NEW: Trump Pivots Towards Democrats After Health Bill Disaster


The White House issued a warning to Republicans yesterday. In the wake of the failure of the president’s health care reform bill, the Trump Administration signaled that it is willing to reach out to Democrats to advance its agenda if it can’t win support from the various Republican factions.

White House Chief of Staff Reince Priebus underscored the potential shift in strategy on “Fox News Sunday” (quoted in the Wall Street Journal). “This president is not going to be a partisan president,” Priebus said. “I think it’s time for our folks to come together, and I also think it’s time to potentially get a few moderate Democrats on board as well.”

When asked if President Trump would move on from health care reform and allow the implosion of Obamacare to run its course as he threatened in a tweet, Politico notes that Priebus answered, “I don’t think the president is closing the door on anything.”

“It’s more or less a warning shot that we are willing to talk to anyone. We always have been,” he said in Time. “I think more so now than ever, it’s time for both parties to come together and get to real reforms in this country.”

Since the decision to remove the AHCA bill from consideration on Friday, President Trump has alternately blamed the Democrats, blamed the House Freedom Caucus and reached out to Democrats.

The Washington Times reports that Senate Minority Leader Chuck Schumer (D-N.Y.) was receptive to Trump’s overtures. “We Democrats, provided our Republican colleagues drop [repeal and replace] and stop undermining the ACA, are willing to work with our Republican friends — as long as they say no more repeal,” Mr. Schumer said. Schumer added in Time that, “if he changes, he could have a different presidency.”

With Republicans holding 52 seats in the Senate, virtually all reform legislation is subject to Democrat filibusters. A minimum of eight Democrats must cross over to kill the filibuster and allow a vote on any individual bill.

The Resurgent speculated in January that President Trump might forge a bipartisan coalition of moderate Democrats and Republicans on a number of issues where the president’s platform is at odds with traditional Republican principles. During the campaign, Mr. Trump said that he wouldn’t mind being a “free agent” in his dealings with Congress.

The price for dealing with the Democrats on health care would be giving up the full repeal of Obamacare. Republicans currently don’t have enough votes for repeal, but many, including those in the House Freedom Caucus, would refuse to vote for anything less. The price of bringing Democrats on board other items in the Republican agenda, from tax reform to immigration, is likely to be just as unpalatable.

The more the president moves to the left to appeal to Democrats, the more Republicans he will lose. The question is whether he can find a workable majority in the middle.

Who is Poisoning the President’s Mind?

On Friday morning, reports started circulating that President Trump was not a fan of the health care plan Republicans were considering. By mid-day Friday, reports started trickling in that Steve Bannon was distancing himself as well. On Friday evening, after the legislation was pulled, President Trump made it clear he considered the House Freedom Caucus friends. Later, at the White House, President Trump privately reassured people as well that he did not blame conservatives or the House Freedom Caucus.

Then, this weekend, President Trump got on Twitter and railed against the conservatives in the House Freedom Caucus and the Club for Growth. What changed?

The truth is that moderates were a bigger problem, though you’d never know that from the Wall Street Journal and talking heads. Conservatives just wanted Republicans to keep their promises, but moderates kept moving the goal posts toward greater government.

In the end, three run of the mill Republicans, ten moderates, and House Freedom Caucus members all were opposed. As compromises moved left, leadership lost more of the right. As compromises moved right, leadership lost more of the left.

Washington establishment types always blame the conservatives. The Wall Street Journal editorial blaming conservatives over the weekend could have been written any time after No Child Left Behind passed in the Bush era. Paul Gigot wears knee pads for the establishment and always has.

But something changed pretty quickly with President Trump. It was not just his public statement, but private statements as well. Most troubling, however, President Trump told the American people on Friday that the House Freedom Caucus members were his friends and not to blame, then on Twitter, he attacked them.

Is someone else tweeting from his personal Twitter feed? Is he schizophrenic? Or is someone whispering in his ear that conservatives are the problem?

President Trump should note that the loudest voices supporting the American Health Care Act were the loudest voices attacking not just him, but his supporters as well. And they are the same voices that have consistently sold out conservatives and broken the Republicans’ promises.

President Trump is in the White House because of all those people breaking their promises and the public turning against them. He should be careful lest he align too closely with those the public has already rejected.

Where Does Obamacare Repeal Go From Here?

The American Health Care Act is dead… at least for now. Next week House conservatives may wake up to the fact that they sided with Democrats to kill a bill that repealed a large part of the Affordable Care Act and defunded Planned Parenthood.  Perhaps the most disturbing thing about the failure of the AHCA is that no better or more realistic alternative for repealing and replacing Obamacare has been offered by the party’s dissidents.

The fundamental problem faced by the GOP is a mathematical one. The Affordable Care Act was passed with 60 Democrat votes in the Senate to overcome a Republican filibuster. It was then amended by a reconciliation bill that only required a simple majority. In 2010, Democrats had 60 seats in the Senate. Today, the Republicans have 52 and five of those are not reliable for a clean repeal. The numbers are just not there for a clean repeal so where does the Republican repeal and replace effort go from here?

Perhaps nowhere. If President Trump stands by his ultimatum that if the AHCA failed that he would bypass Obamacare and move on to other issues, the repeal effort may be dead in the water for the foreseeable future.

On the other hand, while President Trump may not be committed to a repeal of Obamacare, many other Republicans are. However, without the bully pulpit of the presidency backing them, repeal is even more difficult than before.

Republicans face two giant hurdles in their quest to repeal and replace Obamacare. The first is finding a consensus between moderate and conservative Republicans on health policy. The differences range from what to do about the Medicaid expansion to how to treat tax credits for health insurance premiums to defunding Planned Parenthood (Susan Collins, I’m glaring in your direction.) The second problem is finding 60 votes to defeat the Democrat filibuster that is certain to come with any repeal or reform legislation other than a budget reconciliation.

The death of the AHCA does nothing to bridge the gap between the Freedom Caucus and Republican moderates. Like the AHCA, any future bill will have to try to appeal to both wings of the party and, as a result, will probably be reviled by both sides.

Given that the Republicans have only 52 votes available, there are only three viable strategies for repealing the Affordable Care Act.

1. The Nuclear Option. Republicans can change Senate rules to eliminate the filibuster. The problem is that they still fall short of 51 votes due to probable defections by Susan Collins and the Medicaid Four. Without 51 votes, eliminating the filibuster is pointless and counterproductive. There is a good chance that Republicans will decide to eliminate the filibuster to ram other bills through, but this strategy seems unlikely to help them on Obamacare.

2. Stall and wait for 60 Senate votes. The Democrats forced the ACA through with a supermajority of 60 votes. Likewise, the GOP could force a repeal if they had 60 votes. The last time that Republicans held a 60-seat majority was the 61st Congress from 1909 through 1911.

Nevertheless, this is not as unlikely as it sounds. There is a chance for a big GOP win in the Senate in 2018 because 10 Democrat seats in red states are vulnerable to Republican challengers.

The downside is that the 2018 elections are almost two years away and a lot can happen. President Trump is not popular and Republican voters are seething at the way the health care bill was handled. Republicans have blown easy Senate races many times before. A big Republican win in 2018 is probably made less likely if the health insurance system implodes on President Trump’s watch.

3. Compromise. In today’s political environment, compromise is often seen as a dirty word. Nevertheless, it will be necessary to pass repeal and replace legislation any time soon. Not only will Republicans have to compromise among themselves, something the Freedom Caucus has been largely unwilling to do thus far, they will also have to compromise with Democrats. This is likely to be as unappealing as it sounds.

Democrats hold the key to reforming the health care system. Even if large parts of Obamacare can be repealed through reconciliation, much of the health care reform on the Republican agenda will have to pass a Democrat filibuster. With a minimum of eight Democrat votes needed, Republicans will have to learn give-and-take or resign themselves to at least two years of gridlock.

The failure to repeal Obamacare is not about a lack of will among most Republicans. It is about a lack of Republican votes in Congress, even though they hold a slim majority. If Republicans really want to rid the country of Obamacare, they must go beyond “just say ‘no’” to find a realistic legislative pathway to repeal. This will most likely involve compromising on an imperfect bill that can garner a majority.

How Obamacare Was Passed – And Why It Can’t Be Repealed By Reconciliation


A common question since President Trump took office is why Republicans can’t simply repeal the entire Affordable Care Act with a budget reconciliation. The Democrats passed it that way, the argument goes, so why should Republicans have to worry about filibusters, cloture votes and the arcane rules of the Senate when they try to repeal Obamacare?

The most obvious reason is that with the four Republican Senators who are holding out to preserve the Medicaid expansion, Republicans don’t even have a simple majority that would vote for a clean repeal. The Medicaid Four, Lisa Murkowski of Alaska, Cory Gardner of Colorado, Rob Portman of Ohio and Shelly Moore Capito of West Virginia, vowed to oppose any repeal and replace bill that did not allow a phase out of Obamacare’s Medicaid expansion.

A more technical reason is that Obamacare was not passed with a budget reconciliation. Not exactly anyway.

At the beginning of the 111th Congress in 2009, Democrats held 58 seats in the Senate. The wave election of 2008 had given them a majority that was just short of filibuster proof. Then the Democrats got two lucky – or at least underhanded – breaks. First, in what is often considered to be a stolen election, Al Franken unseated Republican Norm Coleman in a hotly contested recount. Second, Arlen Specter (R-Pa.) switched his party affiliation to Democrat in April 2009. Suddenly, the Democrats had the 60 votes necessary to stop a Republican filibuster in its tracks.

Specter’s defection set the stage for the Senate to pass the Affordable Care Act. On December 23, 2009, the Senate voted to end debate on the bill. The next day, Christmas Eve, the Senate passed the bill in a strict party line vote with every Republican voting “no.” The bill then went to the House of Representatives.

The next month, the Democrats faced a setback when Senator Edward Kennedy (D-Mass.) died suddenly. In a special election widely interpreted to be a referendum on the health care bill, Scott Brown defeated the heavily favored Democrat candidate and broke the Democrats’ filibuster-proof majority.

What saved the Democrats was the fact that the House and Senate had negotiated most of their differences prior to the introduction of the bill into the Senate. To win over the final few House Democrats, the Democrat leadership urged them to pass the Senate bill with no changes and then pass a second bill via the reconciliation process. If the Senate bill was passed without changes, it would avoid going to conference and being subjected to a second Republican filibuster attempt before a final vote. The reconciliation bill, although its content would be restricted to tax, spending and debt limit legislation by Senate rules, would also not be subject to a filibuster.

After President Obama signed an Executive Order that purported to ensure that federal funds would not be used for abortion, Rep. Bart Stupak (D-Mich.) and the last few Democrat holdouts signed onto the bill. The promise not to fund abortion was broken almost immediately.

The Affordable Care Act was passed by the House without amendment on March 21, 2010 and went directly to the president’s desk. The Health Care and Education Reconciliation Act of 2010 was passed by both Houses of Congress on March 25, 2010. President Obama signed the Affordable Care Act into law on March 23 and the Health Care Reconciliation Act on March 30.

The bottom line is that Obamacare passed with two bills. One was a reconciliation bill and one was not. The largest part of Obamacare legislation was passed in a normal bill that Republicans did not have the numbers to filibuster. The Republicans cannot pass a clean repeal because they do not have the votes to stop the Democrat filibuster that would be certain to come.

But what about the 2015 repeal bill that was vetoed by President Obama? How could this bill repeal the entirety of Obamacare and get past the Democrat filibuster to the president’s desk if it was limited to the Senate rules on budget reconciliations?

The answer is that the bill, HR 3762, which was assigned the unwieldy name “To provide for reconciliation pursuant to section 2002 of the concurrent resolution on the budget for fiscal year 2016,” was not a clean repeal of Obamacare any more than the AHCA was. The 2015 bill, like the AHCA, begins with the statement that the Affordable Care Act is amended, not repealed.

A House Republican fact page about HR 3762 also doesn’t make the claim that the bill would have repealed Obamacare in full. The bill summary on the page says, “HR 3762 repeals the health exchange subsidies and the Medicaid expansion included in the Affordable Care Act (ACA), repeals the ‘Obamacare slush fund,’ eliminates federal funding for Planned Parenthood, repeals the individual and employer mandate penalties, and repeals the medical device and ‘Cadillac’ tax, among other provisions.” If you doubt this, you can read the text of the bill for yourself here.

HR 3762 might have been a better bill than the AHCA, but the Republican position in Congress was also better in 2015. Republicans held 54 Senate seats and 246 House seats in the 115th Congress. In the squeaker election of 2016, President Trump’s short coattails reduced those numbers to 52 Senate seats and 241 House seats. There is still a GOP majority in both houses, but a slimmer one with less margin for defections on votes.

HR 3762 passed the Senate by a 52-47 vote. Two Republicans voted against the measure, Mark Kirk of Illinois and Susan Collins of Maine. Mark Kirk lost his reelection bid in 2016, but Susan Collins remains in the Senate as a prospective “no” vote on the AHCA.

The Medicaid Four were all in the Senate in 2015 and all voted for HR 3762. These four Senators switched their positions on the Medicaid expansion and made it necessary to present a weaker bill to Congress. It is ultimately these four Senators, along with Susan Collins, who should be held responsible for the failure of the GOP to repeal Obamacare because, without their votes, not even a reconciliation bill can pass, let alone a cloture vote on a clean repeal bill.

The failure of the Republicans to pass a clean repeal bill is not due to a lack of will on most members of the party. It is due to math. Democrats used the extremely rare and temporary 60 vote majority to force Obamacare through Congress with no Republican support. The current Republican position is much weaker than that of the Democrats in 2010.

If it is the fault of “RINOs” in Congress, it must be noted that Speaker Paul Ryan (R-Wisc.) is not the RINO to blame. Ryan and other Republican leaders worked to provide the strongest bill possible given the electoral realities of their caucus.

The blame lies with a handful of Republican Senators who are holding up the drive for a strong bill to replace Obamacare. Their names are Lisa Murkowski (Alaska), Cory Gardner (Col.), Rob Portman (Ohio), Shelly Moore Capito (W. V.) and Susan Collins (Maine).

Call Your Congressman: Tell Him to Step Away From the American Health Care Act

Call your congressman at (202) 224-3121 and tell your congressman to step away from the American Health Care Act. There is absolutely no reason for him to support it today. In fact, there is no reason for it to be voted on today. It is a terrible piece of legislation that will neither reduce the deficit nor lower health care costs in America.

The House Freedom Caucus is standing firm, exposing what a piece of crap this legislation is. But your congressman needs to hear from you.

There are three things the House of Representatives could have done and did not do.

First, the House could have sent the Senate an actual repeal bill and let the chair rule that it was in order under the Byrd rule. That was the easiest and best option and could have gotten it through.

Second, the House could have used their 2015 legislation that they all supported as the framework for the new legislation.

Third, the House could have just passed the 2015 legislation that they all voted for originally.

They could still do one of those three things. It is still possible. They do not have to pass this legislation.

Call your congressman now.

Is It Worse for GOP if Health Bill Fails or Passes?

As the American Health Care Act heads toward an uncertain future in the House, there is speculation that Republicans might be better off if the bill is killed quickly in its first vote. With many members of the Freedom Caucus lining up against the bill, Margot Sanger-Katz and Nate Cohn, who respectively cover healthcare and elections for the New York Times opined on which was worse for the GOP, having the bill fail or having it pass.

“I think there are two big forces behind the progress of this bill,” Cohn said. “One is that no one wants to be responsible for its failure. So I agree that if the House passes something, there will be a lot more pressure for the Senate to figure something out. They might not be able to do it, but they might really try.”

“Two is that the speed is good for the Republicans,” he continued. “It has a better chance of passing if they move quickly, before public opinion turns against it. It’s better for the Republicans if it fails quickly, because they can move on to other things.”

“I think the Republicans are in a tough spot either way, but I think they’re better off if the bill fails,” Cohn continued. “They’ll get bad press, but voters have fairly short memories and I think the Republicans will move on. They’ll still be able to blame problems on Obamacare, even if it will be less credible. If they pass this plan, I have no idea how they intend to defend it. And I think hurting vulnerable Americans would go against the core of Trump’s appeal to the decisive Obama-Trump vote in the Midwest and Northeast, with little benefit. I think the best position for a lot of Republican members is to vote for the bill, but hope it fails. On the other hand, if the bill passes, it will be nice to be among the Republicans who voted against it.”

If the bill does manage to pass the House, it won’t pass the Senate as written. “The Senate has more of a moderate problem than the House, it appears,” said Sanger-Katz. “There are two senators — Lisa Murkowski and Susan Collins — who don’t like that the bill defunds Planned Parenthood. There are a few senators from states that expanded Medicaid who are worried about changes to that program. There are also some concerns about the generosity of tax credits, particularly for older Americans.”

If the bill is amended to win the votes of Murkowski (R-Alaska) and Collins (R-Maine), it will face increasing opposition from Senators on the right such as Rand Paul (R-Ky.) and Ted Cruz (R-Texas). Still, the best chance for repeal and replace seems to be to pass versions of the bill in both houses and work to improve it in the conference committee that irons out the differences.

The biggest problem for Republicans is the lack of a clear direction if the AHCA fails. “My sense is that there’s just no policy consensus about health care among Republicans,” Sanger-Katz said. “I think they would need that kind of vision and consensus to get something ready in advance.”

Finding a consensus is easier said than done. Many of the problems with the current bill result from trying to find a consensus where there is none. Conservatives want a complete repeal of the Affordable Care Act which is not mathematically possible in the current Congress without Democrat defections. Moderates want to protect citizens of their states that rely on the Obamacare’s Medicaid expansion. The resulting standoff makes it unlikely that enough Republicans can be satisfied to pass any bill without compromise from both sides.

The current bill is the result of an “effort to write this bill, in a hurry, with a jumble of provisions, [that] seems to suggest that they are just trying to find something that can pass, as opposed to articulating a clear policy vision for what they want health care to look like in this country,” Sanger-Katz said.

If the current compromise bill, written to get something passed, cannot pass, what is the future of the Republican repeal and replace effort? Amending it to satisfy members of the Freedom Caucus would probably spur moderates to vote “no” and vice versa. If the bill dies, there is no clear path forward.

Failure of the current bill might have the effect of moving healthcare reform to the left. If conservatives cannot be brought on board, President Trump may tack to the left and craft a bill that could pass with a coalition of moderates from both parties.

Failing to repeal Obamacare won’t be good for Republicans. Neither is passing a bill that leaves much of Obamacare intact. Finding a bill that can pass will require walking a tightrope that leaves the GOP vulnerable to attacks from both the left and the right.





BURN. Mike Lee Scorches House Leadership Over SwampCare

In an interview with CNN, Senator Mike Lee (R-UT) scorched the House Leadership’s proposed Obamacare replacement bill for perpetuating the status quo.

Citing a comment from Speaker Paul Ryan, Wolf Blister prefaced his question to Senator Lee by saying conservatives will get roughly 85 percent of what they want from the American Health Care Act. Lee respectfully but strongly disagreed with Speaker Ryan’s assertion that this bill provides 85 percent of what conservatives want in healthcare reform.

“When you put a list of what conservatives want and everything that’s in this bill, you don’t get to anywhere close to 85 percent,” said Lee.

Lee added, “This healthcare bill does far too little at all to bring premiums down.”

He later said on Fox News the House should cancel the vote citing lack of votes needed to pass it.

Mounting opposition against The American Health Care Act is palpable. Over 25 members of the House Freedom Caucus have pledged to oppose the bill — citing its failure to undo the damage wrought by Obamacare. They are confident this alternative bill won’t do anything to lower healthcare premiums, for example. (22 House votes are needed to stop the bill.) With respect to the U.S. Senate, joining Senator Lee in his opposition to the healthcare bill are Senators Rand Paul, Tom Cotton, Ted Cruz and four other rumored ones.

President Trump held a meeting earlier this week and suggested there will be a price to pay if Republicans don’t tow in line to support The American Health Care Act.

“I’m gonna come after you, but I know I won’t have to, because I know you’ll vote ‘yes,’ ” Trump said. “Honestly, a loss is not acceptable, folks.”

Trump pledged to repeal and replace Obamacare. The bill in its current form clearly fails to do so. The lawmakers pledging opposition to the bill should be applauded for keeping their campaign promises. Let’s hope a real, market-oriented healthcare bill — or market-based amendments– could be considered and passed. It’s imperative to get serious with healthcare reform.








The GOP Prepares to Break Its Promise

Republicans promised to repeal and replace Obamacare, but all they are doing is tickling it with their American Health Care Act. The legislation does not get rid of Obamacare, but ratifies it. It does not lower insurance and health care costs, but raises them. It does not repeal or replace Obamacare. It is just another in a long line of broken Republican promises.

The vote is supposed to happen tomorrow. Please use our action center and urge your member of congress to oppose the American Health Care Act. They promised to repeal and replace Obamacare, not tickle it. Take action now.