Diary

Thoughts on the GOP Health Care Reform Debacle

I do not usually watch Hannity- I don’t like him, I often disagree with him and I just find him generally obnoxious.  Friday night I awoke to the television being on and Hannity’s face staring at mine as I got ready to take my dog for his final pee of the night.  Surprisingly, he made a cogent argument regarding the failure of the recent attempt by the GOP to repeal and replace Obamacare.

One of the biggest reasons for the failure, as Hannity noted, was a certain arrogance towards or ignorance of the House Freedom Caucus.  Instead, he suggested that before any major reform be proposed in the form of legislation that all factions be included beforehand, not after the proposal is rolled out.  There was a certain belief that certain Republican factions would simply “go along” because it had been proposed by Republicans.

To me, the biggest travesty is that the Republican Party had seven years to come up with a viable replacement and they essentially squandered those years and political gains made in the House and Senate and now the White House.  Perhaps this was their plan overall- to maintain the status quo until the next round of midterm elections are held and candidates more amenable to the GOP plan can be elected to the House and Senate.  But, one doubts that the Republican leadership thinks in such terms.  This was rushed-through ineptitude.

Another thought that occurred to me is that Donald Trump has expressed a liking towards a single payer system in the past and may still harbor some fondness for it today.  Was his heart truly in this plan?  Instead, let’s revisit the passage of Obamacare which was done by budgetary sleight of hand and along strictly partisan votes.  As predicted by many economists on the Right, Obamacare focused on getting more people covered rather than lowering costs for insurance purchases.  This was mainly achieved through Medicaid expansion- in effect, a single payer system in disguise.  However, for the remainder of the population ineligible for Medicaid, subsidies gained would be offset eventually by rising premium, deductibles and out-of-pocket expenses.

The system was designed for failure except for those on Medicaid or Medicare- two major government programs.  By the system collapsing financially- the tax penalty to many far outweighs the incentive to purchase insurance on the exchanges- a crisis is created.  That is where the government must step in, we are told, and avoid it through adoption of a single payer system.  I am afraid that is where the debate will eventually end up and how it will turn out, I do not know.

Hopefully the Republican Party has learned a valuable lesson.  Before proposing such a vast, sweeping reform despite the positive talking points and the appeal to those talking points, make sure everyone is included in the discussion.  Let it be known upfront that not everyone will get everything on their checklist.  Most importantly, make sure you have the necessary votes in your caucus to pass the damned thing.  Having failed this agenda item, the next big thing on the “to do” list is tax reform.  Even here, Democrats contend there is room for agreement in certain areas.  The question is whether Republicans agree.

After tax reform- which was made more difficult by this debacle which will simply stiffen Democratic resolve towards obstruction- is infrastructure, an item with which the Democrats actually agree.  If the GOP leadership in the House and Senate found repealing and replacing Obamacare daunting, wait until they encounter a multi-billion dollar infrastructure spending plan within their own caucus.  Ryan and company may actually be counting on Democratic votes and SOME GOP votes to advance any legislation.  Isn’t that what sort of cost Boehner his job?

For Trump, he will likely cast his inability to seal the deal on a bad sales job by his surrogates, or even on the GOP leadership in the House.  Already we hear tinges of that sentiment: Is it TrumpCare or RyanCare?  Remember that this is the same man who during the campaign said he never did anything wrong requiring forgiveness from God.  If he dismisses God so cavalierly, does anyone honestly think he has the back of any Republican in Congress?