“The vote is a reward to the ultras who sabotaged repeal and replace by allowing them to posture one more time as purists who have not forsaken the true faith.”

July 20, 2017

“A new official analysis released Wednesday finds that repealing much of Obamacare without a replacement law would increase the number of people without health insurance by 32 million people, double insurance premiums in the individual plan market and leave most of the United States without an insurer selling such plans by 2026.
The report comes as Republican leaders in the Senate, desperate to pass some kind of health-care law, have said that next week they might consider a possible Obamacare repeal bill that could eventually be amended to include a replacement.
The Congressional Budget Office estimated Wednesday that with a repeal-but-no replacement bill the number of uninsured is expected to be 17 million higher than if Obamacare remains in place. And by 2020 there would be 20 million more uninsured people, CBO said. That tally would grow to 32 million by 2026, the report said.” (A)

“President Trump did not do much to sell the Senate health care bill before its failure. But he gave the sale a shot Wednesday in the White House before cameras and a captive audience of nearly all the Republican senators. His comments were at times confusing, and in some cases, outright incorrect.
It shows the challenge for a president who doesn’t dive deeply into policy to sell his agenda.” (B)
To look at everything Trump said, with some fact checks and context: highlight and click on http://www.npr.org/2017/07/20/538171317/fact-check-trumps-confusing-remarks-to-senate-republicans-on-health-care

“….Trump claimed at the lunch that “we’re very close” to passing a repeal-and-replace bill. It was the latest sign of the disconnect between the president and the Senate. It also came a day after Trump tweeted “let ObamaCare fail” — and two days after he called for a repeal-only bill.” (C)

“Majority Leader Mitch McConnell spurred Republican senators Thursday to resolve internal disputes that have pushed their marquee health care bill to the brink of oblivion. Yet the GOP’s reeling effort to dismantle much of President Barack Obama’s health care law may face even longer odds because of Sen. John McCain’s jarring diagnosis of brain cancer.
“Dealing with this issue is what’s right for the country,” McConnell, R-Ky., said. He added, “It was certainly never going to be easy, but we’ve come a long way and I look forward to continuing our work together to finally bring relief.”
Nursing a slender 52-48 majority, McConnell has been unable to muster the 50 votes he’d need to approve his party’s health care overhaul. Vice President Mike Pence would cast the tie-breaking vote….
Aiming to finally resolve the issue, McConnell has said he’ll force a vote on the legislation early next week….” (D)

“If Collins is a no vote on any form of the legislation and Paul won’t support a replacement, and Capito and Murkowski won’t support the repeal-only approach, and Lee and Moran won’t support the replacement, and it’s unclear if McCain will be back next week … Republicans simply don’t have the votes throughout all the confusing scenarios. And that’s to say nothing of Dean Heller (R-Nev.), who has been cagey all along on any form of the legislation.” (E)

“The vote is a reward to the ultras who sabotaged repeal and replace by allowing them to posture one more time as purists who have not forsaken the true faith. It punishes the cautious senators who recoiled from huge Medicaid cuts by thrusting upon them a clear alternate they would prefer to evade. It intensifies mutual suspicion and ill-feeling inside a caucus where two senators—Nevada’s Dean Heller and Arizona’s Jeff Flake—have been explicitly threatened by the president and head of party.” (F)

“Under the humane approach, with a stronger health care system a shared goal, Republicans and Democrats would work together to fix the marketplace problems and restore confidence among insurance companies. In counties with no insurers, Congress could require the Federal Employees Health Benefits Program to offer coverage. State governments, working with the Trump administration, could create reinsurance programs to reduce the risk that insurers would lose money because of a few very sick patients. This could lower premiums and encourage insurers to operate in sparsely populated parts of the country.
If it chooses to set partisan point-scoring aside, the Trump administration would continue subsidy payments to insurers, House Republicans would drop their lawsuit and, going forward, Congress would appropriate money for these payments so that they could not be used to undermine the health care law. Quick action is needed on all fronts because insurers and state and federal regulators must finalize rates and policies for next year in the coming weeks. (G)

(A) CBO: Obamacare repeal bill would raise number of uninsured by 32 million by 2026, by Christine Wang and Dan Mangan, http://www.cnbc.com/2017/07/19/cbo-obamacare-repeal-bill-would-raise-number-of-uninsured-by-27-million-by-2020.html
(B) Fact Check: Trump’s Confusing Remarks To Senate Republicans On Health Care, by Danielle Kurtzleben, http://www.npr.org/2017/07/20/538171317/fact-check-trumps-confusing-remarks-to-senate-republicans-on-health-care
(C) Trump threatens electoral consequences for senators who oppose health bill, by Sean Sullivan, Kelsey Snell and David Nakamura, https://www.washingtonpost.com/powerpost/trump-challenges-senators-to-resurrect-obamcare-repeal-effort-were-close/2017/07/19/468c2dc0-6c8f-11e7-9c15-177740635e83_story.html?utm_term=.bd1cd4cb38f1
(D) McConnell prods senators on health care bill, amid dim odds, by Erica Werner and Alan Fram, http://abcnews.go.com/Health/wireStory/gop-senators-ditch-rescue-health-care-bill-48740322
(E) Senate Republicans Report New Life On Their Health Care Bill, by Matt Fuller, http://www.huffingtonpost.com/entry/senate-republicans-new-life-health-care_us_59702f8be4b0aa14ea7711b7
(F) The Paradox of Mitch McConnell’s Repeal-Only Vote, by David Frum, https://www.theatlantic.com/politics/archive/2017/07/the-paradox-of-mitch-mcconnells-repeal-only-vote/534129/
(G) The Trumpcare Bonfire, https://www.nytimes.com/2017/07/18/opinion/trumpcare-obamacare-let-it-fail.html?smprod=nytcore-ipad&smid=nytcore-ipad-share