Another Assault on the PPACA/ACA Coming in 2017

The Present

If you thought it was over, it is not. Now that Schumer/Pelosi have removed the debt limit issue in front of Republicans with a Trump agreement, one more impediment to assaulting healthcare has been cleared away. John, I have cancer and have healthcare, McCain has come out to support a bill proposed by Senators Lindsay Graham and Bill Cassidy to repeal Obamacare. Maybe Trump knew and maybe he did not know; but, he did a nice pivot with Schumer and Pelosi with Ryan and McConnell shocked by his abandonment of Republican partisan values. A good friend of Graham, John McCain, who has a guarantee of healthcare anyway he wants it through federal government insurance or the VA, has thrown his support to Graham on healthcare.

The Graham-Cassidy legislation would essentially dismantle much of Obamacare’s federal infrastructure, turning over federal dollars to the states to do with what they wish, though that flexibility at the state level would come at a sharp cost. Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities, told Politico on August 1 that she estimated it would result in 16 percent less federal spending in 2020 versus the Obamacare status quo’s spending on Medicaid expansion and market subsidies.

The Recent Heroics

Who can forget the noble, cancerous Senator from Arizona with a scar above his left eye marching into the Senate to make a deciding vote? Such bravado . . . Unfortunately, it was all about getting even with Trump and supposedly Senate Order for McCain.

“We don’t answer to Trump no matter how much he stomps his foot. We answer to the American people regardless of how much our decisions will impact them. We must be diligent in discharging our responsibility to serve as a check on his power and screw them in our own way. And we should value our identity as members of Congress more than our partisan affiliation.”

That last sentence is priceless. Value your identity as a senator, a step above the citizenry so we do not engage in partisan affiliation. The Republican persona has been about party affiliation “uber alles.” Amongst themselves the Republicans are split along partisan lines and no longer represent the citizenry they lay claim too. McCain is about using a proper order in screwing the constituents in favor of partisanship.

Some History and Procedure

It was Aaron Burr in 1806 who recommended “the Previous Question” Motion (call for a vote or end debate) be discontinued as senators were gentlemen and knew when to end debate and when to move on to the next question. The motion was rarely used. Of course, that was then and today is today. So what happened? The “Previous Question” motion was eliminated and being gentlemen in the Senate without party affiliation died with it as the age of the filibuster came to be. This is want McCain alludes to in his Senate Order comment. It is so far in the Senate past an few senators would understand Aaron Burr’s comment.

Under today’s rule, the Republicans will have to repeal portions of the ACA using Reconciliation; which requires a majority of 51 votes, can only impact budgeting, and not create a deficit 10 years out (think the sunset of the 2001/2003 tax breaks). Unless there is a special session called by Ryan, the House is in session for 12 days in September and this year’s budget ends this month. There can only be one Reconciliation per budget year.

Pessimism

Trump seized the moment to solve the potential debt limit crisis approaching EOM September. It also appears he has resolved some other issues politically with the support of the Democrats and has moved one step closer to his goals of killing the ACA and Tax Reform. The issues remaining on the table are:

1. Revising the ACA in 2017 before EOM September using Reconciliation.
2. Create a 2018 Budget with Reconciliation Rules for Tax Reform.
3. 12 congressional days to accomplish these two tasks.

Democrats gave up an impediment to Republicans, the passage of the debt limit, too early in the remainder of the 2017 budget year. McCain is on board for revising the ACA, the ultra conservatives will support it as it has block grants to states, and it will create the budget surpluses needed to do tax reform. To get Tax Reform in 2018, they need surpluses, which the revision of the ACA will provide and a new budget with Reconciliation Rules.

Can Republicans get both of these tems accomplished in 12 days? I am sure McConnell and Ryan will increase the rowing tempo of the drum this close to the goal. If Republicans pull it off, Democrats are going to look mighty dumb in helping them along.

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