Radio America Online News Bureau

repeal

‘Tone Deaf Up in the Bubble’

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Senate Republicans appear unable to pass a straight repeal of Obamacare or a more comprehensive plan, and one of the most fiscally conservative members of Congress says the GOP either needs to do what it promised or prepare to watch the rest of the Trump agenda wither away.

Senate Majority Leader Mitch McConnell says he still plans to hold a vote on repeal, identical to the one that passed Congress in 2015.  However, four Republicans are already opposed, including three who voted for the the 2015 plan which was ultimately vetoed by President Obama.

Sens. Rob Portman, R-Ohio, Lisa Murkowski, R-Alaska, and Shelley Moore Capito, R-West Virginia, are the ones now opposing the plan they backed two years ago.  Sen. Susan Collins, R-Maine, is also opposed, but she also opposed the 2015 bill.

For those pounding the table for repeal, the dashing of hopes in the Senate is stunning.

“I thought there would be some movement toward the 2015 plan, but then the three senators who previously voted for the 2015 bill came out and said they were going to vote against the 2015 bill.  That is fairly shocking,” said Rep. Dave Brat, R-Virginia, a member of the House Freedom Caucus and the House Budget Committee.

“When you vote 50 times to repeal and you say you’re going to repeal, then it’s fairly simple.  You ought to do what you told the American people you were going to do.  So now these folks are really, really hurting the Republican brand,” said Brat.

He says the GOP needs some serious soul-searching.

“What do we stand for?  Do we stand for small federal government?  Do we stand for free markets?  Do we stand for fiscal responsibility or are we just going down the Democrat path and bankrupting the country?” asked Brat.

“The rest is just pure politics and I don’t care for that realm.  The first principles are what made us the greatest country on earth.  You put Adam Smith and James Madison together and you get some great outcomes.  We’re departing from those first principles every day,” said Brat.

He says what many Republicans are focused on in Washington is a far cry from what voters want from them.

“I just don’t understand how you can be that far off the reservation politically and that tone deaf to what the American people want.  Everybody back home is just yelling to get it done.  We’re once again tone deaf up in the bubble,” said Brat.

Brat is also frustrated by how Republicans have tortured a simple policy approach into something far more complicated.

“Once you change the definition of repeal…to a health care thing run by the federal government with all sorts of subsidies and billions of dollars for other programs attached, you’re getting too far away from Republican first principles.  The messaging hasn’t been good because we keep twisting the meaning of common sense words,” said Brat.

Brat is also concerned about how the failure to pass health care legislation will impact other major priorities in this Congress, especially major tax reform.  He says between not eliminating Obamacare taxes and the expected scuttling of the border adjustability tax, Congress is already starting with a two trillion dollar disadvantage.

As a result, the Trump administration is now adjusting it’s push for a corporate tax rate.  Instead of dropping it to 15 percent, Brat says the president’s team is now gunning for the 20-25 percent range.

He says the GOP simply cannot screw up tax reform.

“The worst thing we can do is to goof up tax reform and not get this economy rolling again.  Everything hinges on that,” he said.

Brat still hold out hope for a health care bill since President Trump is still energized to get something done, although Brat suggests the president has been more “transactional” in his approach and needs to be more specific about what he wants.

However, Brat is not enthused about bringing Democrats into the talks since that would lead to government in health care.

“I think he’s starting to recognize that when you move toward the Democrat side, the policy end up utterly complex and fails,” said Brat.

The congressman also laughs off the assertion of Democrats that Republican opposition to Obamacare – and not the law itself – is responsible for uncertainty that drives up the cost of premiums and deductibles for many Americans.

“What’s a central planner going to say about the monopoly.  It’s never their fault because they own it,” said Brat.  “They have to give that kind of response because they don’t have a free market system that is sustainable over the long run.”

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‘They Have Promised This for the Last Four Election Cycles’

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Republican hopes of repealing or even drastically reforming Obamacare appear more bleak than ever after enough lawmakers emerged in the past day to scuttle an amended health care bill and sink a promised vote on a repeal bill.

Nonetheless, free market health advocates believe there is a way for this Congress to make headway while the GOP still controls the levers of power in Washington.

Moderates and conservatives are glum Tuesday.  Senate Republican leaders were clinging to hopes of squeaking their amended bill through, even after Sens. Susan Collins, R-Maine, and Rand Paul, R-Ky., announced their plans to vote against the motion to proceed to the bill, albeit for completely different reasons.

However, on Monday evening, Sens. Mike Lee, R-Utah, and Jerry Moran, R-Kansas, publicly opposed the plan for not doing enough to eliminate taxes, reduce premiums, or kill regulations.  With all 48 Democrats firmly opposed, four GOP defections spelled defeat for the legislation.

“I think there are just too many factions within this Republican caucus and with only two votes to spare, there just was not enough room for differences of opinion,” said Galen Institute President Grace-Marie Turner.

She says moderates were not willing to give up the federal Medicaid dollars.

“You’ve got the moderates who are very worried about losing the incredibly generous Medicaid match that their states are getting.  Most of them are from states that expanded Medicaid.  Remember, the federal government initially paid a hundred percent of the cost of the usually joint federal-state program if the states would put more people on their Medicaid rolls,” said Turner.

She says conservatives had their own reasons to balk at the larger GOP bill.

“Many conservatives are worried, rightly, about the regulations in Obamacare that are so difficult to reach through this narrow pathway that the Senate has to pass legislation with only a simple majority of votes,” said Turner.

“There’s some conservatives, like Rand Paul, who feel that any effort to try to do something else to provide subsidies to people going forward is really perpetuating Obamacare,” said Turner.

In response, Senate Majority Leader Mitch McConnell said he would bring forward a bill to repeal much of Obamacare and trigger a two-year sunset to give lawmakers time to craft a replacement.  While hailed by conservatives, those hopes were also soon dashed as Collins and Sens. Shelley Moore Capito, R-West Virginia, and Lisa Murkowski, R-Alaska, revealed they would not vote on a repeal without seeing a replacement bill.

Both Capito and Murkowski voted for the same repeal bill in 2015 despite the absence of a replacement plan.  President Obama vetoed the earlier repeal.

Turner says lawmakers act differently when a bill has no chance of becoming law than when it does.

“They knew President Obama was going to veto it, so there’s a difference between messaging and governing,” said Turner.

With Senate leaders unable to bridge the narrow divide between conservatives and moderates and the straight repeal apparently headed to defeat, many on the right believe it’s time to move on to other priorities.

Turner says that is not an option.

“They can’t not do something on repealing Obamacare.  They have promised this for the last two election cycles.  Every single member is going to have to go to his or her constituents and explain why, after all of this debate over Obamacare, they can’t get it done,” said Turner.  “They known they have to do something.”

President Trump now suggests he may just let Obamacare collapse and blame Democrats since they did nothing to solve the problem.  Turner says that strategy won’t work.

“They are going to be blamed for the millions of people that would lose coverage if nothing is done because these exchanges are failing, insurance companies are signing up to provide coverage next year because they are losing so much money providing so-called insurance under Obamacare rules that don’t work,” said Turner.

“Republicans own it.  How can you have the White House and both houses of Congress and say that you don’t own this problem,” said Turner.

That being said, Turner is also slamming Democrats for asserting that Republican promises to repeal Obamacare are creating uncertainty among insurers and that is why premiums and deductibles are skyrocketing, rather than the Obamacare provisions themselves.

“That is just so completely beyond the realm of reality.  The reason that costs are going up under Obamacare is because of the flawed structure of the bill that, for one thing, encourages people to wait until they’re sick to sign up for coverage and that provides all sorts of opportunities for people to drop coverage and game the system,” said Turner.

She still holds out hope that lawmakers will send power back to the states to address health care problems in the most effective way.

“Washington-centralized solutions are not the answer, whether Republicans are developing them or Democrats are developing them,” said Turner.

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‘Do What You Told the Voters You Were Going to Do’

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Senate Majority Leader Mitch McConnell says it may not be possible to unite 50 Republicans on any health care overhaul and that the only action may be a collaboration with Democrats to adjust certain parts of the system, an evaluation that a leading House conservative finds unacceptable.

On Thursday, McConnell told a town hall-style event in Kentucky that political realities inside the Senate Republican Conference make it very difficult to find consensus.

“I’m in the position of a guy with a Rubik’s cube, trying to twist the dial in such a way to get at least 50 members of my conference who can agree to a version of repealing and replacing” said McConnell, according to NBC News. “That is a very timely subject that I’m grappling with as we speak.”

 

“If Republicans are not able to agree among themselves, the crisis will still be there and we’ll have to figure out the way forward at that point,” added McConnell, who later said that could mean working with Democrats to provide options for Americans in the individual insurance marketplace but have no plans available where they live.

Rep. Jim Jordan, R-Ohio, who is also a co-founder of the House Freedom Caucus, says Republicans had an obvious path to avoiding this political mess.

“Sometimes we forget what our responsibilities are in Congress.  Some are pretty basic.  Do what you told the voters you were going to do.  We were very clear over the last six years when we told the American people we were going to repeal Obamacare.  That’s what we should have done.  That’s what the Freedom Caucus proposed,” said Jordan.

Jordan wanted the same approach in the House but didn’t get it.

“I actually introduced that clean repeal, the same bill we voted on [in 2015] that we put on President’s Obama’s desk, we thought we should put it on President Trump’s desk and have a two-year phaseout where we had time to do the replacement.  Unfortunately, that’s not the path that was chosen by our leadership,” said Jordan.

While congressional leaders insist Senate rules limit what legislation can pass with a simple majority of votes, Jordan says the passage of the 2015 repeal proves otherwise.  On December 3, 2015, the Senate approved the Obamacare repeal by a vote of 52-47.

All current Republican senators who were in office then voted for the repeal, with the lone exception of Sen. Susan Collins, R-Maine.

As many as 14 Republicans have expressed opposition or reservations about the Senate bill, which McConnell pulled off the Senate schedule late last month.  Some insist Congress must make good on vows to repeal and replace Obamacare and make sure that any legislation drives down the cost of premiums.

But moderates who are opposed to the measure are upset that there is not a greater role for government, as they demand more generous Medicaid expansion, Planned Parenthood funding, billions for opioid addition treatment or other priorities.

Despite the individual issues raised, Jordan says there’s a more discouraging fact behind the GOP’s inability to move this effort more smoothly.

“When you boil it all down, read Byron York’s column a few months back, where he said that the reason that Republicans aren’t doing a full repeal is because some Republicans don’t want to repeal Obamacare.

Jordan suggests that fact can be seen in how some GOP members are worried about limiting Medicaid expansion just 18 months after backing a much more conservative approach.

“That bill said Medicaid expansion goes away after two years.  You don’t add to it.  You don’t phase it out.  It’s done.  It’s a two-year wind down and the expansion part is no longer the law.  That’s what we passed a year ago.  Now we can’t do it, so that’s the frustrating thing for all of us,” said Jordan.

But all hope is not lost.  Jordan says the Senate could be salvaged from a conservative perspective if lawmakers there embrace an amendment from Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah.

“The Cruz Amendment creates what we call freedom of choice or a consumer choice option, which would say as long as an insurance company provides one plan in each category that meets with all the Obamacare regulations, they could then also offer any other plan that consumers and patients also want,” said Jordan.

“That would be moving us back toward a market that would bring down premiums for so many families and just makes good common sense to me.  If that amendment goes in, I think the bill is good and you would see conservatives support it on the House side.  Let’s see if that amendment gets in the Senate bill,” said Jordan.

While some Republicans in Washington bemoan the complexity of the issue and the legislative process, Jordan says the business owners and families in his district see things very clearly.

“Traveling in our district, we hear from employers all the time.  Even this morning they said, ‘Here’s what’s happened to our health care costs.  These aren’t even people who are in the small group or the individual market.  They’re in the large group market.  They’re costs are going up too.

“They want changes.  They know what Obamacare has done.  They want changes there, they want changes in the tax code.  They want us to do what we said.  They want us to secure the border,” said Jordan.

“Let’s get after doing what we told them we were going to do.  After all, that’s what our job is.  We better get doing that and the sooner the better,” said Jordan.

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‘All the Wrong Moves in the Obamacare Direction’

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A key member of the House Freedom Caucus says the Senate health care bill drifts too far towards the existing framework and that the smartest approach would be to repeal Obamacare and then get to work on a replacement, although he does not expect GOP leaders to choose that path.

Rep. Dave Brat, R-Virginia, taught economics for 20 years before pulling off a stunning defeat of then-House Majority Leader Eric Cantor in a 2014 Republican primary.  He could not support the Senate bill unveiled by leaders last week.

“The original bill coming out of the Senate kind of made all the wrong moves in the Obamacare direction, which is shocking,” said Brat.

“It’s not just about adding more coverage or helping more people.  That’s the way most people are thinking about this.  What I think people lost track of is Economics 101.  Obamacare is in the ditch because of its own economic logic,” said Brat.

He says lawmakers on both sides struggle to see the big picture.

“That Obamacare logic was just about 100 percent attention paid to coverage and no attention paid to the price of health care.  As a result, people were covered with gold-plated health insurance policies, but no one could afford health coverage,” said Brat.

With Senate Republicans now unable to move their own bill, Brat enthusiastically endorses the suggestion of Sens. Rand Paul, R-Kent., and Ben Sasse, R-Neb., to repeal Obamacare now and then get to work on a replacement that can pass.

“The rational politics would have been, initially, to repeal Obamacare, which all of those senators voted for when it didn’t count.  They all voted for the 2015 package to repeal Obamacare,” said Brat.

He says that’s exactly what Republican voters expected after the 2016 elections, but they aren’t getting it.

“When you vote 50 times to repeal and then you tell the American people you’re going to repeal and then you end up very close to Obamacare logic.  That is not good for the Republican brand,” said Brat.

Brat is confident that if repeal came first, there would be plenty of interest across the spectrum in getting on board with the replacement bill.

“Then you have the leverage to work with the Democrats.  There’s no shortage of people who want to add programs in D.C. in the swamp, right?  So you first repeal and then the floodgates are open to add.  You can get as many votes as you want from any politician to say yes.  Politicians love to say yes.  That would have been a brilliant move back in January,” he said.

So will House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell embrace that idea now that a comprehensive bill is flailing in the Senate?  Brat is not holding his breath.

“I went to seminary so I’ll be praying for it, but I’m doubtful.  That would be too good of news.  I don’t think we’ve got a big enough spine to carry that off,” said Brat.

But why?  Republicans scored decisive wins in three separate election cycles, due in large part to their promises to repeal Obamacare.  So why aren’t they following through?

Brat sees three key reasons: keeping the special interests happy, the effort to protect vulnerable Senate incumbents from unpopular votes, and a relentlessly hostile media.

“Up in D.C., you’ve got to appease the swamp, so there’s all sorts of moneyed special interests you have to appease, ” said Brat, noting that the insurance companies love what the Senate GOP produced.  “Then if you’re in tough seats, you’ve got to try to support those tough seats.”

Brat says the influence of the major insurance companies is a big problem, one that James Madison and Adam Smith warned against long ago.

“Both of them had the exact same logic.  You want a large number  of small competitors duking it out in this country.  We’ve lost that.  That’s the American way.  Instead, we’ve got a few huge oligopolies running from D.C., which the elites can put their thumb down on and that’s why the American person is getting hammered right now,” said Brat.

As for the media, Brat says the avalanche of false, negative coverage is tough for many members to weather.

“After we passed the House bill, the mainstream media repeated misinformation and fake news for the next week.  It was one simple line: House bill gets rid of pre-existing conditions.  Everybody with pre-existing conditions is on their own and there’s going to be death in the streets,” said Brat.

“It is daunting to have confidence in the people back home, that they can see through that message when that’s all you see as a politician is that mainstream media.  CNN, New York Times, Washington Post: House guts, destroys obliterates – all these crazy words.  Then they say, ‘Politicians, you guys have to be more civil,’ as they lambaste us with falsehoods constantly,” said Brat.

One of the main reasons Brat opposes the Senate bill is because it fails to deal with what he sees as the fatally flawed framework of Obamacare.

“At least the House package had a little bit of room to negotiate some of the regulations and the regulations are Obamacare.  If you don’t get rid of the Obamacare regulations, a young person cannot go out and buy a catastrophic package out of college, so they’re left with a gold-plated plan with a $2,000-$3,000 deductible.  And I don’t know a lot of college grads with two or three grand in their pocket,” said Brat.

He is imploring his fellow Republicans to proceed on the principles they constantly espouse about the success of the free market.

“If you believe in free markets and the standard American package of free enterprise, etc., that will deliver the goods.  Everybody knows these eye surgeries that started out at $6,000 per eye are down to $450 per eye to get your Tiger Woods eye surgery,” said Brat.

“That’s what the market can do if you let it alone.  If you let the government intervene, you end up with Medicare, which is insolvent in 2034.  You end up with Social Security, which is insolvent for the kids in 2034.  $20 trillion in debt, $100 trillion in unfunded liabilities to those major programs, and we’re going to add more government,” said Brat.

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‘You Said It’s What You’re Going to Do’

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Senate Republican leaders are not offering an specifics on their health care reform bill but reports of critical concessions in at least three major areas leave skeptical conservatives worried that years worth of Obamacare repeal promises are wilting before our eyes.

In recent weeks, reports have described the difficulty of Republicans in cobbling together 50 or 51 votes to advance an Obamacare overhaul.  As a result, leaders are reportedly considering a more generous approach to Medicare expansion, effectively adopting the Obamacare approach to people with pre-existing conditions and, most recently, allowing tax payer funding of Planned Parenthood to continue.

Former Virginia Attorney General and current Senate Conservatives Fund President Ken Cuccinelli says efforts to make everyone happy appear to have taken any meaningful teeth out of the legislation.

“I’m concerned anytime (Senate Majority Leader) Mitch McConnell is talking the way he is.  A deal to Mitch McConnell to you and me means capitulation,” said Cuccinelli, who was also the 2013 Republican nominee for Virginia governor.

He says if McConnell embraces a badly watered-down bill, he is breaking promises he clearly made while running for re-election in 2014.

“I remember, ‘Root and branch.  We’re going to pull it out root and branch,'” said Cuccinelli, mimicking McConnell’s 2014 declaration.  “[He ] paid for over 30,000 anti-Obamacare ads in October alone for his re-election in 2014.  He apparently had no intention of keeping those promises.”

But it wasn’t just McConnell.  Every Republican senator has campaigned on addressing Obamacare, with the vast majority vowing to repeal and replace the 2010 law.  What has changed now that the GOP is in a position to do something about it?

“A lot of them lie.  That’s the sad truth that is now being brought home to us,” said Cuccinelli, who also has no use for the argument that dealing with Obamacare is far more complex than a simple repeal vote.

“They love to tell us how complicated it is.  What that means is, ‘You’re stupid and I’m the smart senator.  You don’t know what you’re talking about so you should just adopt my soft, unprincipled position that, oh by the way, is not what I campaigned on,'” said Cuccinelli.

“It’s demeaning to the American people.  It’s patronizing.  It’s elitist and it’s a lie,” said Cuccinelli.

Rather than try to mollify every critic, Cuccinelli says there’s a much simpler way for lawmakers to proceed – do what they promised voters they would do.

“They didn’t say, ‘We’re going to undo parts of it.’  They didn’t say, ‘This is complicated and I’m going to simplify it.’  They said they were going to repeal it.  There was a good article by one of the Fox (News) contributors a little while ago about simply doing what you say you’re going to do.

“Will some people not like it?  Yeah, some people will not like it, but you said it’s what you were going to do,” said Cuccinelli.

Cuccinelli points to Wisconsin Gov. Scott Walker’s controversial effort to ease the grip of unions on state government as an example of honoring your word in a tough environment.

“We saw the largest protest in the state capital we have ever seen, 100,000 people.  They physically shut the place down with their obstruction.  Scott Walker and the Republicans in the Wisconsin legislature soldiered on and did what they said they would do,” said Cuccinelli.

He says the voters ultimately rewarded that consistency when opponents were able to put a recall election on the ballot.

“Guess what?  The people who had been largely silent, the people of Wisconsin, came back out and returned Scott Walker to office with essentially the same margin as his first election.  He got re-elected again three years after that,” said Cuccinelli.

“The moral of the story is even when people disagree with you, they respect it when you keep your word, even when it’s hard,” said Cuccinelli.

While the House has passed a bill, Cuccinelli says it also is not what voters were promised.  He says President Trump’s biggest mistake was to let GOP leaders lead the process.

“One of the mistakes…was for the White House to turn this over to (House Speaker) Paul Ryan.  What they got was a donor bill.  They did not get a repeal bill.  That’s what the House leadership does.  They caucus with donors,” said Cuccinelli.

Contending that repealing the burdensome regulations in Obamacare is of top priority, Cuccinelli points out that the House bill only address one and a half out of 24 key regulations in the law.

Cuccinelli was the first attorney general in the United States to challenge the Affordable Care Act in court after it was passed into law.  He doesn’t understand why Republicans in Washington don’t just vote on a full repeal.

“They ought to put a real repeal bill up and have a vote.  If you lose Lisa Murkowski and Susan Collins, that’s still 50 (votes).  And Rand Paul will vote for a real repeal.  He just won’t vote for the other junk.  Then the vice president can break that tie,” said Cuccinelli.

He also says it’s not out of the question for vulnerable Democrats up for re-election in red states next year to get on board.

Cuccinelli and other conservatives balked at the original version of the House’s American Health Care Act, or AHCA.  Most conservatives only got on board after amendments were added to ensure premiums would not increase, even in the short term.

Cuccinelli sees a lot of the same problems emerging in the Senate.

“If we get to an insurance situation instead of a mandate situation, then the bill may be OK.  But if you’re having community rating and forcing pre-existing conditions, it’s not insurance any longer.  It’s a welfare program, which is what Obamacare is right now.

“Until they move it from a welfare program to insurance, where risk is assessed and priced and the market can determine where people land, then it’s not going to be an acceptable bill,” said Cuccinelli.

And would these concessions impact costs to consumers?

“It isn’t going to lower premiums, critically.  All the while, Obamacare is crashing around their ears.  It’s amazing.  How destroyed does this concept have to be until they reject it.  This is classic government.  ‘If it’s broke, do more of what you did before,'” said Cuccinelli.

The reported consideration allowing taxpayer funding of Planned Parenthood would be designed to assuage Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska.  Cuccinelli says Murkowski’s stand on this component is particularly galling.

“Lisa Murkoswki has been against funding Planned Parenthood during her campaigns and has viciously fought for it after she’s elected.  This is not the first time for Sen. Murkowski to lie to Alaskans about this and to flip back to her pro-abortion position,” said Cuccinelli, asserting no one with that record should be a chairman in a GOP-run Senate.

 

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Warren Slams Obama, GOP Wilting on Obamacare Repeal, Headaches at Heritage

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Jim Geraghty of National Review and Greg Corombos of Radio America react to Elizabeth Warren criticizing former Pres. Obama for leaving millions of Americans feeling like they’ve been “kicked in the teeth” in the current economy.  They also groan at reports that up to 50 House Republicans really don’t want to repeal Obamacare and many of those are even wobbly on giving states more flexibility.  And they discuss the ouster of Jim DeMint at the Heritage Foundation and address speculation that Steve Bannon might replace him.

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Will Republicans Pass A Health Bill?

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Just days after winning conservative support for an amended bill to gut the taxes and mandates associated with Obamacare, Republicans are still struggling to find the votes for passage, but the man leading the legislative effort is confident the votes will eventually be there.

GOP leaders have given their blessing to an amendment championed by Rep. Tom MacArthur, R-N.J., and House Freedom Caucus Chairman Rep. Mark Meadows, R-N.C.  But while giving states more say in the health plans offered to their residents is winning the applause of conservatives, moderates seem to be leaving in numbers big enough to sink the bill.

House Ways and Means Committee Chairman Kevin Brady, R-Texas., is confident the votes will eventually come around.

“I think the hesitation has only been to be able to digest this, to be able to think about how it applies back home, before they commit their vote.  The conversations that I’ve been in are very positive and we’re just going to keep working on it,” said Brady.

And despite the pressure from Democrats and the media on the timetable for getting this done, Brady says he’s less concerned about meeting a specific deadline.

“I’m a big believer in letting the consensus drive the timing.  So don’t set a date.  I want to deliver on my promise to repeal Obamacare: all the taxes, all the mandates, all the subsidies, defund Planned Parenthood and return control to the states.  That is what I am intent on doing,” said Brady.

Brady, who played a key role in crafting the original American Health Care Act, says the current bill is an improvement.

“Centrists and conservatives sat down and said, ‘How can we make this better?’  As a result, the MacArthur amendment , as well as the Palmer amendment before it, continue to lower premiums , which is what we want for every American, gives states more flexibility to design plans that are right for the state and the community rather than Washington control,” said Brady.

Brady says if this bill can get through and Health and Human Services Secretary Tom Price acts to roll back regulations, much of Obamacare will be history.

“Getting steps one and two done with the White House repeals 90 percent of that or more and puts in place free market options but we still have more work to do,” said Brady.

“Allowing types of business to join together, to buy across state lines, to have much better options, (as well as) malpractice reform, where we get those junk lawsuits out of medicine.  All of those are going to have to be standalone bills,” said Brady, noting that Senate rules cannot allow everything to be done by reconciliation, which would skirt the possibility of a filibuster.

Brady says some of the more popular provisions in the current law would stay, including no one being refused coverage for pre-existing conditions, allowing children to stay on their parents’ policies until age 26, abolishing lifetime caps and more.

Brady says it is not only vital to pass the AHCA in order to bring relief to struggling Americans, he says it’s vital for the next major priority – tax reform.

“We never anticipated in tax reform having to also repeal another trillion dollars of taxes that were included in Obamacare.  All these taxes hurt the economy.  They raise costs on patients.  They hammer small businesses.  We need them gone, but if we had to do that through tax reform, that would mean we couldn’t lower the rates as much for families or local businesses or to become competitive against China and Europe,” said Brady.

In fact, Brady believes getting the AHCA through is really the trigger for accomplishing much of the Trump agenda.

“This is all about momentum for the Republican conservative agenda in Washington.  This president wants to shake things up.  We need to be right there to deliver on these big changes, so building the momentum off of health care into tax reform, I think, is helpful,” said Brady.

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Brat Bullish on Health Reform

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House Republicans are reeling from their failure to pass health care reform legislation, but a key House Freedom Caucus member says the GOP is getting close to a consensus that will make conservatives happy and make it to President Trump’s desk.

Rep. Dave Brat, R-Va., a former economics professor, says the embarrassing spectacle of having to pull the American Health Care Act, or AHCA, from the floor never had to happen.  He says the arbitrary voting deadline imposed by House leadership doomed the bill just as critical common ground was found between conservatives and the White House.

“At the end of that process, we were already making good headway.  We met with President Trump himself.  He OK’d a lot of the regulatory pieces we wanted.  Based on what he said, we thought we were at a yes.  Then it got mulled around and kicked around on Capitol Hill and it turned into a no somehow,” said Brat.

He says House conservatives were also very receptive to some of Vice President Mike Pence’s ideas to decentralize the health care sector.

“It’s just to go the states route and let moderate or liberal states keep the elements of Obamacare they like, let conservative states take the legs out to lower prices the way they see fit that matches their population,” said Brat.

But despite the promises, many Freedom Caucus members couldn’t vote yes for a very simple reason.

“That hasn’t ever been delivered in print yet,” said Brat, noting the official language of the AHCA never reflected the changes Trump and conservative lawmakers agreed upon.

Brat says this has been a frustrating process since the AHCA is not what he says Republicans promised to voters in the past four election cycles.

“We thought we were going to end up in pretty good shape with some competition across state lines, HSA’s and private innovation, price discovery and transparency, so people could shop for health care products and know what they’re paying for,” said Brat.

“Then we got a bill put before us that is way too much federal government which is way too federal government-oriented for my taste and three weeks to deal with it,” said Brat.

Despite his disappointment in the AHCA, Brat says he’s trying to scratch his way to supporting the bill, with the right changes.

“Some of us weren’t so happy with that product, but we also want to keep the Trump agenda going on and realize you need tax revenues to do tax reform in short order.  So we want to get to yes but we’ve got to be plausible and reasonable,” said Brat.

It’s a fine balancing act, says Brat, as conservatives faced intense pressure to back the health bill put forth by their own party.

“I’ve had very intelligent people say, ‘Just forget about it.  Just vote yes on that bill and move on because we want tax reform.’  Are you serious?  It’s one-sixth of the entire economy and just dispatch it?” said Brat.

He says Republicans have a chance to address this and other issues that may not come around again for a very long time.

“This is a once-in-a-century opportunity we have with the House and the Senate and the White House.  So this isn’t really the time to do marginal, small little adjustments.  This is the time to get your first principles right and set up an economy and a health care system that our kids will flourish under,” said Brat.

And for the record, Brat says moderates are much more responsible for the AHCA mess than the House Freedom Caucus.

“There was a certain number of House Freedom Caucus folks that were a no vote, but it wasn’t unanimous.  There were way more moderates who were going to do a jail break once the [number of GOP no votes] got to 20.  It wasn’t reported at all.  It’s not a blame game.  Let’s just tell the truth out there in public so we can get to a solution.  You’ve got to know the truth before you can find good policy options,” said Brat.

Brat says the media, including the Wall Street Journal, are not telling the truth on policy either.  He says stories of heartless Republican policy proposals are simply not matched by the facts.

“Not only are we OK with pre-existing conditions, we’re OK with a $120 billion pot for high-risk pools for pre-existing conditions.  Then we’re OK with the main amendment language of (Ariz. Rep David) Schweikert, (Alabama Rep. Gary) Palmer and (Maryland Rep.) Andy Harris, which also helps pre-existing conditions.  It’s kind of been applauded by everyone for reducing prices for health care and providing more coverage,” said Brat.

“The high-risk pool is the solution there, because five percent of the folks with pre-existing conditions of a serious nature are 50 percent of the health care costs of the country.  They can’t get insurance.  Obamacare’s failure was that it just focused on insurance coverage.  It never focused on price.  That’s why you had death spirals, because people’s premiums are going up 30 percent and insurance companies can’t stay in business,” said Brat.

Brat is confident House members can reach a consensus in the week or two after lawmakers return from recess.  And he warns Senate Republicans not to tinker much with any legislation the House sends their way.

“The bill better come back very close to how we sent it over.  So if there’s a major rewrite on the Senate side, then it’s business as usual, and we’ve got to do better,” said Brat.

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‘Let’s Do What We Said, Let’s Repeal Obamacare’

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Republican leaders are hoping to pass their health care replacement plan on Thursday, but the conservative sponsor of legislation to fully repeal the Affordable Care Act says the current GOP preserves far too much of the current system and must be rejected.

Rep. Jim Jordan, R-Ohio, is also a co-founder and former chairman of the House Freedom Caucus and has introduced legislation to fully repeal the Affordable Care Act, also known as the ACA or Obamacare.  Jordan is vigorously opposed to the current version of American Health Care Act, arguing this is not what Republicans promised voters since 2010.

“We’re not repealing Obamacare.  Even people who are for it, like Charles Krauthammer, has said it’s Obamacare-lite.  It keeps the Obamacare structure and that’s not what we told the voters.  If you don’t repeal Obamacare, you’re never going to bring down the cost of insurance for middle class and working class families,” said Jordan.

“So it is really that basic.  Let’s do what we said.  That’s what they sent us here to do.  Let’s actually repeal Obamacare.  A clean and complete repeal is what we’re after.  This doesn’t do it,” said Jordan.

The American Health Care Act, or AHCA, is vigorously endorsed by President Trump and House Speaker Paul Ryan, R-Wisc.  Ryan argues the plan does fulfill the promise to repeal and replace Obamacare.

Jordan laid out several areas he insists are key differences between a complete repeal and what the GOP plan does.

“We didn’t tell voters we were going to repeal Obamacare but we were going to keep some of the taxes in place, which the speaker’s plan does.  We didn’t say we were going to repeal Obamacare but take the Medicaid expansion and extend it for several years, which the speaker’s plan does,” said Jordan.

“We certainly didn’t say we’re going to repeal Obamacare and start this new program of refundable tax credits and repeal Obamacare and get rid of the mandate but keep this 30 percent surcharge that we tell insurance companies you have to levy on people who don’t maintain continuous coverage,” said Jordan.

The most disturbing issue for Jordan is Republicans getting ready to own a massive health care reform that he believes will not lower the cost of health insurance.

“This is just Obamacare in a different format, and because of that it will not bring down the cost of insurance.  It will not bring down premiums.  Therefore, middle class families are still going to see the ridiculous high levels they’ve seen over the last several years,” said Jordan.

Jordan and several other members of the House Freedom Caucus are demanding a full repeal of Obamacare, just as the GOP-controlled Congress did in 2015 before the legislation was vetoed by President Obama.

“The one thing we know about our plan is it’s passed before,” said Jordan.

So why won’t leaders bring up that same bill?

“They’re saying some people may not vote for that, which is amazing to me.  During election time you can do one thing, but once you get in office and it actually counts you can’t?  That’s what drives voters crazy,” said Jordan.

Jordan also doesn’t buy the GOP leadership’s three-step approach to reform, which includes this bill, letting Health and Human Services Secretary Tom Price roll back many of the regulations in the current law and then passing market-based reforms in a separate bill that will likely require 60 votes to clear the Senate.

“That’s a joke,” said Jordan.

“We know phase two is going to get tied up in court.  You saw what the courts have done on President Trump’s executive order on the travel ban.  You’ve seen how he reworked it and came back with something we know is consistent with the law.  And where is that right now?  It’s tied up in court.  So to think the left is not going to take Obamacare and tie it up in court is just ridiculous,” said Jordan.

As frustrating as it has been for full repeal proponents to plead their case with leadership, Jordan says the difference between conservatives and Democrats on the issue is like night and day.

“They view success as signing people up for government, Medicaid or Obamacare.  We define success as let’s put in place the policies that make insurance affordable so that people can pick the plan that meets their needs.  That’s what we’re trying to get accomplished,” said Jordan.

While Trump is vociferously supporting the GOP plan, Jordan is hopeful the president will be able to broker changes to the legislation that will rid the law of crippling insurance regulations dictating what has to be in all policies, allow for market based reforms that will drive competition and lower costs and repeal other burdensome regulations by statute.

Jordan, who met with Trump along with other Freedom Caucus members, says the White House has been far more accommodating than Republican leaders in Congress.

“We appreciate the outreach the White House did being willing to work with us.  Our leadership initially talked about this binary choice, take-it-or-leave-it approach, which I don’t think is helpful.  Since then I think they’ve been more open to talk with us, probably driven by the fact they don’t have the votes,” said Jordan.

With a vote planned for Thursday, Jordan suspects a scramble is underway to find more support for the AHCA.

“One thing I learned a long time ago is when leadership is out there saying they have the votes, that means they probably don’t have the votes.  Based on what I know from our members of the Freedom Caucus and some other people, I believe they do not have the votes, so we’ll see how negotiations go this week,” said Jordan.

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‘It’s A First Step’

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Conservatives and liberals are savaging the House Republican health care plan, but one of the leading advocates for a market-driven approach says the bill is a good start to imploding Obamacare and setting the stage for additional conservative reforms.

The plan is getting hammered by conservatives for not fully repealing the 2010 Affordable Care Act, failing to allow the purchase of coverage across state lines, and for allegedly replacing one entitlement program with another.  Liberal critics say the plan would knock millions of Americans off health insurance and leave them one illness from bankruptcy again.

So what about those claims?

Galen Institute President Grace-Marie Turner is a veteran of Washington health care debates and was a fierce opponent of the Clinton health care reform effort in the 1990’s and Obamacare since 2009.  She is encouraged by what she sees in the American Health Care Act and says the realities on Capitol Hill force this kind of legislation.

“It’s a first step.  They’re pushing as far as they can with the process they have to go through.  They do not expect any Democrats, in the House or the Senate, to vote for this.  That means they have to do this through a particularly difficult process called reconciliation that limits the kinds of things you can repeal,” said Turner.

“They can’t repeal everything in the law through this process because it has to have direct spending and budget implications.  They’re doing as much as they can and they have plans to go forward with other pieces of legislation, for example, that will allow people to purchase health insurance across state lines.  That’s not possible through this particular pathway,” said Turner.

She says this legislation is needed to gut the worst parts of Obamacare.

“There will also be follow-on legislation going forward, but not if this [doesn’t pass].  You can’t build change on the crumbling infrastructure of Obamacare.  You’ve got to begin with changes that lead us in a new direction,” said Turner.

“It’s like a battleship or an aircraft carrier.  It takes a long time to turn this around ,” she added.

Turner also says a lot can be done to ease the burden on all Americans without involving Congress.  She says Health and Human Services Secretary Tom Price can accomplish a lot through the powers granted him in the original Affordable Care Act.

“Sec. Price has control of the regulatory mechanism.  There were 20 million words of regulation written to enforce Obamacare.  He has the power to undo a lot of those and to rewrite them but also to provide new guidance to the marketplace to engender much more competition and consumer choice,” said Turner.

Sec. Price outlined the very same strategy Tuesday at the White House.

Turner says the GOP bill offers important provisions like eliminating a trillion dollars worth of taxes on the economy and protecting coverage while the system transitions from Obamacare.  She also says the bill takes a smarter look at Medicaid dollars that should mean less burden on the taxpayers.

“It begins the pathway to reform the Medicaid program, arguably one of the worst health care programs in the country that is bankrupting the states.  At the same time, millions of people (on Medicaid) can’t find a doctor to see them,” said Turner.

And how would it do that?

“This legislation would begin the process of giving states a per capita allocation.  A per capita allocation is very different from a block grant.  It basically says we are going to make a distinction between moms and babies who are healthy and people who have multiple disabilities,” said Turner.

She also likes that states will have much more say over health care while Washington backs off.

“It gives states more power and more authority, not only to figure out how to take care of their citizens that are on Medicaid, but also to provide their citizens with more choices from the kind of health insurance that they want to buy, rather than have the federal government tell them the health insurance they have to buy,” said Turner.

But will the plan ultimately lower premiums and deductibles?  Turner says that hinges on getting people to stay on insurance for the year once they’ve purchased it and getting more, young healthy people into the system.

“You need young, healthy people in the system.  What do you do?  You try to give them more choices, more options of more affordable coverage.  So attracting people, giving them incentive to want to stay covered, by giving states more options to provide them with choices for health insurance – not just Washington’s three or four cookie-cutter policies,” said Turner, who also advocated for multi-year policies so patients could lock in rates for years at a time.

While acknowledging the fierce opposition to the plan from the right and left, Turner says the bill not only makes key changes but looks at health care in a whole new way.

“It’s a really different philosophy of giving people the market incentive to respond to consumers who are newly empowered and want to make responsible, good choices,” said Turner.  “People want insurance but they don’t want insurance that costs more than their mortgage.”

This is one of multiple perspectives we will be sharing on this legislation as the debate continues.

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