“Some GOPers Want To Play Chicken”: Getting An Obamacare Repeal Bill On Obama’s Desk; For What?
There’s an interesting Rachel Bade/Jennifer Haberkorn piece up at Politico about all the trouble congressional Republicans have encountered in trying to use the budget reconciliation process to pass a simple veto-proof “root and branch” repeal of the Affordable Care Act. Seems the Senate parliamentarian is telling them they’d have to limit themselves to items with an immediate budgetary impact in any reconciliation bill. But any “partial” repeal–much less a replacement–legislation would raise policy questions on which Republicans disagree, and might also involve deficit-boosting consequences for which offsets would have to be found. So some GOPers want to play chicken:
Some conservatives and staff in both chambers, like House Freedom Caucus Chairman Jim Jordan (R-Ohio), are urging the chambers to do a straight one- or two-sentence repeal of everything. They argue that the parliamentarian has to look only at the words in front of her during reconciliation and should not be able to force lawmakers to break out the provisions on their own.
One aide working on the matter suggested they may try this and see if it works — but others are doubtful.
I guess I’m unclear as to why this is worth the trouble. Getting legislation repealing Obamacare onto Obama’s desk, long the obsessive goal of congressional Republicans, will not accomplish a thing other than confirming that Obama doesn’t want to kill his signature domestic policy achievement and Republicans do. I think most voters out there for whom opposition to Obamacare is a “bullet vote” have probably already figured out they should vote Republican in 2016. So the whole exercise appears to be one of those “energize the base” things whose value I am always questioning.
I do think that if SCOTUS kills Obamacare subsidies in states using federal exchanges there will be some value in Republicans getting a bogus “fix” onto the president’s desk in order to blame him for the subsequent chaos. In that contingency they could almost certainly structure a bill that would meet the conditions for reconciliation, and could probably tamp down any internal opposition by ensuring dissenters there’s zero chance any of it will become law. But on “root and branch repeal,” they might as well just promise they’ll git er done when President Bush or Walker or Rubio takes office.
By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, June 1, 2015
“Forget About Repealing Obamacare”: Too Many “Message” Votes Have Put The GOP In A Bind
If at first you don’t succeed, try, try again? That certainly seems to be the motto of House Republicans. Last week, the House GOP took its 56th vote to repeal the Affordable Care Act, President Barack Obama’s signature health care reform law.
The bill’s prospects for consideration in the Senate are low and the president has repeatedly promised to veto such a measure anyway. After 56 tries, the House votes to repeal the health care law have become so commonplace that hardly anyone in Washington even blinks an eye at them anymore. Even the president says he’s lost count of how many repeal votes there have been. If House Republicans are serious in their quest to roll back the Affordable Care Act, why do they keep pursuing a strategy they know is doomed to fail?
They do it because these multiple repeal votes aren’t a serious attempt to void the health care law. They are merely symbolic message votes. Voting to repeal the Affordable Care Act was a popular campaign message for candidates on the right, and the recent House vote gave them a chance to fulfill their election year promises.
The repeal votes also give the Republican party a platform to continue talking about their opposition to the health law and to highlight its differences with the president. However, too many “message” votes may have also put the party in a bind. After 56 votes on essentially the same piece of legislation, the Republican party has faced criticism, according to The Hill, for failing to articulate an alternative plan. The repeated symbolic votes also expose the party to criticism for failing to lead in a critical policy area. The time spent in fruitless endeavors to repeal the law could have instead been used to negotiate on policies to fix the Affordable Care Act’s weaknesses. When it comes to health care policy, Republicans have simply become the party of no.
It’s time to switch tactics. Following the House votes last week, Sen. Orrin Hatch, R-Utah, Sen. Richard Burr, R-N.C., and Rep. Fred Upton, R-Mich., released a proposal for an alternative health care plan. The proposal is a good first step and perhaps necessary as, for the first time, three House Republicans voted against repeal of the Affordable Care Act in protest of their party’s apparent lack of a plan to replace it.
In addition to putting an actual health care plan on the table, Republicans may also want to consider trying to make changes to the current health care law in pieces. There could be opportunity for negotiation on aspects of the law that remain unpopular, such as the medical device tax, the Medicare Independent Payment Advisory Board and the definition of a full-time work week. Further, the Supreme Court ruling on the King v. Burwell case later this year regarding the legality of the subsidies being provided for the purchase of health insurance on the federal exchanges could provide Republicans with another opportunity to change the law. If the Supreme Court rules against the subsidies, a legislative fix may be necessary. By taking advantage of these opportunities, the party might be able to make the law more palatable for its constituency and improve its credibility in the process.
House Republicans have made their disdain for the Affordable Care Act very clear. A 57th vote to repeal the law will not be necessary, especially since it, too, would be doomed to fail as long as Obama is in office. However, it’s entirely possible we’ll see one. By focusing strictly on repeal of the entire law, Republicans risk giving the impression that they are completely unwilling to engage in meaningful debate on health care policy. The party should instead work to improve the law and continue putting forward ideas to do so.
A great example of this can be found at the state level. Following the Supreme Court’s decision that the Affordable Care Act’s Medicaid expansion was optional, several Republican governors have proposed alternative Medicaid plans to the administration. Some have already been successful in putting their imprint on the president’s initial policy because they came to the table in a serious manner. Republicans at the federal level would do well to follow suit.
By: Cary Gibson, a Government Relations Consultant with Prime Policy Group; Thomas Jefferson Street Blog, U. S. News and World Report, February 10, 2015
“A Rickety Scaffold Of Fictional History”: The Sham Lawsuit That Could Eviscerate Obamacare
Republicans in the House voted on Wednesday to repeal the Affordable Care Act—for the fifty-six time. After four years these show votes have become a tedious joke. But Wednesday’s action had bleaker implications, as it was cast in the shadow of a lawsuit that could undermine the healthcare law in fatal ways.
In a few weeks the Supreme Court will hear oral arguments in King v. Burwell, which contends that the text of the ACA allows the IRS to give subsidies only to people who purchase insurance through exchanges set up by their state, and not to those who rely on the federally run marketplace. If the plaintiffs prevail, some 7 million people in the thirty-four states that have declined to set up their own exchanges would lose the tax credits that subsidize their insurance. Coverage would likely become unaffordable for many of them; without enough people in the marketplace, the law could collapse into a “death spiral.” In human terms, a group of hospitals wrote in a brief supporting the government, a ruling in favor of the plaintiffs “would be a disaster for millions of lower- and middle-income Americans…. The ranks of the uninsured will swell again, with all that portends in the way of untreated illness and overwhelming debt.”
To build their case, the plaintiffs have erected a rickety scaffold of fictional history around a single phrase in the 906-page law. The section of the law in question concerns the calculation of subsidies available to people “enrolled in through an exchange established by the State.” The plaintiffs argue that lacking an explicit reference to subsidies available to people enrolled in the federal exchanges, the text indicates that subsidies are only available in states operating their own. Furthermore, the plaintiffs argue, this was not sloppy writing but instead “reflects a specific choice by Congress” to design the subsidies as a carrot to entice states to establish their exchanges and punish them if they failed to do so.
The lack of structural integrity in the plaintiff’s case has become increasingly obvious in the past week, thanks to a sheaf of briefs filed states, lawmakers, and the healthcare industry. In sum, there’s about zero evidence for the challengers’ version of history, and what proof they do muster is shoddy. For example, one brief cites former Nebraska Senator Ben Nelson, who played a defining role in designing the exchanges. According to the plaintiffs, Nelson thought it was “insufficient to merely allow states the option to establish Exchanges,” hence the need for a stick. But Nelson himself stated recently that he “always believed that tax credits should be available in all fifty states regardless of who built the exchange, and the final law also reflects that belief as well.”
It’s not hard to find conservative lawmakers, like Senate majority leader Mitch McConnell, who will argue now that “the language of the law says…subsidies are only available for states that set up state exchanges.” But the idea that subsidies might be withheld was never articulated by anyone during the congressional debate, nor in the months after the law’s passage—even when states began to signal they would not operate their own exchanges. Instead, the same Republicans who endorse the lawsuit now were passing laws and making statements that affirmed the idea that subsidies would be available in all states. Statements from legislators and state officials that back up the plaintiff’s version of legislative history were made only after the implications of that ambiguous phrase in the ACA began to circulate around right-wing thought shops like the American Enterprise Institute and the Cato Institute.
If Congress did intend to use the subsidies as an incentive for states to set up their own exchanges, the fact that many state officials were clueless about the possible loss of tax credits is perplexing. None of the states “had reason to believe that choosing a federally facilitated exchange would alter so fundamental a feature of the ACA as the availability of tax credits,” reads a brief filed last week by nearly two dozen attorneys general representing red and blue states alike. “Nothing in the ACA provided clear notice of that risk, and retroactively imposing such a new condition now would upend the bargain the states thought they had struck,” it continues. The Washington Post’s Greg Sargent spoke with a number of Republican state officials involved in the implementation of the ACA who confirmed that the possibility of losing subsidies was never part of discussions about whether or not to set up state exchanges.
The court could strike a blow against the ACA without fully accepting the strained version of history offered by the challengers. But as legal scholar Linda Greenhouse describes in The New York Times, doing so would require the justices to set aside their own principles and precedents. “The court has permitted itself to be recruited into the front lines of a partisan war. Not only the Affordable Care Act but the court itself is in peril as a result,” Greenhouse writes. “To reject the government’s defense of the law, the justices would have to suspend their own settled approach to statutory interpretation as well as their often-stated view of how Congress should act toward the states.”
It’s tempting to dismiss the lawsuit as a deeply silly partisan attack, akin to the House GOP’s repeated votes for repeal. Its basis may indeed be fluff. And yet it’s entirely possible that it will be this absurd case—not sabotage by Republicans at the state level; not lawsuits challenging the law on its constitutional merits—that dooms the signature achievement of the Obama years, at an immense human cost.
By: Zoe Carpenter, The Nation, February 5, 2015