The Morning Jolt

Politics & Policy

The Obamacare Repeal Can, Kicked Down the Road, One More Time

After all this time, it increasingly appears impossible to get 50 Republican senators to agree on legislation to replace Obamacare.

Last night brought genuinely shocking news as two GOP senators, who up until now hadn’t appeared to be likely “no” votes, announced their opposition: Jerry Moran of Kansas and Mike Lee of Utah.

Moran:

There are serious problems with Obamacare, and my goal remains what it has been for a long time: to repeal and replace it. This closed-door process has yielded the BCRA [Better Care Reconciliation Act], which fails to repeal the Affordable Care Act or address healthcare’s rising costs. For the same reasons I could not support the previous version of this bill, I cannot support this one.

We should not put our stamp of approval on bad policy. Furthermore, if we leave the federal government in control of everyday healthcare decisions, it is more likely that our healthcare system will devolve into a single-payer system, which would require a massive federal spending increase. We must now start fresh with an open legislative process to develop innovative solutions that provide greater personal choice, protections for pre-existing conditions, increased access and lower overall costs for Kansans.

The problem is that “starting fresh” doesn’t change any of the dynamics in place. Republicans (and, by extension, much of the country) want contradictory changes, changes that Moran lists as his requirements. Americans want lower premiums, but they also want insurance companies to keep covering preexisting conditions. They want to see the cost of Medicaid go down, or at least rise slower, but they also don’t want to throw anyone off of Medicaid. They want the number of uninsured to go down, and they want the mandate repealed.

To govern is to choose. The reason health-care policy is so complicated and thorny is because so many people keep insisting that they can have the best of both worlds — more money coming out of the system in the form of innovative, top-of-the-line treatment and care with minimal waiting times, and less money going into the system in the form of premiums, copays, and deductibles.

Lee:

After conferring with trusted experts regarding the latest version of the Consumer Freedom Amendment, I have decided I cannot support the current version of the Better Care Reconciliation Act. In addition to not repealing all of the Obamacare taxes, it doesn’t go far enough in lowering premiums for middle class families; nor does it create enough free space from the most costly Obamacare regulations.

The recent decision to keep some of the Obamacare taxes in there — in particular, a 3.8 percent tax on investment income on high earners — was designed to defuse the easiest Democratic criticism that the bill takes away from the poor and gives tax cuts to the rich. That particular tax cut could be readdressed in the tax-reform bill later in the year.

But no, these guys have to torpedo this particular bill, and its effort at improvement, in the name of some theoretical much better version that has yet to be written.

While recovering from eye surgery, Senator John McCain issued this statement:

One of the major problems with Obamacare was that it was written on a strict party-line basis and driven through Congress without a single Republican vote. As this law continues to crumble in Arizona and states across the country, we must not repeat the original mistakes that led to Obamacare’s failure. The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.

McCain and the likes of Ohio governor John Kasich keep spouting this “input from both parties” happy talk, but that optimistic assessment ignores an ugly truth. The Democrats — the party that rammed this through and promised America they could keep their plan, keep their doctor, and would pay $2,500 per year less than before — aren’t willing to go along with any significant conservative ideas for reform.

According to a Wall Street Journal editorial:

When Senate Republicans reached out to Heidi Heitkamp this spring to negotiate on health care, the North Dakota Democrat told Politico she had these demands: No per capita Medicaid block grants to the states and no rollback in ObamaCare’s Medicaid expansion. And that was merely “the price of admission for me sitting down.” Ms. Heitkamp is the second most conservative Senate Democrat after West Virginia’s Joe Manchin.

Ms. Heitkamp would never get a real chance to negotiate in any case. If their current effort fails, Republicans would then need 60 Senate votes to pass anything, and that gives Mr. Schumer the whip hand. His price for cooperating would include the Medicaid status quo; preserving the individual and employer mandates; tens of billions in higher subsidies to lure insurers back into the failing exchanges; and probably a limit on the policy flexibility the Trump Administration could allow states.

Some congressional Democrats insist the main problem with the law is that the mandate is not enforced enough, and that if the administration and IRS would start cracking down on people who aren’t buying health insurance, everything would get better. Or they want higher subsidies for purchasing insurance. Or, like senators Tim Kaine of Virginia and Tom Carper of Delaware, they want to “provide funding to offset larger than expected insurance claims for health-insurance companies participating in the state and federal insurance marketplaces.” (More taxpayer money getting sent to health- insurance companies.) And quite a few congressional Democrats want the public option — “Medicaid for all,” which would allow any American at any income level to set up insurance through the federal government.

Conservatives who oppose government mandates, subsidies, bailouts, and state-run health care wouldn’t like any of that.

Do We Want to Continue the Iran Deal or Not?

An eye-opening bit of reporting from Eli Lake, albeit one that showcases the problems with impulsive, ad hoc policymaking from the White House:

So just as [Secretary of State Rex] Tillerson was preparing to inform Congress on Monday that Iran remained in compliance with what is known as the Joint Comprehensive Plan of Action, Trump called it off, according to administration officials. He wanted to know his options and what would happen if Tillerson didn’t make the announcement.

And for a few hours on Monday afternoon, it looked like the White House was going to tell Congress it could not certify Iran was complying, without saying Iran was in breach of the pact. This would have triggered a 60-day period in which Congress could vote to re-impose the secondary sanctions lifted as a condition of the deal, or to strike it down altogether.

The predicament, according to administration officials, was that Congress, not to mention the other signatories to the seven-party agreement, was not prepared. Trump had yet to even put forward a broader Iran policy. What’s more, the U.S. intelligence community feels that Iran is pushing the edges, but overall is in compliance [with the] Iran deal.

Eventually, Trump walked back from the ledge, and the administration certified Tehran’s compliance.

I’m all for a tougher stance on Iran, and this is a situation where I’ll go so far as to say the president’s instincts are serving him well. But this sort of policy U-turn can’t be enacted at the last minute.

Chuck Schumer’s Political Instincts

Over in Mike Allen’s newsletter, he shares an anecdote from Josh Green’s Devil’s Bargain: Steve Bannon, Donald Trump, and the Storming of the Presidency.

Early on, Chuck Schumer was deeply worried that [Steve] Bannon’s nationalism might fracture the Democratic coalition: “I know what you’re doing, and I’m not going to let it happen,” the Senate Dem leader told Bannon in the early days of the administration.

I read that and remembered who I had heard confidently declaring that working-class white voters wouldn’t gravitate to Trump last summer: Chuck Schumer.

Back in July 2016, I saw Schumer speak to Democrats and media at a restaurant during the Democratic National Convention in Philadelphia. He spoke about the upcoming election, and quoted demographic figures, geographic trends, all kinds of information about the electorate in particular detail . . . 

“The number one factor in whether we retake the Senate is whether Hillary Clinton does well, and I think she’s going to do really well,” Schumer says of his former fellow New York senator. He notes that Senate Majority Leader Mitch McConnell urged Senate Republicans in difficult races to localize their elections, rather than get too tied to Trump’s positions and comments and scoffs, “Sorry, Mitch, this is a national election if there ever was one.”

At least publicly, Schumer has no worries about his party’s dwindling fortunes among working-class white voters. “For every blue-collar Democrat we lose in western Pennsylvania, we will pick up two moderate Republicans in the suburbs in Philadelphia, and you can repeat that in Ohio and Illinois and Wisconsin.”

Schumer knew his data, but the trade-off of blue-collar Democrats for white-collar suburban Republicans didn’t shake out the way he predicted.

ADDENDA: Jamie Dimon is CEO of JPMorgan Chase, and during a conference call on July 14, he just let loose with his frustration with the country:

We have become one of the most bureaucratic, confusing, litigious societies on the planet. It’s almost an embarrassment being an American citizen traveling around the world and listening to the stupid **** we have to deal with in this country. And at one point we all have to get our act together or we won’t do what we’re supposed to [do] for the average Americans. And unfortunately people write about this saying like it’s for corporations. It’s not for corporations. Competitive taxes are important for business and business growth, which is important for jobs and wage growth. And honestly, we should be ringing that alarm bell, every single one of you, every time you talk to a client.

Dimon is a Democrat. Is there room for a pro tort-reform, pro-tax-simplification, anti-bureaucracy movement in the Democratic party?