In the wake of growing panic about credible threats from House and Senate conservatives to thwart plans for Obamacare “repeal-plus” legislation, the empire struck back with its own threats. Using the dependable Beltway bulletin-board of whispers to Politico, congressional GOP leaders made it known they will crush the rebellion with help from the Trump administration.
Take it to the bank, GOP leaders are all but declaring: The House will vote to repeal and replace by the end of this month.
Their confidence, coming after months of dead ends and false starts, is fueled by the belief that President Donald Trump has their back — even if some conservatives currently don’t.
There has been significant grumbling among House conservatives that the “repeal-plus” plan is just “Obamacare-Lite.” They are concerned that the legislation continues the Affordable Care Act’s basic premise of expanded government-subsidized health insurance instead of focusing on lowering costs for consumers and taxpayers alike.
But more important, three GOP senators — exactly the number needed to kill a repeal bill — have taken to demanding a simple repeal bill like the one Congress approved and Obama vetoed early last year, without a lot of added provisions designed to cushion the blow and protect coverage.
Speaker Paul Ryan professes not to be worried:
“We’re all working off the same piece of paper, the same plan,” Ryan said at a Thursday news conference when asked about conservative opposition. “We are in sync — the House, the Senate and the Trump administration, because this law is collapsing.”
Privately, senior Republican lawmakers and staff are more blunt. They say they have no problem steamrolling conservatives by daring them to vote against an Obamacare repeal that their constituents have demanded for years.
Indeed, says Politico, leadership figures believe Trump will take rebellious conservatives to the woodshed if they don’t fall into line. That assertion reflects an entirely unprecedented degree of certainty about the thinking of the 45th president, on Obamacare or much of anything else.
Maybe it’s a coincidence, but Politico has also gotten its hands on what is purported to be the latest draft of the House Obamacare repeal plan, and it shows few if any concessions to right-wing objections. Yes, it is reported that the sponsors might add a cap on income eligibility to the otherwise age-based tax credits for insurance purchases. But the real conservative angst involves the other end of the income spectrum, where people without income-tax liability would be given “refundable” tax credits — i.e., a check from the IRS. That makes it “welfare” instead of a “tax cut,” you see — “redistribution” instead of “letting people keep more of their own money.” But refundability is pretty much essential if you want to avoid millions of low-income Obamacare beneficiaries falling back into the ranks of the uninsured.
The main changes in the House bill seem to reflect not the demands of conservatives but the needs of private health-insurance companies, to keep them playing ball during the transition from one system to the other.
So the question of the day is whether these developments represent icy Establishment confidence or a bluff? And that may come down to whether Team Trump is actually onboard.
The excited Politico account of Establishment muscle-flexing puts great stock in an appearance by Vice-President Mike Pence and HHS Secretary Tom Price in Paul Ryan’s hometown today:
It’s the clearest display of unity yet between the White House and GOP leadership on an Obamacare replacement strategy.
Maybe, though, the appearance is a nonpublic event for employees and executives of an agricultural-supply company. And according to a C-Span notice, it will be followed by a Pence speech on “jobs and the economy.” These are not the most obvious opportunities for a message on Obamacare designed to strike fear into the hearts of Rand Paul, Ted Cruz, Mike Lee, and their fellow-rebels in the House. They scoffed at the last alleged display of administration solidarity with Ryan, the president’s vague reference to health-care tax credits in his speech to Congress. It’s doubtful conservatives will really get worried unless they hear unambiguous discouragement from Donald Trump’s Twitter account.