Wednesday, July 26, 2017

Senate Republicans Do Something About Obamacare Schadenfreude!

The Senate on Tuesday voted by the narrowest margin to move forward with its Obamacare repeal push, a significant step for Republicans that still leaves senators searching for an agreement on how best to follow through on a campaign promise that has defined most of the last decade.

Vice President Mike Pence was forced to break a tie as the Senate voted 51-50 to start debate on proposals to change the landmark health-care law. The vote comes after weeks of setbacks for Republicans as party divisions stalled multiple versions of their plans to overhaul the American health-care system.

Passing the motion to proceed does not mean Republicans have a consensus on a bill they can pass. The procedural vote starts a complicated period in which senators will float varying alternatives for reshaping Obamacare.

Sens. Susan Collins, R-Maine, and Lisa Murkowski, R-Alaska, who have pushed for a bipartisan Obamacare fix, opposed the motion to proceed. The return of Sen. John McCain, R-Ariz., to the Senate on Tuesday after a surgery for a brain tumor meant it would have taken three "no" votes to block the motion.
How the GOP brought Obamacare repeal back from the deadTough road ahead for McConnell on ObamaCare.
The successful procedural vote sets up 20 hours of floor debate and votes on a virtually unlimited number of amendments, known as a vote-a-rama.

Many of these amendments will fail, and some will pit centrists in the GOP conference against conservatives, a division that has made it exceedingly difficult for Republicans to move forward on ObamaCare repeal.
Our Self-Interested Senators
The House bill isn’t perfect—no bill ever is—but it amounts to the biggest entitlement reform in history. It repeals crushing taxes. It dramatically cuts spending. And it begins the process of stabilizing the individual health-care market and expanding consumer freedom.

None of this is good enough for a handful of senators, so now it’s time to make this exercise all about them. Mr. McConnell should make clear that the overwhelming majority of the Republican Party stands ready to make good on its repeal-and-replace campaign promise—and that it would have done so already were it not for a cynical or egotistic few. It’s time for some very public accountability.
Sadly, probably true. It’s time to tell the truth to ourselves. We will not get rid of the government guarantee of health care coverage
William Teach of The Pirate’s Cove concluded, in an article entitled CNN Poll: Fewer Want GOP To Repeal And Replace Obamacare:
The time to kill Obamacare was the 2012 election. With a President Romney, he could have slowed or even stopped the implementation of Obamacare, even without control of the Senate. All the rules and regulations could have been spiked. Once it was implemented, though, getting rid of it would be damned difficult. How many Big Big Big Government programs have been killed off? A handful at best? Instead, most become institutionalized, and, even when they are failing, even with miserable performance, they still stick around.
Of course they do: even the worst government program has some beneficiaries, people for whom maintaining the program is far more important to their economic well-being than the waste of money is to taxpayers in general.
 Avik Roy: Why CBO Projections Of GOP Health Bills All Look About The Same . Because it's all driven by the individual mandate. Drop the mandate, and many people gratefully drop their insurance. Leaked CBO Numbers: 73% Of GOP “Coverage Losses” Caused By Individual Mandate Repeal112,000,000: Medicaid Enrollees Set to Climb 40,000,000 Under Obamacare

By Way of Wombat-socho's "In The Mailbox: 07.24.17" the always insightful Megan McArdle explains that Obamacare's Big Win: It Helps Some People Be a Little Less Poor
But we’re spending more than $100 billion a year on Obamacare. That is a lousy way to save people $5.5 billion in medical debt. It will be troubling if we continue to find good evidence of small effects like these, and less compelling evidence of the substantial benefits we were promised in return for all that money.

A history of why the US is the only rich country without universal health care. Left out? Because we're smarter than they are. Cities Fear Obamacare Repeal, Warm To Single-Payer Cities always warm to being subsidized.

Medicaid: The Snag in Obamacare Repeal. That which can't be sustained, won't. But like, a long fall, it's the hard stop at the bottom that hurts. Have Repeal Efforts Always Been a Republican Ruse? For some, no doubt.

Trump Should Pocket Minor Healthcare Win and Move to Tax Reform Immediately
Unlike the insoluble healthcare reform, many forms of tax reform work or at least suffice. Just lower taxes, especially the absurdly high corporate taxes that keep billions in American corporate cash locked in foreign banks, add some incentives to bring it back, and watch our economy zoom. Among other things, employers will start giving more generous health plans -- you can depend on it -- with lower deductibles. They'll be competing for employees.

Meanwhile, Republicans and those Democrats who will abandon their party's conventional neo-Stalinist approach and actually work with the other side (assuming such an animal exists) can knock themselves out finding the final solution to healthcare. Let a hundred committees bloom. They should take as long as they wish. They have nothing to worry about. The day-to-day medical care of Americans will struggle along as it always has. People will go the doctor. Emergency rooms will treat the poor. (The actual death of Bessie Smith occurred in 1937. That's eighty years ago now.) It's worth noting that America has had a closet version of socialized medicine virtually forever on levels that may be greater even than Europe's. Who do you think pays for those emergency room visits by the indigent, Mr. and Ms. Taxpayer?
Time to get some points on the board.

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