Democrats to Use Senate Rules to Challenge Health Care Bill

Democrats are preparing to challenge these provisions, among others:

Planned Parenthood: The Senate Republican bill would cut off federal Medicaid funds for Planned Parenthood for one year.

Age ratios: The Senate bill would let insurers charge older consumers five times as much as young adults. Under the Affordable Care Act, they can charge no more than three times as much. Democrats say the purpose of the change is purely regulatory, not budgetary

Waiting period: People who went without insurance for approximately two months in the prior year would be required to wait six months before they could start coverage under the Senate bill. Democrats say the purpose is not to save money, but to regulate insurance and to encourage people to obtain coverage without imposing an “individual mandate.”

.. Democrats are also expected to challenge a provision of Mr. McConnell’s bill that would allow states to impose work requirements on some Medicaid beneficiaries
.. And they are prepared to challenge a proposal by Senator Ted Cruz, Republican of Texas, that would allow insurers to sell stripped-down insurance, free of most federal regulations, if they also offered at least one plan that complied with insurance standards like those in the Affordable Care Act. Health plans could, for example, omit coverage of maternity care or mental health care.

Going Small on Health Care

The Democratic bill in 2010 delivered significantly to the party’s base; the Republican bill in 2017 delivers significantly only to the party’s donors.

.. In order to mitigate its unpopularity, Senate Republicans keep making their bill more like, well, Obamacare, which raises the question of why they’re attempting something so complex for such a modest end.

.. the smaller bill would repeal the individual mandate requiring the purchase of health insurance. It would replace it, as the Senate bill does, with a continuous-coverage requirement — a waiting period to purchase insurance if you go without it for more than two months.

.. Instead of wringing almost $800 billion out of Medicaid over 10 years, it would try to reduce the program’s spending by $250 billion — just enough for deficit neutrality.

.. That’s it. That’s the whole thing. Eliminate the hated mandate, keep the exchanges stable, cut a few health care taxes, and pull Medicaid spending downward. Pass the package, declare victory, and pivot to tax reform.

.. Republicans could campaign in 2018 on the credible claim that they had maintained Obamacare’s coverage for most people who wanted it, while reducing its burdens on those who don’t.

.. the Republican Party is too divided on health care, too incompetently “led” by its president, and too confused about the details of health policy to do something that’s big and sweeping and also smart and decent and defensible.


Why Wasn’t Trumpcare More Popular?

Conservative health-care analysts on why the GOP couldn’t come up with a stronger replacement for Obamacare

.. outside groups—he implicated Heritage Action and Club for Growth—were urging Republicans to repeal Obamacare as quickly as possible. Because of that, House Republicans “didn’t give themselves enough time

.. “Repeal and replace” seemingly meant different things to different Republicans. Moderates wanted to protect the law’s more popular provisions while tweaking its subsidy structure.

.. the AHCA was authored in a way such that it would cut federal spending—the goal of conservative Republicans—not necessarily boost health-care coverage.

.. a 1989 plan from the Heritage Foundation—the one that started it all—also included tax credits and an individual mandate.

.. “The original outline was their idea!”

.. That’s because there are two basic models for health systems, Laszewski says: single-payer or Obama/Ryan/Trump/Heritage/PriceCare. One is a government-run system offers a rudimentary plan to everyone. The other one is a delicate Jenga tower of mandates, credits, and incentives, all balanced on the rickety table of the private-insurance industry.

.. Republicans had to go with the AHCA, that is, because there just aren’t that many other, non-socialist ways to do health insurance coverage.
.. Ultimately they settled on Obamacare, helping the poor at the expense of the better-off, while the AHCA would have done the opposite.
.. “We used to say Republicans didn’t have the health-care gene,”