Intrigue: Obamacare Repeal Not Dead and Buried After All?

Posted: Apr 07, 2017 10:45 AM

As a follow-up to my post and Justin's piece earlier in the week, House Republicans are continuing their negotiations to amass 216 'yes' votes on legislation to repeal and replace Obamacare, after that effort cratered in late March. The White House, and the Vice President in particular, has been heavily involved in the process of assembling the elusive pieces needed to produce a viable bill. There were rumblings that perhaps a vote could be called prior to the April recess, but Speaker Ryan poured cold water on that time frame on Wednesday:

House Speaker Paul Ryan indicated Wednesday that the House would not take up a bill this week to repeal and replace Obamacare, and said Republicans need more time to reach an agreement among Republicans this week. "We're at concept stage right now," said Ryan, R-Wis., who added that lawmakers are discussing elements in the bill now. "I'm hopeful, I don't want to put any specific odds on it, or an artificial timeline." He said Republicans are "90 percent" in agreement on a healthcare package, but added, "we need to be at 95 percent," and said he's not willing to schedule another vote at this point.

On Thursday, Ryan provided an update on his conference's progress:

"While we still have work to do to get all the way there, we have made some real progress this week. That’s why we’re all here today. We have come together on a new amendment that we all believe will lower premiums and provide added protections for those facing real challenges gaining access to affordable care. This brings us closer to the final agreement we all want to achieve. This idea was offered by two of our most conservative members, Gary Palmer and Dave Schweikert, but it has been embraced by a broad spectrum of our conference, as you can see by just a few of the members here today. I’ll let the authors speak more about it, but let me just say briefly: This amendment would create a new federal risk-sharing program. It is a high-risk pool that will lower costs for people with pre-existing conditions and lower costs for everyone else. And the authors of this amendment will go into more detail. Following votes today, I have asked the House Rules Committee to mark up this amendment and add it to what we were already considering before."

With Capitol Hill consumed with the Senate's nuclear detonation yesterday, this piece of news flew under the radar. In short, the Speaker asked the House Rules Committee to advance a policy idea offered by two staunch conservatives, which would be added to the existing structure of the American Health Care Act. Potential state waivers to some of Obamacare's existing regulations remain an important sticking point, but the the "risk sharing" provision was another item on the table -- the goal of which is to help offer more immediate premium relief for families. The Congressional Budget Office's analysis of the AHCA predicted (reminder: big grain of salt) that the GOP bill would reduce premiums, but not for a few years. This item is intended to hasten that process. In any case, even if the House isn't going to vote on a broader bill before the recess, CNN's Phil Mattingly explains why Ryan asked that this step be taken now:

This is progress, to be sure, but the tougher hill to climb involves the state waivers of Obamacare mandates -- a thorny issue, for reasons explained here.  The House Freedom Caucus chairman says that if Pence's offer makes it into legislative language, a significant majority of his crew would support the bill; the trick is getting those provisions inserted in a way that satisfies both wings of the party.  Conservative opponents of the AHCA may not have appreciated the sense of urgency "rush" from leadership earlier in this process, but there are reasons beyond logistical sequencing that suggest the GOP would be well-served to get their reforms moving sooner rather than later (or not at all).

Allahpundit cites two new polls, one of which indicates that Americans are ready to start blaming Republicans for healthcare problems, even damage caused by the continued deterioration of a terrible law they unanimously opposed.  The message from voters is, you're in charge now, and you said you'd fix this mess.  And then there's the perennial concern, borne out by some data, that people who are fed up with the status quo might just throw up their hands and embrace the theoretically simple "solution" of single-payer healthcare.  If conservatives want to make things better with improved policy, they'd better get crackin'.