After a couple of weeks of President Trump and GOP House leadership insisting “Nope, this is it! Kiss this pig or it’s nothing!” and conservatives replying “Die in a fire!” it looks like the GOP establishment has finally gotten the message.
First came this news from Senator Mike Lee:
Sen. Mike Lee, R-Utah, said on Wednesday that the Senate parliamentarian has told him that it may be possible for Republicans to push harder on repealing Obamacare’s regulations than the current House bill, which contradicts the assertion by House leadership that the legislation goes after Obamacare as aggressively as possible under Senate rules.
“What I understood her to be saying is that there’s no reason why an Obamacare repeal bill necessarily could not have provisions repealing the health insurance regulations.”
Now Speaker Paul Ryan, the pig’s primary pimp, has relented as well:
In a last-minute bid to woo conservatives ahead of a high-stakes vote on Thursday on repealing and replacing Obamacare, House leaders are considering gutting more Obamacare regulations.
The news comes as President Trump and White House officials are in talks with House conservatives over changes that can win over holdouts and secure enough votes to move the bill to the Senate.
Among the many arguments conservatives have made against the House healthcare bill, one of the most significant is that it leaves too many costly regulations in place and thus fails to address long-standing criticisms of Obamacare — that it limits choices and drives premiums higher than they otherwise would be.
Previously, House leaders have argued that the regulations could not be nixed, because doing so would blow up the bill in the Senate, where Republicans will have to pass the measure under restrictive rules to enable it to clear with a simple majority.
But a House leadership aide told the Washington Examiner on Wednesday that Republicans received new information from the Senate, indicating that axing the regulations would not automatically doom the bill from being considered on an expedited basis.
House Speaker Paul Ryan’s office is now more open to nixing the regulations, known as “essential health benefits.” Under Obamacare, all insurance policies must include ten categories of benefits, such as maternity care and preventive coverage, that make policies more comprehensive but also make it costlier for individuals who would prefer cheaper plans with fewer benefits.
You know what would be a great bill? One that completely repealed ObamaCare. You know, the way every Republican House and Senate member running for election since 2010 has promised.
The Trump Administration can also gut Obamacare without any help from congress:
Within the bill there are 2,500 references to “the Secretary”. 700 times the Secretary “shall” do something, 200 times the Secretary “may” do something, and 139 occasions when the “Secretary determines” what should be done.
These “shall” and “may” determinations cover things like what type of insurance coverage Americans are required to have, how insurance networks and exchanges are organized, how grant money is doled out, what the “essential health benefits” that every insurance policy must cover are.
Suppose the new Secretary determines that Americans “shall” only be required to have catastrophic insurance? Or no insurance at all? What if the “essential health benefits” are left to the discretion of the purchaser of the insurance policy? What if the Secretary “determines” that there will be no insurance mandates or penalties? Or that insurance “may” be sold across state lines?
The Secretary also has discretion over “pilot programs” and “demonstration projects” for controlling costs. These include wellness plans, information technology, quality measures, and national payment for Medicaid. Perhaps throw in tort reform and a rollback of many of the many more onerous regulations strangling the medical profession. The Secretary “may” implement these reforms.
In reality, the Secretary has the statutory power to infect Obamacare with the cancer of repeal and replace, metastasizing into so many aspects of the law that what emerges is a shadow of the original bill. Repeal and replace from within.
The downside to this approach is that any future Democratic administration could restore all the Obamacare nightmare taxes and regulations at will.
Still, there’s no reason Republicans can’t pursue a two-track approach: Gut it administratively while also working on a full legislative repeal.
Both approaches are far superior to the original “embrace and extend” ObamaCare bill Republican leadership originally tried to cram down representative’s throats….