GOP members of the House finally climbed aboard the Trump Train.
It’s about time.
Putting aside their posturing and pontificating, Republicans at long last produced a win for the Trump White House and for Americans, passing a bill to replace ObamaCare. This was a central promise of the past several years; they needed to get it done.
It wasn’t easy, but as Joe Biden might say, “This is a big f—ing deal!”
The earlier failure to pass the American Health Care Act (AHCA) was a serious setback for the Trump White House, portraying the president and his aides as ill prepared to manage the affairs of the nation.
Voters were incredulous that after seven years of railing about the deficiencies of ObamaCare, Republicans didn’t have a shared vision for what should replace it.
The inability to muster votes on the first bill exposed long-simmering disputes within the Republican party – disputes barely muted by Trump’s astonishing victory in November.
Thursday’s successful vote is a major victory for President Trump. House members have credited the president for sticking with the fight, and the punditry is astonished that the AHCA, declared dead just a few weeks ago, actually passed.
Trump wheedled and cajoled, invited objectors from across the political spectrum in for an Oval Office chat, encouraged compromises and won over recalcitrant members of his own party. This is what we expect from Trump; this is the Art of the Deal.
It is also a needed much-needed victory for the House leadership. Trump supporters are impatient with the lack of legislative progress since the election, perhaps unrealistic in their expectations. The spending bill passed this week by Congress, which failed to reflect numerous conservative priorities, enraged many on the right. Repealing ObamaCare will mollify some of those critics.
Not only is the vote a win for health care reform; it is also a win for tax reform. The repeal of the taxes that supported the Affordable Care Act will save Americans one trillion dollars over the coming decade. That savings makes further tax cuts much easier to pass, since the reduced rates will be applied to a lower tax base. As the GOP struggles to produce a tax bill resulting in revenue neutrality, that trillion will loom large.
Thursday’s narrow victory is of course not the end of the story. The Senate will now get a whack at the bill that will replace ObamaCare; that expected row will usher in more hand-wringing from the left.
Democrats cleverly put the GOP on the defensive early on in this fight, portraying President Obama’s legacy plan as the Holy Grail of health care solutions. Even as it continues to fail across the country.
Much has been written of the shortcomings of ObamaCare, focusing in particular on the soaring premiums and rising deductibles that will only worsen this year. The truth is that a sizeable share of the population can afford health care insurance under the current plan, but not health care.
The central failure of ObamaCare is that it does not allow insurers to charge more for customers that will require higher expenditures. Women, for instance, who require higher medical expenditures, pay the same as men under ObamaCare. Also, people with so-called “pre-existing conditions” pay the same as all others. Simply put, this is not insurance, it is welfare.
Providing affordable insurance to all Americans – even those who are sick -- is now expected. The question is how to do that while keeping private insurers in the game. That is the intent of the modifications made to Paul Ryan’s bill, including an extra $8 billion provided to cover high-risk pools for those people with pre-existing conditions.
The vote comes before the Congressional Budget Office has had a chance to score it. Democrats will jump on the eventual CBO report, which will most likely project that some people will lose coverage. The GOP bill will be portrayed by Democrats as heartless and mean-spirited.
What will not be reported by the New York Times or CNN is how many Americans have stopped going to the doctor because their ObamaCare deductible is just too high.
Or how many parts of the country no longer have an insurance exchange available.
Just in the last few weeks several companies have pulled out of Iowa, citing losses, threatening to leave that state with no individual plans. Virginia, too, is bleeding plans, as are many other states.
ObamaCare is simply not working; it is indefensible.
This fight is not over. Democrats do not want to see President Obama’s principle achievement ditched. The GOP has to manage the conversation, and explain how the new bill will help middle-class Americans. They should be ready to go with ads that feature working Americans unable to pay their doctor bills, even as they are covered by ObamaCare, or Obamasnare, as it might be portrayed for millions trapped in their costly plans.
Nancy Pelosi has accused Republicans of wanting to destroy health care and take protections away from millions., all the while providing massive tax breaks for plutocrats.
Republicans must drown out such extreme voices, remind Americans that ObamaCare is failing, and move forward with the Trump agenda.
That’s what they were elected to do.