratic votes, means major changes to the left in the Senate -- changes that I don't think the House will swallow easily.

[The_Doctor]

Read this in another forum:

Immediately before the vote, they passed an amendment that would make the AHCA apply to members of Congress. Because this bill will affect Congress' pay and benefits, it is no longer considered a budget reconciliation and can therefore be filibustered in the Senate. That amendment was passed unanimously, with every 'yea' voter knowing it means the bill dies in the Senate.

Anyone know if this is true?

Its a separate bill so I assume that its not considered part of the bill the House passed.

[The_Doctor]

Good.  Have Collins or Murkowski said anything yet?

Collins wants to wait for the CBO score and no word from Murkowski.

[The_Doctor]

This is just the beginning of the winning!

Hopefully we can build the wall, ban abortion, ban gay marriage, deport all the illegals and get rid of the anchors babies! USA!

Go do your homework, little boy.

All done my friend!

Good while we have you here can you tell us why you support the bill? And can you defend it?

[The_Doctor]

GOP Senate plans to draft a whole new bill rather than use House bill as starting point
https://twitter.com/philipaklein/status/860211993571098624

So in other words the House vote was moot except as a vehicle to get stuff to the Senate?

So basically what did the GOP in the House walk the plank for if the Senate is going to do its own version? They could've passed any old shell bill and sent it to the Senate.

[The_Doctor]

So Portman, Heller, and Capito, and Collins have major issues with the bill in the Senate. That, combined with 48 Democratic votes, means major changes to the left in the Senate -- changes that I don't think the House will swallow easily.

Murkowski also won't vote for any bill that guts Planned Parenthood spending.

I'm forgetting but theres another pro choice GOP Senator too. So the PP funding stays.

[The_Doctor]

excuse me but one more time....

is there in fact ANY way to solve this with 50 votes without killing the filibuster? reconciliation even...thinkable?

They'll use reconciliation. I don't understand the question? The filibuster isn't applicable because of the use of reconciliation.

[The_Doctor]

Some of you guys need to chill with these low-blow attacks. Yes, these Republicans who voted for this are scumbags and I want them to lose their seats and hopefully face their conscience no less than anyone else here. In fact, I already wrote my Congressman who voted for this law a very strongly worded message of condemnation. But hoping their children get chronic conditions? Wanting them to get hit by an ambulance? Come on, you know that's not right.

this

i understand people getting pissed if they or someone they know lose their healthcare insurance but trump voters are getting screwed the most anyway and the right thing to do atm would be to get active and to make sure to communicate who is responsible for doing what and how to stop it,

Don't get mad. That triggers the dopamine in their brains. You have to ask them why they support the bill and defend it. That's when the hemming and hawing begins.

[The_Doctor]

Austrian, the way it works is that this bill will be considered a shell bill that goes to the Senate. Then the Senate will substitute the House bill with its own bill, which then goes to a final vote. They've given themselves reconciliation power over healthcare so that they can do this with 51 votes. So once that happens they can then revoke that power and use it for the tax bill.

(In other words I demonstrate I know more than Klartext about the US government)

[The_Doctor]

Some of you guys need to chill with these low-blow attacks. Yes, these Republicans who voted for this are scumbags and I want them to lose their seats and hopefully face their conscience no less than anyone else here. In fact, I already wrote my Congressman who voted for this law a very strongly worded message of condemnation. But hoping their children get chronic conditions? Wanting them to get hit by an ambulance? Come on, you know that's not right.

this

i understand people getting pissed if they or someone they know lose their healthcare insurance but trump voters are getting screwed the most anyway and the right thing to do atm would be to get active and to make sure to communicate who is responsible for doing what and how to stop it,

Don't get mad. That triggers the dopamine in their brains. You have to ask them why they support the bill and defend it. That's when the hemming and hawing begins.

Exactly. Don't put someone in such a reflexively defensive position, because then they simply double-down and refuse to even consider reflection. You want to challenge their thinking; ask questions, challenge their logic, make emotional appeals that'll connect with them. Pure confrontation is like spanking a child because they did something that upset you; it's not going to correct the problem, it only creates more and temporarily makes you feel better.

Also, do not condescend or simply condemn Trump and Republican voters. They made an awful choice for which many of them will be disproportionately negative affected, but they're still human beings deserving of basic human decency, which should include health care. We must engage these voters, challenge them to justify their views (like TD has been saying), and appeal our case. Most won't be convinced, but we only need a minority of them to take back the House, Senate, and majority of state governments, then the White House.

Let me put down my snark for a second. A long and serious post (and I want everyone to read it instead of skipping if you're waiting for a bit of my anti Trump talk it's not coming).

As much fun I get at making Trump people red in rage (and believe me I enjoy it) here's an interesting trend. The longer we get into the Trump WH the more his supporters realize that just beating Hillary wasn't enough and that they need to sustain themselves over 4-8 years. They know that whatever they accomplish they have to defend electorally.

Reagan succeeded in his legacy because he won a mandate twice. His party came out looking better than it started. Bill Clinton's Democratic Party was somewhat successful because of his two terms. The common denominator was that - as it should be - people were better off than what they were eight years prior. In contrast Bush and Carter were abandoned by their parties and disowned. For Trump to succeed in branding the party the country needs to be significantly better off than it was eight years ago. That's one reason this House vote wasn't going to succeed in the Senate.

Over time I've seen a number of Trump supporters here moderate their tone and admit that Trump wasn't perfect. This is a politically educated forum but still I expect it to run ahead of the population by a few years. But realistically they're realising Trump is a con artist. Very few people will defend Trump or the GOP here if pressed. That's because intellectually they can't; their political support is predicated on opposition to x or y, not in favor of z.

So the longer we get away from 2016 and the longer the Republican incumbency lasts the more the faithful in the party become restless and focus more on the ruling party's achievements. We should expect to see even less enthusiastic support for Trump and the GOP by 2018-2019 and definitely by 2021 if they're still in power.

What I've described is why the party in the White House changes every eight years. Congress has also changed parties in the Senate every eight years and in the House 12. (That puts the Democrats on track to win back the White House in 2024, the Senate in 2022 and the House in 2022).

The most important thing to remember is nobody in this forum is among the 1%. The neoliberal experience has hollowed-out a lot of economic strength along the working and middle class and bills like this don't help them. This is the GOP's greatest failure.

Our friends on the Trump Right know this deep down and realize it which is why they rely on the dopamine rush of considering this a bill to repeal ObamaCare rather than considering the costs of the bill.

[The_Doctor]

Glad that I skipped the last six pages of this thread because the usual suspects were derailing it with their trash-tier trolling.

Anyway... this thing has basically zero chance of passing in the Senate, right?

We don't know. Also you proved my point in my lengthy missive.

[The_Doctor]

Reporting my posts isn't gonna change my mind.

You getting mad is what Krazen and Klartext want. It settles the debate in their minds; if they had to debate the bill with you and you asked (as should every opponent of the bill) to defend it, they would basically be crickets.

I've never had more than 3 reported posts despite being extremely snarky and acerbic (which kind of stuns me). The last reported post was like several months ago or more. And I can be extremely rude, lol.

[The_Doctor]

What I want to know is what the Senate will do with preexisting conditions and the Medicaid expansion. I think they could get away with everything in the House vote except those two factors.

[The_Doctor]

KY GOP Sen Paul on Fox. Says GOPers voted to pay taxpayer money to insurance companies.
https://twitter.com/ChadPergram/status/860233627245924352

Mitch is a big stud and a real man of the people. He is also a master tactician. We all should have learned that from the Heist he did on the Supreme Court!

The votes will come.

I never knew you were into older men or gay. Nothing wrong with that.

[The_Doctor]

TD, this has been boggling my mind for a while so why not ask here.  Why is that you dislike Medicare and Social Security but support Obamacare?

Well, I don't support ObamaCare, if you read my post here. I've edited it a bit about Medicare to make my position clearer on healthcare. But I'll get back to that.  

To start with, I don't like the New Deal; I think it was an overreaction to the Great Depression, where the Federal Reserve would have done just fine had they turned on the money spigot. That said, I think the New Deal created a dependency culture that expects people to be taken care of by government no matter what. I think that Social Security went from being an old age program to a catchall program that takes in a lot of people at unsustainable rates. Ultimately, I don't find it sustainable without higher taxes. With Medicare, same type of objections (although my plan would cover everyone and be a replacement for Medicare/Medicaid). That said, I wouldn't vote to repeal either because the instability caused by the loss of these programs would be immense and economically disastrous. If ever down the line, we can figure out how to repeal it in favor of a more libertarian set of ideas (thanks to technology or whatnot), that'd be something I'd like to explore if the disruption is minimal.

As far as ObamaCare goes, I don't support it (I think it was too cumbersome, unnecessarily so, and I didn't like some of the regulations that required companies to give healthcare if you worked over 30 hours, and whatnot). It's a little better than the New Deal, which were straight up cash and benefits programs, so I'm not as hostile. Also, healthcare is much bigger than retirement and there we have to help sick people who would otherwise die if we don't help them, so I'm more sympathetic on healthcare. But I didn't support the law when it was enacted and would prefer to repeal it in favor of a better law.

That said, I don't support this bill, because it abruptly pulls out the plug on those who gained Medicaid access and disrupts tons of healthcare plans that were designed with the ACA in mind. Any unwinding at this point should have been over ten years, and done with an eye to keeping markets stable as we transitioned to a better plan. The GOP plan, in my eyes, isn't that replacement. They rushed the plan, they didn't find the spot between good policy and good politics, and didn't even wait for a CBO score. Their political posturing has led to this (and admittedly, I was on the ObamaCare repeal bandwagon for many years without thinking about what would come after; which is why I raised the point of asking people to defend this law). We'll see if the Senate crafts anything worthwhile.

Hopefully that makes sense.

[The_Doctor]

Before SS and Medicare, the percentage of elderly people in poverty was astronomical. If your adult kids couldn't afford to support you, you were up a creek. Living with adult children stopped being a realistic approach when we transitioned away from an agrarian society.

People weren't living healthy, independent lives before the New Deal. They were dying poor, broke, sick and alone.

That is all true but we've changed radically since the 1930s. People are living longer, our living standards have gone up (some would argue that's because of the New Deal but I don't know I agree), and there's abundant new technology to allow our seniors to live better lives.

So, why can't we shift to a system where we allow people to save more for retirement and bring a decent market based healthcare system to help deal with senior health issues?

At the very least Social Security and Medicare should go back to being for the aged and truly disabled, rather than the expansive government programs they are. Essentially we already have a single payer program named Medicare and Medicaid in this country.

[The_Doctor]

American conservatism isn't ready to accept that sort of role on healthcare. Even the most right wing European plans (which I like) are heavily disfavored. It's because the American right is still operating on the Libertarian - Evangelical pro business axis begun in the 1980s under Reagan. It's hard for a lot on the right to deal with healthcare in a comprehensive fashion as a result since it goes deeply against their instincts.

Barring a realignment the reality is the ACA is as far right the GOP will tolerate. It isn't a sustainable position on the Right but its the reality.

[The_Doctor]

I don't think they can win a second House vote. The number of bombshells in the Ten Day Massacre have made it too politically toxic to repeal ObamaCare on top of defending Donald Trump. I think the Ten Day Massacre makes it extremely difficult. They need to pick and choose; defend Trump or repeal ObamaCare.

If CBO kills the bill, Ryan gives up.

The GOP should go back to the drawing board, pick a good plan that can command bipartisan support, and then claim all the credit for reforming the law. This is not the time to try an ideological plan; just go for a plan that limits the expansion and cleans up the law.

[The_Doctor]

You should understand the secrecy and the way McConnell is doing it is symptomatic, I believe, of McConnell intending a vote but not intending to care about the bill post vote. He wants to put the Senate Republicans on record on repealing the AHCA and produce a dead body, most likely (the dream of ACA repeal). If they wanted to pass and sell the bill, they would be trying to spin the bill massively and trying to lay the groundwork for the public getting behind it. McConnell is a pro who reads numbers (he knows that more voters care about the ACA than Russia) and he knows that if this risked becoming law, the Republican caucus would need to be doing a lot more than this 20 hour debate session. (Yes, I know McConnell has been scheduling thrice a week policy luncheons on the law and trying to create room for passage. Doesn't mean he cares about passage of a law).

McConnell doesn't want a nasty drawn out Senate vote. He wants this to go back to the House and all the pressure put on the House to fail it, if it passes the Senate. If it fails the Senate, he doesn't care. He's in classic "this is not our problem" mode. He's done with the drama. He wants to get to the point where he cuts a deal with Schumer to "reform" the law and call it a win. He knows this is the only real out at this point.

Ditto the fact no Senate Republicans have seen the bill suggests strongly to me that McConnell is doing this to minimise exposure, get a vote up, and get on to taxes, where they'll be doing a lot more public relations footwork. They haven't even shown the WH the legislative copy and the President hasn't been selling this at all.

Trumpy being silent is the biggest tell the Senate GOP isn't planning to care about the AHCA. The power of the presidential pulpit is needed to sell the bill to the public if it became law. That's how it works. Trump isn't even messaging about it even on a cursory basis. He's let the opposition consume the air waves and all the talk to define the ACA and the AHCA this year.

So, I could be wrong, but I think the Senate GOP is going to cut bait. This is all, by the way, pretty much what the Framers intended about legislation like the AHCA. The Senate, by design, is intended to slow walk and kill bills that would cause a massive backlash. This is a big reason the ACA took like a year to pass and barely passed cloture.

[The_Doctor]

Trumpy being silent is the biggest tell the Senate GOP isn't planning to care about the AHCA. The power of the presidential pulpit is needed to sell the bill to the public if it became law. That's how it works. Trump isn't even messaging about it even on a cursory basis. He's let the opposition consume the air waves and all the talk to define the ACA and the AHCA this year.

Is it possible they are just using the Trump-Russia scandal as cover? They are doing all their work in secret, and the scandals are allowing that to happen without as much of a fuss as there normally might be.

I'm just wondering if Senate passage would be enough to get attention on it, and if the House could actually agree on something. Or is the point that Mitch won't let the bill pass, even if it could?

Sorry, I meant to do my usual monologue of three long winded posts but I went to shower and forgot.

It's not, in my view, really possible to pass a major law, even with a scandal like Russia, in total secrecy. It affects 1/6th of the economy and tens of millions of people. Voters, in fact, consistently rank healthcare ahead of Russia on their list of concerns. So, eventually, any bill passed would undergo heavy scrutiny, if not outright condemnation. You'd have the GOP being attacked for a year for killing the expansion, threatening the Medicaid status of people, and weakening the healthcare markets. Even if they passed and signed a law, there would be a strong outcry.

No Congressman or Senator wants to deal with that crap. I think if I were McConnell, I'd kill the law, and then immediately push tax reform through and try to send people home in September with that win under the GOP's belt.

I'm not really sure the GOP wants to go into 2018 with Russia and healthcare around their necks along with a weakening economy and undisciplined President. I don't think Mitch McC wants to either so I think a lot of this is him trying to minimize the outrage, get something up for a vote, and then get on with life.

Could McConnell be trying to pass something but have Schumer and Co agree to push for amendments on a 'bipartisan fix'? No, I don't think so, because the Democrats would have the public on their side and they would push hard for restoring the ACA.

Remember, the ACA was a live issue for Democrats for eight years. Why would the GOP want to create a long running live issue that simply motivates Democrats to vote?

[The_Doctor]

Said “feudal machine” isn't good enough. 46% of the Presidential vote and 49% of the House vote sucks. I would be willing to wager that number drops a couple of points in 2018 if Donnie stays at 40% or below.

I still don't see how Republicans don't figure they can make a primary challenge and general election problem go away if they fix the ACA and take that off the table. Base activists don't get that much leeway to toss a senator on endorsing a popular fix.

[The_Doctor]

You must be logged in to read this quote.

This is the part that I always fall back to whenever I think the Senate might actually pass this thing. Politically it doesn't make sense to have this bill become law.

They may get a short bump in the polls, but long-term this bill will sink them since they would effectively own the issue of healthcare and all of it's problems. As much as they want to, they can't blame Democrats.

Better to have this thing flop and move on to something else and then months later cut a deal with Democrats and claim you "saved" the ACA. The public won't notice and the press will never call them out for their hypocrisy.

Exactly ... we even have precedent. In 1988, Congress passed a health care law dealing with catastrophic premiums. It was such a flop that in 1989, they repealed it.

This is pure evil.

I really hope TD is right, but I can't exactly feel relieved right now.

Yeah, I'm definitely going on a limb here. But I'm fairly confident that the usual signs of a major initiative becoming law isn't there. There's no media staging, there's no foreshadowing, Trump isn't going out there to sell the law, his approvals are way in the dumps, they're not being open, there's a ton of things that make me think they're doing kabuki theater.

In my honest perception, the GOP does NOT want to pass a law that they would be saddled with. They did this to the Democrats for 8 years and why would they want to go through that hell? Why would you want to go through "23 million lose Medicaid" as an attack line for 8 years?

Think of it this way: that's something the GOP has to always defend. The longer the ramp out, the longer they have to defend the potential consequences. Example: the Democratic nominee in Maine would charge "Collins voted for a law that would kick you off Medicaid in 2023. Why are you giving her a x term in response to that?"

It just creates a live issue that stays alive.

My new policy on anything related to the GOP mindset is to just listen to TD

And he's right. The GOP has been laying groundwork for tax reform like crazy. Not a peep about HC

Hopefully I'm right. Worth mentioning: I'm basing the GOP mindset on the usual American political mindset that costs and benefits are weighed against each other in terms of electability and sustainable electoral models. The GOP went through Bush. I'd be puzzled why they would want to repeat W's presidency on steroids domestically in terms of repealing the ACA and generating nonstop healthcare negative coverage.

See my points about the GOP not doing anything to tee up the spin for healthcare coverage. It's all about getting to tax reform and the reconciliation vehicle.

Said “feudal machine” isn't good enough. 46% of the Presidential vote and 49% of the House vote sucks. I would be willing to wager that number drops a couple of points in 2018 if Donnie stays at 40% or below.

I still don't see how Republicans don't figure they can make a primary challenge and general election problem go away if they fix the ACA and take that off the table. Base activists don't get that much leeway to toss a senator on endorsing a popular fix.

It's always darkest before Don, right? No president since FDR won two terms and still kept congress...and amazingly, no Republican.

This is unusual but accurate.

My new policy on anything related to the GOP mindset is to just listen to TD

And he's right. The GOP has been laying groundwork for tax reform like crazy. Not a peep about HC

He is worth listening to if the next month comes to pass without a HC bill on OO desk.

I would dispute this in the sense that I think I say valid things about a number of GOP priorities. If you read my timeline, about RyanCare, it passed the House after a furious battle because of the fight over the Medicaid expansion. That's exactly what's happening now. The GOP's ancient issue is that they want to cut benefits but voters hate that concept (but their core activists love it).

There are fundamental disconnects between the Republican Party's stated goals and what the American electorate will tolerate as far as benefits go. That disconnect has existed since they became a majority coalition in 1980 (allied with the Southern Democrats).

This is why repealing ObamaCare is so hard. It's why they can never touch Medicare or really change Medicaid or Social Security. The public is just invested in their benefits as a way of life and the Republican conundrum is to fundamentally challenge it without providing legitimate and concrete assurances that people won't be harmed.

[The_Doctor]

Basically, I've come to endorse Vox's framing even if I think they're a little too liberal and cute by half. The GOP cares about tax cuts and "starving the beast" as far as they can electorally maintain their coalition. There's widespread agreement about tax cuts, widespread agreement that they can get away with some budget cuts, but they don't simply have the firepower to take down Medicaid, Medicare, or Social Security, or at this point, the more popular parts of the ObamaCare law.

Also, don't forget. The GOP base is perpetually in a state of accepting the current entitlements but hating future ones. They're far more realistic than they like to pretend in a lot of ways. They are big on cutting their losses as far as wars go on the welfare state.

Lastly, never forget this. The GOP vote is split between upscale white middle class families and struggling evangelical blue collar Republicans. These blue collar Republicans are what makes the GOP the majority coalition. They come from the Midwest and the South. They're also heavily reliant on things like the Medicaid expansion. McConnell knows this extremely well; his own KY is one of the poorest states in the Union and one of the most reliant on welfare programs.

Does anyone here think Mitch is going to undermine Kynect or his constituents' benefits? No, because Mitch has spent 40 years building the Kentucky Republican Party and knows that if the communities lose their benefits and vote their anger, they'll undo his work.

Donald Trump may not care (he may not even be President when this finishes) but McConnell, Portman, Toomey, Moore Capito, Burr, these guys who have spent decades building their state Republican parties do care. They know their constituencies and know that these constituents will go on voting their evangelical beliefs only and only if their economic situation is assured. And that includes healthcare benefits granted and woven into the safety net under Obama.

It's (to me) as simple as that.

[The_Doctor]

Because they think it doesn't matter because no one thinks they are going anywhere.The election today, if Handel wins, will solidify the notion that Republicans have a locked in electorate because of their feudal party machine.

Let me save this quote and let's see the result and I'll respond based on the results.