Obamacare requires all members of Congress and their staff to purchase coverage through the health law’s marketplace, just like Obamacare enrollees. The politics of that plank were simple enough, meant to demonstrate that if the coverage in this law were good enough for Americans, it should be good enough for their representatives in Washington.
That’s been happening for the past four years now. Fast-forward to this new amendment, which would allow states to waive out of key Obamacare protections like the ban on preexisting conditions or the requirement to cover things like maternity care and mental health services... If congressional aides lived in a state that decided to waive these protections, the aides who were sick could presumably be vulnerable to higher premiums than the aides who are healthy. Their benefits package could get skimpier as Obamacare’s essential health benefits requirement may no longer apply either.
Five Key Questions as a Government Shutdown Looms
the Trump administration wants to use the deadline as a point of leverage that Democrats — and at least a few Republicans — do not believe they have, raising the prospects of a shutdown that had seemed unlikely.
.. “We expect a massive increase in military spending. We expect money for border security in this bill,” Mr. Priebus said on NBC’s “Meet the Press.” “And it ought to be. Because the president won overwhelmingly. And everyone understands the border wall was part of it.”
.. some Democrats would plainly relish the political upside of a unified Republican government ushering in Mr. Trump’s 100th day by failing to keep the lights on.
.. Mr. Mulvaney has offered a trade of sorts: $1 of subsidy payments under the Affordable Care Act — paid to insurers to lower deductibles and other costs for low-income consumers who buy plans through the law’s marketplaces — in exchange for every $1 to pay for the border wall that the president wants to build.
.. When he ran for president, Mr. Trump presented himself as a champion of coal miners, promising to put them back to work.
.. a dispute over health benefits for retired miners who were set to lose their coverage.
Trump and his aides take hard line on border wall, as threat of government shutdown looms
Mulvaney has said that the administration is willing to negotiate with Democrats — funding insurance subsidies under the Affordable Care Act (ACA) in exchange for support for wall funding.
.. “The White House gambit to hold hostage health care for millions of Americans, in order to force American taxpayers to foot the bill for a wall that the President said would be paid for by Mexico is a complete non-starter,”
.. Further complicating matters for the White House, some Republicans in Congress say they don’t view wall funding as a must-have item in a short term spending bill.
.. Meanwhile, the Trump administration plans to release a very general sketch of its tax reform plan this week, Mulvaney said.
“I think what are you going to see Wednesday is some specific governing principles, some guidance,” he said, explaining that the White House will not release specific legislative text. “Also some indications of what the rates are going to be.”
Asked whether the plan will be revenue-neutral, Mulvaney replied, “I don’t think we’ve decided that part yet.”
The Balloon, the Box and Health Care
In particular, if you want to make care available to Americans who have pre-existing medical conditions — including the condition of being not rich and being relatively old, but not yet eligible for Medicare — you have to find some way to subsidize them.
Obamacare provides those subsidies in part with direct public funding, in part with regulations that implicitly use premiums paid by the healthy to cover the cost of caring for the less healthy.
.. The important thing to remember is that these problems don’t keep popping up because the people devising the plans are careless, and keep forgetting crucial issues. They’re popping up because the G.O.P. is trying to stuff a big balloon into a small box, and every time you squeeze it somewhere it inflates someplace else.
And because the task Republicans have set for themselves is basically impossible, their ongoing debacle over health care isn’t about political tactics or leadership. Even if Donald Trump were the great deal maker he claims to be, or Paul Ryan the policy wonk he poses as, this thing just can’t work.
.. There are some things we could do that would probably make it even cheaper, but they would all involve moving left — say, introducing a public option, or going all the way to single-payer.
.. If Republicans never had a plausible alternative to Obamacare, if this debacle was so inevitable, what was the constant refrain of “repeal and replace” all about?
The answer, surely, is that it began as a cynical ploy; at first, the Republicans hoped to kill health reform before it really got started. And now they’ve trapped themselves: They can’t admit that they have no ideas without, in effect, admitting that they were lying all along.