SLOW DOWN & START OVER (policy) versus REPEAL & REPLACE (politics)
Lessons Learned to inform the next round of TrumpCare.
“If the halting, messy debate over legislation to overhaul health care has taught us anything so far, it’s that when it comes to health care, Republicans don’t know what they want, much less how to get it.
After years of campaigning on the promise of repealing the Affordable Care Act, when it finally came time to act, Republicans put together a plan that looks like a stingier, skimpier version of Obamacare in the individual market, plus a rollback of the law’s Medicaid expansion (delayed until after the next presidential election — long enough that it might not happen).
When asked about the status of the health care bill this week, Senator Pat Toomey, Republican of Pennsylvania, responded, “I didn’t expect Donald Trump to win, I think most of my colleagues didn’t, so we didn’t expect to be in this situation.” In short, Republicans didn’t plan on having to follow through on their promises. (A)
“When Republicans left Washington last week, the Senate’s attempt to overhaul the Affordable Care Act was in grave condition.
Time doesn’t appear to have helped things much.
Consider these two quotes from opposite ends of the Republican spectrum:
1. Maine GOP Sen. Susan Collins: “There was only one issue. That’s unusual. It’s usually a wide range of issues. I heard, over and over again, encouragement for my stand against the current version of the Senate and House health-care bills. People were thanking me, over and over again. ‘Thank you, Susan!’ ‘Stay strong, Susan!’ ” (Washington Post, 7/4)
2. Kentucky GOP Sen. Rand Paul: “The bill is just being lit up like a Christmas tree full of billion-dollar ornaments. And it’s not repeal.” (“Fox News Sunday,” 7/2)
Neither of those quotes sound like there’s much softening from either senator in their opposition to the current version of the health care bill. In fact, both quotes suggest that Paul and Collins are even more convinced that they need to continue to oppose the legislation.” (B)
“Consider, in particular, Republican leaders’ strategy on health care. At this point, everything they say involves either demonstrably dishonest claims about Obamacare or wild misrepresentations of their proposed replacement, which would — surprise — cut taxes for the rich while inflicting harsh punishment on the poor and working class, including millions of Trump supporters…..” (C)
The current health-care debate is often distilled into a series of binary choices for public consumption: good or bad, healthy or sick, help for the rich or help for the poor. As a result, a growing number of Americans are starting to believe that the GOP’s health-care legislation is a cruel ploy to hurt millions of Americans. This is in large part a messaging failure: Good policy must be sold with good arguments, and Republicans have not articulated their own vision of what the American health-care system should look like.” (D)
“As a result, a growing number of Americans are starting to believe that the GOP’s health-care legislation is a cruel ploy to hurt millions of Americans. This is in large part a messaging failure: Good policy must be sold with good arguments, and Republicans have not articulated their own vision of what the American health-care system should look like. A conservative approach to health policy would ideally create a thriving market system, with a sufficient number of insurers to compete for consumer business leading to low prices and quality coverage. A targeted safety net would protect the truly vulnerable, and tax credits would be provided on a sliding scale to those who need help purchasing private coverage.” (E)
“At its core, offering greater “choice” in health plans means eliminating both standardization and basic quality minimums.
Eliminating standardization — for example, Obamacare’s rules for what benefits are covered, coverage tiers and out-of-pocket maximums — would make it much harder for consumers to comparison-shop.
Shopping for health insurance is already super-complicated and time-consuming, and lots of people make objectively bad choices. You have to comb through fine print and in-network doctor lists. You have to sort out which deductibles and premiums match your family’s likely needs and risk tolerance. Imagine how much more complicated this would become if insurers could offer many more plan configurations with more hidden exceptions and fewer quality controls.” (F)
“On Thursday, Mr. McConnell again suggested that Republicans might find themselves in negotiations with Democrats on a modest plan to shore up the existing health insurance exchanges if they cannot advance their own legislation. “ (G)
(A) Time for Republicans to Start From Scratch on Health Care, by Peter Suderman, https://www.nytimes.com/2017/07/07/opinion/republicans-health-care-new-start.html?smprod=nytcore-ipad&smid=nytcore-ipad-share
(B) Why the Senate health care bill is in trouble, in 2 quotes, by Chris Cillizza, http://www.cnn.com/2017/07/05/politics/health-care-susan-collins-rand-paul/index.html
(C) Attack of the Republican Decepticons, by Paul Krugman, https://www.nytimes.com/2017/07/07/opinion/republican-healthcare-obamacare.html
(D) The GOP’s Health-Care Messaging Needs Serious Work, https://www.yahoo.com/news/m/5e007bfa-e254-3397-aa23-cdcea0cc603a/ss_the-gop%E2%80%99s-health-care.html
(E) The GOP’s Health-Care Messaging Needs Serious Work by Juliana Darrow, http://www.nationalreview.com/article/449279/gop-health-care-reform-messaging-problem
(F) The reason Republican health-care plans are doomed to fail, by Catherine Rampell, https://www.washingtonpost.com/opinions/the-reason-republican-health-care-plans-are-doomed-to-fail/2017/07/06/4bb40f92-6286-11e7-a4f7-af34fc1d9d39_story.html?utm_term=.c4fa12366e6d
(G) Mitch McConnell, Master Tactician, Faces Daunting Challenge: A Health Bill, by CARL HULSE, https://www.nytimes.com/2017/07/07/us/politics/mitch-mcconnell-senate-health-care-bill.html?smprod=nytcore-ipad&smid=nytcore-ipad-share