The white smoke rose Monday afternoon from the Congressional Budget Office as the fiscal forecasters published their cost-and-coverage estimates of the GOP health-care reform bill. Awaiting such predictions—and then investing them with supposed clairvoyance—are Beltway rituals. The coverage numbers weren’t great for Republicans, but they shouldn’t allow an outfit that historically underestimates the benefits of market forces to drive policy.
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The non-partisan Congressional Budget Office has estimated that 24 million fewer people will have health insurance by 2026 under the House GOP plan to replace Obamacare. That projection is unsurprising, and quite likely overstated. But what is surprising about the CBO report is the ways in which it makes the GOP bill look better than expected, and how it points to how the bill can be improved. The bill would cut taxes by $1.2 trillion, and spending by $880 billion, for a net deficit reduction of $337 billion. And that’s before you take into account the macroeconomic effects that those tax cuts would have on economic growth, and thereby on greater tax revenues. Over ensuing decades, the fiscal impact would be even greater, because the bill entails the most significant effort at entitlement reform in American history. The bottom line: Republicans shouldn’t abandon the AHCA because of a superficially unflattering CBO score or its failure to meet their own purity tests. They should work all the more to correct its flaws. If they do, in 2020, the real world very well may vindicate them instead of the CBO.
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The draft legislative texts that will make up the American Health Care Act cleared two House committees this week amid vociferous complaints about the legislation, seemingly from all quarters. At some level this is understandable. After all, nobody expected the Democrats to stand up and applaud a replacement for the Affordable Care Act. And for Republicans, three other factors contribute. First, health-care reform is hard, and there are widely varying views of the best policy. Second, these are draft bills, not final legislation. The markup process is supposed to identify and modify unpopular provisions. Finally, the bill’s scope is limited by the budget reconciliation rules that fast-track Senate consideration. It is simply not possible to embody the full range of policy issues in a reconciliation bill, and some disappointment directly follows from what has had to be left out.
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The Senate is advancing Seema Verma, President Trump’s nominee to lead the Centers for Medicare and Medicaid Services.
Senators voted 54-44 Thursday on her nomination, which needed only a simple majority to overcome the initial procedural hurdle.
The Senate could take a final vote on Verma on Friday night, but her confirmation is expected to be kicked to Monday.
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A Republican proposal to revise the Affordable Care Act claimed its first major victories Thursday amid a backlash that both Republican leaders and President Trump spent the day trying to tamp down.
Trump met with conservative critics of the plan, signaling both a willingness to negotiate its details and that it does not yet have enough votes to emerge from the House. More acknowledgment of the proposal’s problems came from Senate Republicans, who suggested Thursday that the measure is moving too quickly through the House and in a form unlikely to succeed if it gets to the upper chamber.
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One of the most controversial provisions (for conservatives) of the American Health Care Act (aka Obamacare repeal and replace) is the creation of an advanceable, refundable tax credit for individuals to purchase health insurance. It would be available to anyone not offered health insurance at work, or eligible for Medicare or Medicaid. It would be bigger for older folks and smaller for younger folks. It would means test starting at $75,000 ($150,000 for married couples). The credit would be available month to month to offset health insurance premiums as a direct offset. It is paid for by repealing Obamacare.
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Our health-care system is broken. It was inefficient before Obamacare, and Obamacare’s Washington-knows-best-mandates made it many times worse. The American people have suffered as a result. We can’t return to the pre-Obamacare status quo, because Americans need more access to health care. But we also can’t leave the American people tied to a sinking Obamacare ship, forced to face higher annual premiums and fewer provider choices. We need relief based on clear principles: Government shouldn’t dictate our health-care choices, health care should be driven by market principles, and we must help those who truly need our help.
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Republicans have a point that their Obamacare replacement plan is particularly hard for the Congressional Budget Office to score, budget experts say.
The bill, which Democrats are sharply criticizing for its lack of a CBO score, gives states much more leeway in how they would provide — or not provide — health insurance for people. And predicting how states will behave over the next decade is a time-consuming and tricky task for the agency.
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The House GOP’s bill to reform health care is hardly a surprise: Its key elements were part of the “Better Way” agenda championed last year by Speaker Paul Ryan. Republican lawmakers discussed the principles in several special conference meetings. The legislation was then written from the bottom up by the appropriate committees instead of being imposed from the top down.
The bill would repeal much of President Obama’s framework for government-run, highly prescriptive, one-size-fits-all health care. In its place would stand conservative reforms to unleash market forces, give consumers choice, and return power to the states.
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Leaders of conservative groups that oppose the House Republicans’ health-care bill met with President Trump at the White House on Wednesday night, part of a high-profile effort to quiet anger from the right. In the process, the conservatives heard the president and his team express some openness to tweaks to the bill that go further than House or Senate leaders might accept.
Trump and his team did not outright reject changes on at least three components of the GOP’s American Health Care Act, said some of the meeting’s attendees, speaking on the condition of anonymity. One idea was accelerating the timetable for key changes to Medicaid under the House GOP plan from 2020 to 2018.
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