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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Ed Kilgore

April 6: GOP Getting Worried About “Safe” Kansas U.S. House Seat

We all know there’s a red-hot special congressional election in Georgia April 18. But a week earlier, Kansans go to the polls in another “special” that was supposed to be a snoozer. Now Republicans are getting jittery, as I discussed at New York:

It’s an old story by now that Republicans are jittery about holding onto the Georgia U.S. House seat once held by Newt Gingrich and Johnny Isakson, and mostly recently by HHS Secretary Tom Price, in an April 18 special election. But it’s another thing altogether to learn that Republicans are worried about a special election a week earlier in Kansas to replace CIA director Mike Pompeo. Here’s the news from Politico:

“The NRCC is pouring money into a last-minute TV ad buy in Kansas ahead of a Tuesday special election, seeking to pump up Republican enthusiasm and turnout in a district that President Donald Trump carried by 27 percentage points just a few months ago.

“The late independent expenditure seeks to boost Republican state Treasurer Ron Estes …. Kansas Republicans are fretting that Estes’ margin is closer than expected in his race against Democrat James Thompson, an attorney.

“’Kansas should not be in play, but Kansas is in play,’ said one Kansas Republican consultant.”

Yikes.

Just last month the authoritative Cook Political Report rated this race “Safe Republican.” And no wonder: Aside from Trump’s margin in the 4th district of Kansas, Pompeo won it two-to-one last November, and it hasn’t gone Democratic in a presidential or House election since 1992….

[M]aybe GOPers are just getting jumpy, or maybe they are seeing something in Kansas and elsewhere in their own ranks that suggests underwhelming turnout. The NRCC ad, which basically calls Thompson an enthusiastic baby-killer, is about as subtle as an electric cattle prod plunged into the bathwater of GOP base voters.

If the idea is that Republicans need to beat expectations in all these special elections to avoid a buzzkill for the troops or a Twitter screed from the White House, the NRCC going medieval on Thompson makes some sense. But if they’re really worried about losing KS-4, that should terrify Elephant-Party people everywhere.


GOP Getting Worried About “Safe” Kansas U.S. House Seat

We all know there’s a red-hot special congressional election in Georgia April 18. But a week earlier, Kansans go to the polls in another “special” that was supposed to be a snoozer. Now Republicans are getting jittery, as I discussed at New York:

It’s an old story by now that Republicans are jittery about holding onto the Georgia U.S. House seat once held by Newt Gingrich and Johnny Isakson, and mostly recently by HHS Secretary Tom Price, in an April 18 special election. But it’s another thing altogether to learn that Republicans are worried about a special election a week earlier in Kansas to replace CIA director Mike Pompeo. Here’s the news from Politico:

“The NRCC is pouring money into a last-minute TV ad buy in Kansas ahead of a Tuesday special election, seeking to pump up Republican enthusiasm and turnout in a district that President Donald Trump carried by 27 percentage points just a few months ago.

“The late independent expenditure seeks to boost Republican state Treasurer Ron Estes …. Kansas Republicans are fretting that Estes’ margin is closer than expected in his race against Democrat James Thompson, an attorney.

“’Kansas should not be in play, but Kansas is in play,’ said one Kansas Republican consultant.”

Yikes.

Just last month the authoritative Cook Political Report rated this race “Safe Republican.” And no wonder: Aside from Trump’s margin in the 4th district of Kansas, Pompeo won it two-to-one last November, and it hasn’t gone Democratic in a presidential or House election since 1992….

[M]aybe GOPers are just getting jumpy, or maybe they are seeing something in Kansas and elsewhere in their own ranks that suggests underwhelming turnout. The NRCC ad, which basically calls Thompson an enthusiastic baby-killer, is about as subtle as an electric cattle prod plunged into the bathwater of GOP base voters.

If the idea is that Republicans need to beat expectations in all these special elections to avoid a buzzkill for the troops or a Twitter screed from the White House, the NRCC going medieval on Thompson makes some sense. But if they’re really worried about losing KS-4, that should terrify Elephant-Party people everywhere.


March 31: Opposition to Medicaid Expansion: It’s Not the Money, It’s the Ideology

There was a brief flurry of excitement this week about the possibility of more states accepting the Affordable Care Act’s Medicaid expansion. I poured some cold water on the idea at New York:

The train wreck involving the American Health Care Act in the U.S. House last week offered a burst of fresh hope to those in the 19 states that have not yet accepted the Medicaid expansion authorized by the Affordable Care Act and made optional by the U.S. Supreme Court. Most versions of GOP health legislation have canceled the expansion and its generous federal funding with variations in terms of speed and ferocity. The version of AHCA that slipped and fell while approaching the House floor contained a flat prohibition on any new expansions, reportedly at the behest of the House Freedom Caucus.

Coincidentally or not, early this week a coalition of Democrats and moderate Republicans in the Kansas legislature sent conservative governor Sam Brownback a bill designed to make that state the 32nd to expand Medicaid eligibility to poor people without children or disabilities…. But alas for any sense of momentum for Medicaid expansions, Brownback promptly vetoed the legislation, with a message that should remind everyone that rejection of the expansion has often been about ideology rather than money:

“I am vetoing this expansion of ObamaCare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs.

“Most grievously, this legislation funnels more taxpayer dollars to Planned Parenthood and the abortion industry. From its infancy, the state of Kansas has affirmed the dignity and equality of each human life. I will not support this legislation that continues to fund organizations that undermine a culture of life.”

Alrighty then!

Vox has just conducted a quick survey of the non-expansion states and didn’t find much new activity despite some optimistic talk from expansion proponents. Virginia governor Terry McAuliffe has launched a new Medicaid-expansion campaign, but unless Democrats make gains in the legislature he will continue to be blocked. In Maine a ballot initiative has already been certified for November of this year to force an expansion that Governor Paul LePage has bitterly opposed.

There’s some mysterious talk in Georgia about Governor Nathan Deal’s administration approaching former Georgia congressman and now HHS Secretary Tom Price for “major changes” to the Medicaid program. Under HHS’ previous management, this might have been an allusion to one of those deals the Obama administration encouraged whereby states were given waivers to conduct conservative policy experiments with the entire Medicaid program in exchange for grudgingly accepting expansion and the massive federal funding that accompanied it. Since the Trump administration doesn’t support the expansion in the first place, it’s unlikely that it will be interested in bribing additional states into going along. It’s more likely Georgia will seek and perhaps receive permission to do unpleasant things to the existing Medicaid population.

All in all, the AHCA fiasco removed a big new disincentive to additional Medicaid expansions. But it didn’t remove the determination of conservatives in many states to reject free money to achieve better health coverage on grounds that it would benefit the undeserving, or make government too popular. That’s a forever thing.


Opposition to Medicaid Expansion: It’s Not the Money, It’s the Ideology

There was a brief flurry of excitement this week about the possibility of more states accepting the Affordable Care Act’s Medicaid expansion. I poured some cold water on the idea at New York:

The train wreck involving the American Health Care Act in the U.S. House last week offered a burst of fresh hope to those in the 19 states that have not yet accepted the Medicaid expansion authorized by the Affordable Care Act and made optional by the U.S. Supreme Court. Most versions of GOP health legislation have canceled the expansion and its generous federal funding with variations in terms of speed and ferocity. The version of AHCA that slipped and fell while approaching the House floor contained a flat prohibition on any new expansions, reportedly at the behest of the House Freedom Caucus.

Coincidentally or not, early this week a coalition of Democrats and moderate Republicans in the Kansas legislature sent conservative governor Sam Brownback a bill designed to make that state the 32nd to expand Medicaid eligibility to poor people without children or disabilities…. But alas for any sense of momentum for Medicaid expansions, Brownback promptly vetoed the legislation, with a message that should remind everyone that rejection of the expansion has often been about ideology rather than money:

“I am vetoing this expansion of ObamaCare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs.

“Most grievously, this legislation funnels more taxpayer dollars to Planned Parenthood and the abortion industry. From its infancy, the state of Kansas has affirmed the dignity and equality of each human life. I will not support this legislation that continues to fund organizations that undermine a culture of life.”

Alrighty then!

Vox has just conducted a quick survey of the non-expansion states and didn’t find much new activity despite some optimistic talk from expansion proponents. Virginia governor Terry McAuliffe has launched a new Medicaid-expansion campaign, but unless Democrats make gains in the legislature he will continue to be blocked. In Maine a ballot initiative has already been certified for November of this year to force an expansion that Governor Paul LePage has bitterly opposed.

There’s some mysterious talk in Georgia about Governor Nathan Deal’s administration approaching former Georgia congressman and now HHS Secretary Tom Price for “major changes” to the Medicaid program. Under HHS’ previous management, this might have been an allusion to one of those deals the Obama administration encouraged whereby states were given waivers to conduct conservative policy experiments with the entire Medicaid program in exchange for grudgingly accepting expansion and the massive federal funding that accompanied it. Since the Trump administration doesn’t support the expansion in the first place, it’s unlikely that it will be interested in bribing additional states into going along. It’s more likely Georgia will seek and perhaps receive permission to do unpleasant things to the existing Medicaid population.

All in all, the AHCA fiasco removed a big new disincentive to additional Medicaid expansions. But it didn’t remove the determination of conservatives in many states to reject free money to achieve better health coverage on grounds that it would benefit the undeserving, or make government too popular. That’s a forever thing.


March 30: A Health Care Zombie Apocalypse?

Just when you thought it was safe to write a firm post mortem of GOP efforts to repeal and replace Obamacare this year, strange growling noises emerged from Congress and the White House. I wrote about them at New York.

It seems the source of this alleged reanimation may be the GOP faction most attributed as causing Trumpcare’s death — hard-core conservatives associated with the House Freedom Caucus. Just before the story broke of renewed high-level GOP meetings on health care, Representative Mo Brooks, a Republican from Alabama and a Freedom Caucus bravo who was an announced opponent of AHCA, let it be known he was filing a “discharge petition” to force a House vote on a simple Obamacare repeal (presumably similar to what Congress passed last year in the safe knowledge Barack Obama would veto it). It’s an extreme, long-shot measure to bypass the committee system and the leadership, made sensible only by the Freedom Caucus’s dogmatic belief those enslaved by Obamacare would rattle their chains and bellow their support for such a measure.

While it’s unclear whether Brooks’s determination to force health care back onto the GOP agenda had anything to do with it, something must have sent an impulse into the slowly cooling cadaver of the dead bill. According to the New York Times, there’s activity across the full spectrum of Republican opinion, with the unlikeliest ringleader of all:

“The new talks, which have been going on quietly this week, involve Stephen K. Bannon, the president’s chief strategist, and members of the two Republican factions that helped sink the bill last week, the hard-right Freedom Caucus and the more centrist Tuesday Group.”

It is abundantly unclear how these talks will fare any differently than earlier talks that exposed the deep divide between conservatives who thought AHCA was too generous and “moderates” who though it was too stingy, particularly since every available compromise seemed to make the disastrous coverage and cost numbers the Congressional Budget Office assigned to the legislative product even worse. Bannon’s involvement is even stranger, though obviously if he were able to pull off a legislative feat that eluded Paul Ryan, the cheering in Breitbart-land would be ear-shattering.

The story keeps getting odder. At his daily press briefing yesterday, Sean Spicer provided his usual clarity when asked about the reported revivification:

“Staff has met with individuals and listened to them….
Have we had some discussions and listened to ideas? Yes. Are we actively planning an immediate strategy? Not at this time … So there has been a discussion and I believe there will be several more.”

Paul Ryan, probably wanting to make it clear Bannon hasn’t cut him out of the picture, churned still more fog into the air:

“We want to get it right,” Speaker Paul Ryan told reporters after a GOP conference meeting Tuesday. “We’re going to keep talking to each other until we get it right. I’m not going to put a timeline on it, because this is too important to not get right and to put an artificial timeline on it.”

Meanwhile, Ryan’s Senate counterpart, Mitch McConnell, was having nothing of it:

“Mcconnell [sic] making clear Obamacare repeal efforts dead. ‘We have the existing law in place and we’ll just have to see how that works out.'”

If that’s not enough Republican confusion for you, there are fresh reports today that some GOP senators don’t agree with McConnell, and remain interested in moving their own repeal-and-replace legislation, independently from what the House is thinking about doing.

And to top it all off, the president of the United State told a bipartisan group of senators last night that enacting a health-care bill was going to be a snap:

“I know that we are all going to make a deal on health care.

“That’s such an easy one.”

All this talk had better materialize into action pretty quickly, or it may be too late. Anti-abortion activists are already eyeing the abandoned reconciliation instrument that was supposed to make passage of Trumpcare easier, and demanding that it be used for their pet cause, the defunding of Planned Parenthood, so that that item won’t wind up being filibustered by Democrats as part of a stopgap appropriations bill. For those still discussing health-care legislation, it’s use-it-or-lose-it time. The dead can’t walk much longer.


A Health Care Zombie Apocalypse?

Just when you thought it was safe to write a firm post mortem of GOP efforts to repeal and replace Obamacare this year, strange growling noises emerged from Congress and the White House. I wrote about them at New York.

It seems the source of this alleged reanimation may be the GOP faction most attributed as causing Trumpcare’s death — hard-core conservatives associated with the House Freedom Caucus. Just before the story broke of renewed high-level GOP meetings on health care, Representative Mo Brooks, a Republican from Alabama and a Freedom Caucus bravo who was an announced opponent of AHCA, let it be known he was filing a “discharge petition” to force a House vote on a simple Obamacare repeal (presumably similar to what Congress passed last year in the safe knowledge Barack Obama would veto it). It’s an extreme, long-shot measure to bypass the committee system and the leadership, made sensible only by the Freedom Caucus’s dogmatic belief those enslaved by Obamacare would rattle their chains and bellow their support for such a measure.

While it’s unclear whether Brooks’s determination to force health care back onto the GOP agenda had anything to do with it, something must have sent an impulse into the slowly cooling cadaver of the dead bill. According to the New York Times, there’s activity across the full spectrum of Republican opinion, with the unlikeliest ringleader of all:

“The new talks, which have been going on quietly this week, involve Stephen K. Bannon, the president’s chief strategist, and members of the two Republican factions that helped sink the bill last week, the hard-right Freedom Caucus and the more centrist Tuesday Group.”

It is abundantly unclear how these talks will fare any differently than earlier talks that exposed the deep divide between conservatives who thought AHCA was too generous and “moderates” who though it was too stingy, particularly since every available compromise seemed to make the disastrous coverage and cost numbers the Congressional Budget Office assigned to the legislative product even worse. Bannon’s involvement is even stranger, though obviously if he were able to pull off a legislative feat that eluded Paul Ryan, the cheering in Breitbart-land would be ear-shattering.

The story keeps getting odder. At his daily press briefing yesterday, Sean Spicer provided his usual clarity when asked about the reported revivification:

“Staff has met with individuals and listened to them….
Have we had some discussions and listened to ideas? Yes. Are we actively planning an immediate strategy? Not at this time … So there has been a discussion and I believe there will be several more.”

Paul Ryan, probably wanting to make it clear Bannon hasn’t cut him out of the picture, churned still more fog into the air:

“We want to get it right,” Speaker Paul Ryan told reporters after a GOP conference meeting Tuesday. “We’re going to keep talking to each other until we get it right. I’m not going to put a timeline on it, because this is too important to not get right and to put an artificial timeline on it.”

Meanwhile, Ryan’s Senate counterpart, Mitch McConnell, was having nothing of it:

“Mcconnell [sic] making clear Obamacare repeal efforts dead. ‘We have the existing law in place and we’ll just have to see how that works out.'”

If that’s not enough Republican confusion for you, there are fresh reports today that some GOP senators don’t agree with McConnell, and remain interested in moving their own repeal-and-replace legislation, independently from what the House is thinking about doing.

And to top it all off, the president of the United State told a bipartisan group of senators last night that enacting a health-care bill was going to be a snap:

“I know that we are all going to make a deal on health care.

“That’s such an easy one.”

All this talk had better materialize into action pretty quickly, or it may be too late. Anti-abortion activists are already eyeing the abandoned reconciliation instrument that was supposed to make passage of Trumpcare easier, and demanding that it be used for their pet cause, the defunding of Planned Parenthood, so that that item won’t wind up being filibustered by Democrats as part of a stopgap appropriations bill. For those still discussing health-care legislation, it’s use-it-or-lose-it time. The dead can’t walk much longer.


March 24: And The Next GOP Health Plan Will Be: How About Never? Does Never Work For You?

In the wake of the rapid and total collapse of the American Health Care Act today, I sat down to write at New York about the GOP’s health care policy options going forward, before realizing there might not be any. Here were my thoughts:

The good news for Republicans that nobody much appreciates right now is that there was nothing mandatory about this whole messy enterprise. Yes, if they just give up on enacting a budget-reconciliation bill for fiscal year 2017 (that’s technically what the American Health Care Act is), they will defy the “instructions” they gave themselves back on January 13 when they enacted the budget resolution that put this runaway train in motion. Yes, there are both political and fiscal consequences for just bagging it. But there’s no judge who will fine them for it. So technically, the president is right: They can “move on,” and they can “punish” the American people by letting the Affordable Care Act stay in place.

And there was certainly nothing in Speaker Paul Ryan’s press conference after the bill was pulled to suggest any present intention to go back to the drawing board and come up with another bill. He admitted repeatedly that Obamacare would be in place “for the foreseeable future.” And then Donald Trump put the lid on the coffin by repeatedly saying nothing would happen on health care until Democrats joined in after Obamacare “explodes.”

Barring some second wind for a repeal/replace effort, or the unquenchable possibility that Donald Trump will change his mind, it will probably become an agenda item that slips into the future, or at least until 2018. The possible exception, particularly if the current system of individual health insurance continues to struggle with higher premiums and the withdrawal of insurers from purchasing exchanges, would be for Republicans to ask Democrats to cooperate in some sort of “fix” that they could market as sort of repeal-and-replace on the cheap.

Is it possible Democrats would be interested in this sort of deal once they finish celebrating the implosion of Trumpcare? Probably not anytime soon. The only vehicle for a bipartisan compromise at the moment is the Cassidy-Collins proposal that lets states decide whether to stick with Obamacare (including the Medicaid expansion) or move in a more conservative direction. This might have been enticing to some blue-state governors and Members of Congress back when it looked like Republicans had the means to enact something far more draconian. But at the moment it would look like a betrayal of Democratic constituencies in red states.

What might happen instead is that Republicans, freed from the responsibility of actually enacting anything, which their trifecta and the budget reconciliation made possible, will retreat to proposing impracticable health-care legislation they know Democrats won’t support and can easily filibuster. It will be just like Obama is still president and Republicans could demagogue on health care to their hearts’ desire!

In the short term, Republicans will have to deal with some immediate challenges exacerbated by this fiasco, like the need to satisfy their anti-abortion constituents by “defunding” Planned Parenthood, pursuing a tax-cut package without the improved revenue “baseline” that AHCA would have provided, and finding a new vehicle for “reforming” Medicaid (i.e., capping federal expenditures).

From a longer perspective, Republicans now understand how Democrats felt when the Clinton Health Plan went down to defeat in 1994. If it takes them half as long as it took Democrats to take another swing for the fences on health-care policy, we won’t soon see any vindication of the doomed effort that died today.


And the Next GOP Health Plan Will Be: How About Never? Does Never Work For You?

In the wake of the rapid and total collapse of the American Health Care Act today, I sat down to write at New York about the GOP’s health care policy options going forward, before realizing there might not be any. Here were my thoughts:

The good news for Republicans that nobody much appreciates right now is that there was nothing mandatory about this whole messy enterprise. Yes, if they just give up on enacting a budget-reconciliation bill for fiscal year 2017 (that’s technically what the American Health Care Act is), they will defy the “instructions” they gave themselves back on January 13 when they enacted the budget resolution that put this runaway train in motion. Yes, there are both political and fiscal consequences for just bagging it. But there’s no judge who will fine them for it. So technically, the president is right: They can “move on,” and they can “punish” the American people by letting the Affordable Care Act stay in place.

And there was certainly nothing in Speaker Paul Ryan’s press conference after the bill was pulled to suggest any present intention to go back to the drawing board and come up with another bill. He admitted repeatedly that Obamacare would be in place “for the foreseeable future.” And then Donald Trump put the lid on the coffin by repeatedly saying nothing would happen on health care until Democrats joined in after Obamacare “explodes.”

Barring some second wind for a repeal/replace effort, or the unquenchable possibility that Donald Trump will change his mind, it will probably become an agenda item that slips into the future, or at least until 2018. The possible exception, particularly if the current system of individual health insurance continues to struggle with higher premiums and the withdrawal of insurers from purchasing exchanges, would be for Republicans to ask Democrats to cooperate in some sort of “fix” that they could market as sort of repeal-and-replace on the cheap.

Is it possible Democrats would be interested in this sort of deal once they finish celebrating the implosion of Trumpcare? Probably not anytime soon. The only vehicle for a bipartisan compromise at the moment is the Cassidy-Collins proposal that lets states decide whether to stick with Obamacare (including the Medicaid expansion) or move in a more conservative direction. This might have been enticing to some blue-state governors and Members of Congress back when it looked like Republicans had the means to enact something far more draconian. But at the moment it would look like a betrayal of Democratic constituencies in red states.

What might happen instead is that Republicans, freed from the responsibility of actually enacting anything, which their trifecta and the budget reconciliation made possible, will retreat to proposing impracticable health-care legislation they know Democrats won’t support and can easily filibuster. It will be just like Obama is still president and Republicans could demagogue on health care to their hearts’ desire!

In the short term, Republicans will have to deal with some immediate challenges exacerbated by this fiasco, like the need to satisfy their anti-abortion constituents by “defunding” Planned Parenthood, pursuing a tax-cut package without the improved revenue “baseline” that AHCA would have provided, and finding a new vehicle for “reforming” Medicaid (i.e., capping federal expenditures).

From a longer perspective, Republicans now understand how Democrats felt when the Clinton Health Plan went down to defeat in 1994. If it takes them half as long as it took Democrats to take another swing for the fences on health-care policy, we won’t soon see any vindication of the doomed effort that died today.


March 23: TrumpCare Hits Dead End, Or At Least Cul-De-Sac

Near the end of a crazy week in Washington, Republicans just postponed a House vote on their “must-pass” health care plan. I offered a quick explanation at New York.

[I]t was not terribly surprising given the news from a White House meeting earlier today between Donald Trump and members of the conservative House Freedom Caucus, wherein Trump made a “final offer” and very few HFC folk bought it.

It had appeared Wednesday night that Trump and Paul Ryan might have found a way to blow this flawed bill out of the House by promising to include the repeal of Obamacare’s list of “essential benefits” heath plans needed to provide to qualify for federal subsidies (the list includes ten key categories, such as hospitalization, emergency services, and pregnancy care). That had previously been thought to be an unavailable concession thanks to Senate rules limiting budget reconciliation bills to budget-germane provisions. But those backing TrumpCare were now offering assurances (backed up by Sen. Mike Lee, a key Senate conservative who had opposed the original AHCA) the Senate parliamentarian would play ball with this broader bill. So presumably conservatives who wanted more of a complete repeal of Obamacare could, in theory, vote for the bill in the House and then vote against the final House-Senate conference report in case the reports about the parliamentarian’s flexibility were in error or just a ruse.

But the gambit backfired when HFC members meeting with Trump pocketed the “essential benefits” concession and demanded more. According to one account, they wanted even highly popular provisions like protections for people with pre-existing provisions and allowing dependents up to age 26 going on their parents’ policies to be repealed. Regardless of the exact demands, it’s clear conservatives called Trump’s and Ryan’s bluff: if all Obamacare regulations are now on the table, why stop with one or two?

Indeed, even before the vote cancellation, influential conservative commentator Ramesh Ponnuru was arguing that the new information about the parliamentarian meant Republicans should rethink the whole bill, not rush it out of the House. And if nothing shakes loose in the next few days, that may be the new GOP excuse for additional delay.

The trouble is this: even if these reports are right and Republicans don’t have to wait for some improbable second or third “prong” of regulatory or legislative action to get rid of Obamacare, GOP conservatives and “moderates” don’t agree at all on which provisions to trash and which to keep. And the search for a compromise won’t be improved by a fight over features of the bill that could easily be understood and “scored” as making life worse for real-live categories of people now benefiting from the Affordable Care Act.

For now Republicans at both ends of Pennsylvania Avenue have reached a cul-de-sac on health care and need either to turn around and try a different path or pull off some sort of politically dangerous minor miracle. This very bad week for Donald Trump has gotten a lot worse, and for once Paul Ryan is his full partner in misery.

Stay tuned for more GOP health care madness.


TrumpCare Hits Dead End, Or At Least Cul-De-Sac

Near the end of a crazy week in Washington, Republicans just postponed a House vote on their “must-pass” health care plan. I offered a quick explanation at New York.

[I]t was not terribly surprising given the news from a White House meeting earlier today between Donald Trump and members of the conservative House Freedom Caucus, wherein Trump made a “final offer” and very few HFC folk bought it.

It had appeared Wednesday night that Trump and Paul Ryan might have found a way to blow this flawed bill out of the House by promising to include the repeal of Obamacare’s list of “essential benefits” heath plans needed to provide to qualify for federal subsidies (the list includes ten key categories, such as hospitalization, emergency services, and pregnancy care). That had previously been thought to be an unavailable concession thanks to Senate rules limiting budget reconciliation bills to budget-germane provisions. But those backing TrumpCare were now offering assurances (backed up by Sen. Mike Lee, a key Senate conservative who had opposed the original AHCA) the Senate parliamentarian would play ball with this broader bill. So presumably conservatives who wanted more of a complete repeal of Obamacare could, in theory, vote for the bill in the House and then vote against the final House-Senate conference report in case the reports about the parliamentarian’s flexibility were in error or just a ruse.

But the gambit backfired when HFC members meeting with Trump pocketed the “essential benefits” concession and demanded more. According to one account, they wanted even highly popular provisions like protections for people with pre-existing provisions and allowing dependents up to age 26 going on their parents’ policies to be repealed. Regardless of the exact demands, it’s clear conservatives called Trump’s and Ryan’s bluff: if all Obamacare regulations are now on the table, why stop with one or two?

Indeed, even before the vote cancellation, influential conservative commentator Ramesh Ponnuru was arguing that the new information about the parliamentarian meant Republicans should rethink the whole bill, not rush it out of the House. And if nothing shakes loose in the next few days, that may be the new GOP excuse for additional delay.

The trouble is this: even if these reports are right and Republicans don’t have to wait for some improbable second or third “prong” of regulatory or legislative action to get rid of Obamacare, GOP conservatives and “moderates” don’t agree at all on which provisions to trash and which to keep. And the search for a compromise won’t be improved by a fight over features of the bill that could easily be understood and “scored” as making life worse for real-live categories of people now benefiting from the Affordable Care Act.

For now Republicans at both ends of Pennsylvania Avenue have reached a cul-de-sac on health care and need either to turn around and try a different path or pull off some sort of politically dangerous minor miracle. This very bad week for Donald Trump has gotten a lot worse, and for once Paul Ryan is his full partner in misery.

Stay tuned for more GOP health care madness.