Obamacare: Republican Leaders Trying to Quell Revolting Senators

At least some Republicans seem mindful of the concept, “If you break it, you own it.”

Even though Obamacare polls as having more opponents than supporters (see here and here), many of the people who have benefitted from the program are strong supporters. In addition, those who have gotten coverage via Medicaid expansion may not realize that the ACA is the reason. And even with a majority of the public typically polling as not liking Obamacare, only 20% are willing to ditch it with no replacement.

So it should not come as surprise to find that the Republicans, finding themselves in the unexpected position of being able to end Obamacare, are in a squabble over what to do about the, um, opportunity. Obamacare repeal was not a Trump priority and as Lambert has pointed out, Trump has even made statements that sound remarkably un-Republican, like copy the Canadians.

But it appears that regardless of what Trump is willing to do regarding Obamacare, he seems cognizant of the risk of creating disarray and being blamed for it…a concern he oddly does not have on other issues. It’s likely that this caution is purely cynical: that he understands how complicated implementing a replacement or even a stopgap would be, and he does not want Congress spending time on the Republican party bete noire of Obamacare to the detriment of pushing through Trump’s priority items, particularly early in his term when he has the best chance to take ground quickly.

And the Republicans are divided enough to potentially forestall quick action. Politico and Bloomberg put different spins on the same story. Politico goes with the party line: GOP leaders vow to plow ahead with Obamacare repeal. The wee problem is that GOP leadership isn’t what it is cracked up to be. Remember how Boehner was repeatedly unable to bring the unruly Tea Party faction to heel? And one of the first acts of the incoming House, to gut its own ethics office, turned into a PR disaster and was quickly scuttled.

That means there’s good reason to regard the fracture over what path to take with Obamacare as serious. From Bloomberg:

A breakaway group of five moderate Senate Republicans pushed Monday to delay a bill repealing Obamacare until March — potentially enough pressure to force the party’s leadership to comply.

The step is the latest sign of some Republicans’ growing uneasiness about their leadership’s plan to repeal the law with no consensus on a replacement as part of an effort to deliver swiftly on one of President-elect Donald Trump’s top campaign promises.

Senators Bob Corker of Tennessee, Rob Portman of Ohio, Susan Collins of Maine, Bill Cassidy of Louisiana and Lisa Murkowski of Alaska offered an amendment Monday to the budget resolution that would extend the target date for the committees to write an Obamacare repeal bill to March 3 from Jan. 27.

The story points out that any more than one defection in the Senate would stymie their plan to use budget reconciliation to kill Obamacare before Trump is sworn in. And the ranks of the refusniks is growing:

On Monday, more senators said they agreed with a delay on the tax front, including Senator Mike Rounds of South Dakota.

John Cornyn, the No. 2 Senate Republican, told reporters that the taxes used to subsidize insurance for millions of Americans could be dealt with later this year in a larger tax overhaul.

Republicans senators are also grappling with the risks of repealing the law before a replacement is ready.

Senator Ron Johnson of Wisconsin said he wants to see a “pretty darn specific” proposal to replace Obamacare before it’s repealed.

Huffington Post’s whip count has a solid six Republican Senators not willing to repeal Obamacare immediately, and another three nervous:

Anxiety about repealing Obamacare without a replacement got a lot more visible in the U.S. Senate on Monday evening, as a half-dozen Republican senators called publicly for slowing down the process.

It’s not clear how strongly these senators feel about it, or whether they are willing to defy party leadership over how and when efforts to repeal Obamacare proceed.

But at least three other GOP senators have now expressed reservations about eliminating the Affordable Care Act without first settling on an alternative. That brings the total to nine ― well more than the three defections it would take to deprive Republicans of the majority they would likely need to get repeal through Congress.

And the House isn’t fully on board either. Back to Bloomberg:

On the House side, the new chairman of the conservative Freedom Caucus said his group wants to see more details about an Obamacare replacement before voting on the budget resolution.

“We hope they would see the prudence of waiting,” Representative Mark Meadows of North Carolina said Monday night.

Needless to say, there are many substantive issues to be addressed. Some Congressmen want a quick end to Obamacare, while others want a gradual phase-over/out. Some want a replacement scheme that still offers broad coverage, which will be a difficult sell to small government purists.

So the Republican failure to create a consensus around what to do about their hated Obamacare looks about to deliver Trump a lucky break. But Republican divisions may not serve him so well on other fronts. The Cabinet pick that is arguably the most important for Trump to have approved, Rex Tillerson, is also the one most in jeopardy thanks to diehard Cold Warriors like John McCain being firmly opposed to Trump’s plans to improve relations with Russia. Oil companies conduct their own foreign policy, and so an oil executive like Tillerson is one of the few routes open to Trump to get someone outside the Department of State/CIA apparatus with high level foreign experience, and better yet, good working relations with top Russian officials. By contrast, even though Trump may like and want to reward Steve Mnuchin (and other Cabinet nominees), he’s short on relevant experience and could readily be replaced in the unlikely event he were voted down. (Mind you, having any Cabinet pick nixed would be a big proof that Trump’s position with his own party is tenuous, but Tillerson would be a very serious loss for Trump).

It’s one thing for Trump to have the chips fall his way, as they appear to be doing with Obamacare. We’ll see over the coming weeks and months if he can exploit divisions, as opposed to merely create them.

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  1. Disturbed Voter

    Success has many fathers, failure is an orphan.

    No man is safe when the legislature is in session.

  2. dbk

    … as Lambert has pointed out, Trump has even made statements that sound remarkably un-Republican, like copy the Canadians.

    I get the impression T is clued in about how popular a “Canadian-style” health care plan could potentially be.

    That there are this many R senators in doubt/on the fence about this particular repeal might lend hope to the possibility that there might be divisions re: other issues, including key nominees. Let’s hope the D’s have their staffs working full-time on who might be willing/inclined to break ranks for particularly problematic nominations.

    My personal concerns here are those for AG (someone who has emerged straight out of 1963) and the Dept of Education, but the list is long and opinions may differ about priorities.

  3. Larry

    Interesting that there is rumors of a pushback on Tillerson from within the Republican party itself. In all the noise about Russia, that’s one I have not heard. While I know McCain is always itching for a fight with some old enemy, or to create a new enemy, he also has shown the capacity to roll over and play nice as long as he gets something in return. I agree that Tillerson not getting confirmed will be a huge signifier of what kind of relationship Trump is going to have with Congress.

    And as you and Lambert have consistently pointed out, all billionaires are highly conflicted individuals. I suspect that if Congress really wants Trump gone, it will not be hard to either marginalize him with a string of leaked and damaging stories (more unreleased Apprentice tapes) or to drum up information for impeachment. I keep telling my “liberal” friends and colleagues that you may actually see the power vested in Congress during a Trump Presidency, as opposed to the dinner theater we’re normally treated to.

    1. John Wright

      What I don’t understand is why anyone gives credence to McCain on anything.

      His track record for wisdom is short. (McCain Feingold campaign finance?) and his desire to throw the country into more wars is manifest (“bomb, bomb Iran”, Iraq, Syria, Ukraine).

      This goes back many years as he even has the old record for carrying water for the S&L industry as a member of the Keating Five in the 1980’s.

      It is as if the political class is patiently rooting for McCain to finally get something right before he dies while trotting him out when he espouses something they want..

      And the media plays along.

      1. Jim Thomson

        Agree with all the above, esp Keating Five.

        And please don’t forget Ms.Sarah Palin.

        I still cannot understand why ANYONE would select their VP pick from an insane asylum.
        The fact that he did not drop her after the first meeting says more to me about the man than anything else.

        1. NotTimothyGeithner

          I don’t have any reason to not believe the “Game Changer” narrative. McCain knew he couldn’t win and didn’t want to be seen as promoting Tim Pawlenty for 2012.

          Kay Bailey Hutchinson looked crazy when she had to read the Palin talking points on the announcement day. I told the state field director who told me Obama had picked Kaine that I couldn’t imagine a worse pick outside of Evan Bayh (apparently they didn’t get the reaction they hoped; enter Biden), but the Republicans always ride to the rescue of Team Blue.

      2. RUKidding

        No kidding! Whatever moral relevance Old Walnuts McGrumpypants had is long long long gone. Yet I now have latte liberal friends who are clinging and grasping at McCain’s coat tails in some vainglorious notion that he’s our new “savior.” I say: meet the new boss, same as the old boss. IOW, a worthless, greedy, coniving, manipulative, War Hawk, grifiting @sshole. No thanks.

      3. craazyboy

        We can “thank Obama” for helping treat the world to another 6 years of john boy.


        The Palin VP pick was because R election strategists believed Sarah would lock up the evangelist vote. {That may have gone Obama, I guess} Contrasting McCain with some eye candy couldn’t hurt either. I think maybe even pickup the feminist evangelist vote, if there is such a demographic. But I’m no expert on these things.

          1. craazyboy

            It was almost 10 years ago, and she was pretty hot. I saw a internet pic that went viral back then with a republican dude on stage with her and he had a visible boner going on in his suit pants. So she may even be hotter in person. But politics is nasty. I don’t know why anyone wants to do it.

  4. Normal

    They need the lobbyists to write the replacement law ASAP. Then they can proceed with reckless abandon.

    1. Kemal Erdogan

      But, the trouble is the obamacare is more or less what lobbyists wanted.

      So, no I see a real trouble here. However militant the republicans seem they would not shoot themselves in the foot. My take is that they will claim that they replaced the law with something better while not touching anything meaningful at the core of it for the simple reason that for such a system to work, it must be more or less the same as what obamacare is. Think how M. Romney’s plan looks very similar to Obama’s.

      The fact is the other workable alternatives are far too much to the left for their liking. So once such a low is introduced that even marginally helps the mid-lower classes, they tend to stick, unless the country falls into open dictatorship that is.

      1. Code Name D

        Ding ding ding!!! That’s the billion-dollar observation here. Obamacare is Free-market economics at its best. For it to fail would generate an intellectual crisis among neo-liberals and libertarians alike. To repeal the ACA is to admit that free markets don’t work.

        For the industry, their bottom line is literally – the bottom line. That ACA is failing is already apparent. So, something must be done to stabilize the ACA before it collapses completely, and give single payer advocates even more political clout than they already have. Wait too long, and single payer might -gasp- be placed on the table.

        But I am seeing some odd behavior from the Democrats. They seem to be actively pushing the healthcare battle onto the floor. Keep in mind they are convinced the ACA both works and is extremely popular. If they can get Republicans to repeal the ACA, then they win the mid-term elections and retake congress.

        Trump may act the buffoon. But his election proves he is smarter than most people suspect. You underestimate Trump at your own peril. Sending out mixed messages is probably Trumps version of his poker face, while at the same time he is able to read his opponents projections as they react to various seemingly random messages. The further the ACA descends on its death-spiral, the more clout he will acquire to compel changes according to his vision.

        1. Art Eclectic

          Actually, I don’t think the Dems think the ACA works an is extremely popular, I think they see the opportunity to nuke the thing and get single payer on the table. With Trump on records as admiring the Canadian system, that provides an opening (real or not) that would simply not be possible with any other political figure in the oval office. Not even HRC could have pushed through single payer against Republican opposition, Obama did the best he could with Romneycare. The only shot at single payer comes in the form of forcing Trump’s hand, so they might as well take their shot.

          1. NotTimothyGeithner

            What Dems are those? It’s not Chucky or Nancy.

            Don’t give these people the benefit of the doubt. They’ve demonstrated time and time again what pigs they are.

            1. TimmyB

              The Democrats who don’t care about corporate campaign dollars and lobbyists. You can recognize them because they all ride flying dragons.

          2. John k

            Dem elites, specifically including herself, oppose single payer because Pharma health bucks. Don’t blame reps, they will never put Canadian on the table.

          3. Yves Smith Post author

            Huh? The Dems were never serious about the public option, much the less single payer. Did you forget that the public option was inserted merely to be a bargaining chip, and then Obama gave it up without even extracting a concession from the opposition?

          4. River

            Best way to get the Canadian system or something like. Start tweeting to Trump that he doesn’t have the guts make it reality. He’ll probably find a way just out of spite.

            Play on his ego and make him great in spite of himself. Both your nation and his desires can coincide he’ll be remembered as Donald Magnus Americus and the people will get what they’ve been denied. Freedom from healthcare worries.

          5. different clue

            The Clintonites and various other Catfood Democrats all want single payer kept off the table. What Democrats do you think you are talking about? Name one Democrat who favors single payer. ( And no, as any Clintonite will tell you, Bernie doesn’t count).

            1. aab

              I think we all have to distinguish between “citizens who identify as” Democrats and “professional/people who earn money by being” Democrats. There are citizens all over the country who consider themselves Democrats and want single payer. I think there are even suckers — both citizens and “professional” Democrats — who honestly thought (and may still think) that the best/only way to get it was “through” the ACA. Remember that rationale? If we pass this POS system, it will decay miraculously into single payer! I may have briefly bought into that idea, when I was frantically searching for the pony in the Obama presidency room.

      2. Waldenpond

        If they are going to cut off the parasitizing of the pharma and insurance cartels, they need some backup billionaires and industries to step up. Maybe they can come up with automation to dump hospital employees, make and dispense pharmaceuticals, etc so that tech can get a turn at the trough. Still just shuffling the chairs on the Titanic.

  5. Sound of the Suburbs

    In a globalised world you just have to look around to see how expensive the US healthcare system is.

    Check international league tables and copy someone else’s cheaper and better system.

    It’s that easy.

  6. DJG

    President Susan Collins, as Atrios used to refer to her. And here she is again, a wise elder on health care. Sheesh. The flashbacks of her wondrous bipartisanship and moderation are starting to overwhelm me already.

    And President John McCain, who has squandered whatever moral authority he may ever have gained from his stay in the Hanoi Hilton, telling us how to deal with Boris and Natasha.

    And Ron Johnson, the most clueless man in Wisconsin except for Scott Walker.

    They don’t have two synapses to rub together among the three of them. Not one of them has a sense of political economy. They mainly react, and not well. They will end up making Trump look like a statesman. And, ironically, they would have taken the same positions with Hillary Clinton.

    So Obama and Trump are not transitional or tranformational. We are marking time as the roofing tiles drop off the buildings from neglect.

    1. DanB

      “We are marking time as the roofing tiles drop off the buildings…” Well, that is a “transition” of sorts, perhaps better -albeit awkwardly- labeled as entropy speeding up.

  7. Eclair

    Colorado, one of the states that fully embraced the ACA, extending Medicare to hundreds of poor and disabled residents (the state’s uninsured rate dropped from 15.8% in 2011 to 6.7 percent in 2015), is bracing for impact, according to the Denver Post.

    Of course, the state’s voters overwhelmingly rejected a proposed health care cooperative that would have provided residents with universal health coverage a la Canada in last November’s election.

    Thankfully, we can all saunter over to our neighborhood pot store and stock up. Who needs doctors anyway.

    1. Code Name D

      Hahahah! They only THINK they are working on it. The TPM is your typical corporate boardroom speak. “Seek solutions for this, that, and the other thing. Send the right messages. Reassure the confidence fairy. Don’t rock the boat.” In other words, they delegate solutions to minions to figure out while they pose for the camera.

      1. marym

        Agreed on your general assessment of TPM, but not sure I understand your comment. The screenshot is presented as a copy of the actual demands from AHIP, the insurance industry. It does use some pseudo-caring-about-“consumers” language, and I’m no expert, but generally these demands seem to say – keep the money coming; don’t send us too many poor/sick people; don’t make any rules; or at least none that we don’t write.

    2. Code Name D

      Hahahah! They only THINK they are working on it. The TPM is your typical corporate boardroom speak. “Seek solutions for this, that, and the other thing. Send the right messages. Reassure the confidence fairy. Don’t rock the boat.” In other words, they delegate solutions to minions to figure out while they pose for the camera.

  8. RUKidding

    It’s to laugh, otherwise we’ll all cry and/or pound our heads against brick walls.

    It’s my understanding that CA has used ACA in a useful way that is benefitting citizens who otherwise would be really up the creek with no paddle. So be it.

    ACA is what friggin’ BigPharma, BigHospital, BigInsurance, et al, wanted. IOW a Republican’s wet dream of a “health care” insurance system. But because the Blackity Black black black Kenyan Muslim got the credit for it, rather than RMoney… well then it’s simply terrible. If RMoney had enacted the exact same thing, the R Team would be extolling it’s virtues 24/7/365.

    The impact on me, personally, is smallish. I get that it’s been a worthless POS for many, but there are the 20 to 30 million who truly benefitted from it. I know some people personally in that category, and I read comments in blogs from others.

    Of course, the most draconian of TeaPartiers simply want to repeal ACA and that’s the end of it. You’re on your own is their Ayn Randian rally cry. Frankly what’s always bugged the sh*t out of me is that the R Team wasted the last 8 years endlessly (was it 60 times?) attempting to vote out ACA, but they spent not one iota of a second in devising a replacement. They have zip, zilch, nada, bupkiss to offer. What a worthless group of grifters.

    I doubt that Trump gives a stuff what happens to his voters, other than that he probably has a notion that he’ll need their fealty and votes in 4 years. Therefore, Trump may try to get something that has some minimum usefulness enacted.

    I can’t wait. /s

  9. Sylvia Demarest

    Yves–Thank you so much for all the remarkable, and highly informative articles you have posted over the last few weeks. Outstanding. Naked Capitalism keeps getting better!!!!

  10. polecat

    All I will say, is that I want that burning tire around my neck …. the extortionist ‘mandate’ recinded … PRONTO ! ….

    This household has way higher priorities, then to pay-up, by force, for a shitty ‘product’ !!

    other than that …if you want your less than stellar ‘insurance’ aka deathcare … you can keep it ..and choke on it !

    1. John Zelnicker

      @polecat – If you have a balance due on your tax return that includes the Obamacare “Shared Responsibility Payment” (SRP), you can pay the amount due to your income tax liability and refuse to pay the amount of the SRP that is included. The IRS is not allowed to do anything to collect that SRP amount other than apply future tax refunds to it. For example, if I have a balance due of, say, $1,200, of which $675 is the SRP (Line 61 of Form 1040) and $525 is from my tax liability (Line 56 of Form 1040), I can pay the $525 and there is nothing the IRS can do other than apply future tax refunds, if any, to pay off the $675.

    2. d

      well i guess you dont want to have the ability to buy insurance when you have pre existing conditions. cause that will end up with no insurance at all, or single payer. there are no other options. cause forcing insurers to provide insurance to all, will end up with no insurance companies, or all policies being so expensive none have them. including the employer group market too

      1. polecat

        The ACA is a SCAM …. but I’ll grant you d …. it IS insurance … for the Big Corporate Pooh-Bahs, as well as CONgress …. AND the HIGH COURT, NOT to have to go thru all the hoops,and hurtles, that we, the lumpen folk have to maneuver, while they get their’s ….. I repeat .. ALWAYS ! GETTIN ! THEIR’S !!!! …… which we, as tax donkeys, pay for it……. but yeah … I DON”T want to play this game !!

        1. d

          do you want to pay full price for your health care? cause no matter how they try to sugar coat it, that you can ‘shop around’ for it, most doctors etc have no interest it cutting their ‘standard rates’ for those who come in off the street. and given time, they will eliminate the law(s) that mandate hospitals treat all comers. never mind how drug industry will treat you. cause every companies executives need to have their enormous bonuses. and cutting their prices to you cuts their bonuses. and it used to be that rural doctors would get help with their education, no more of that now

  11. d

    given how the R’s ‘helped’ break the interest of the insures to provide insurance in the individual market, and with T pushing to repeal and replace now, one wonders if the R’s werent working to get a single payer program all along, just in their own way. cause when the repeal happens, and the insurers pull out (unless they get paid off) the entire use the market to fund health care will collapse as a failure as insurers wont buy into that scam again. course BIGP will be out of luck too, as that means the demand for their ‘products’ will collapse (as only those with employer supplied insurance will be able to buying them. and at discounted prices too!) . course what will really hurt will be the collapse of the rural hospitals (which is already happening in states that didnt expand Medicaid) as the hospitals close so that most have to go 100-200 miles to the nearest big city to get care. if they can. so one wonders was this the plan all along? and the GOP has walked right into the trap? of was it just an accident that the D’s didnt do so well? its more likely a failure by both, than planned.

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