Obamacare Repeal Moves Steadily Forward
David Catron
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Last week, while most of Washington obsessed over the self-serving cavils of a cashiered federal bureaucrat, Senate Republicans focused on a project much nearer to the hearts of the voters — repealing Obamacare. And the GOP made significant progress in that effort. The Senate parliamentarian ruled that repeal can be passed via reconciliation and Majority Leader Mitch McConnell fast-tracked the process by invoking “rule 14,” which permits the Senate to skip laborious committee hearings that Democrats planned to use for protracted grandstanding. Meanwhile, moderate Republicans are coming around on proposed changes to Obamacare’s Medicaid expansion about which they had expressed reservations.

The ruling by the Senate parliamentarian, Elizabeth MacDonough, was crucial to the GOP plan to get “repeal and replace” done quickly. Thus, the Republican Conference breathed a sigh of relief when Senate Budget Committee Chairman Mike Enzi announced MacDonough’s thumbs up: “The health care bill passed by the House of Representatives, H.R. 1628 — the American Health Care Act of 2017 [AHCA], providing for the repeal and replacement of Obamacare, complies with the Senate reconciliation process.” The use of reconciliation for repeal and replace has been denounced by the Democrats, of course, but they used it themselves to pass Obamacare. Senator Enzi’s announcement provides a summary of how it works:

After the House transmits H.R. 1628 to the Senate, the Senate Majority Leader will have the ability to bring up the legislation under the provisions of reconciliation, which include: a non-debatable motion to proceed that only requires a simple majority vote; no filibuster; time limits on overall debate, amendments, and motions; and adoption of the legislation by a simple majority vote. As well, there are strict parameters for contents of amendments, including the Byrd rule and compliance with various budget restrictions.

It goes without saying that the Democrats are in denial about the parliamentarian’s ruling. The ranking member of the Budget Committee, alleged Independent Bernie Sanders, has already claimed that MacDonough didn’t actually say what she said: “The parliamentarian has ruled in favor of the Republicans on one narrow procedural issue, but it remains to be seen whether the House-passed bill qualifies for reconciliation in the Senate.” The Democrats will hang their hat on the “Byrd rule” mentioned in Senator Enzi’s announcement, which prohibits provisions unrelated to the federal budget from being included in a reconciliation bill. Sanders, et al., will no doubt claim that every provision of AHCA is precluded by the Byrd rule.

But the real fireworks will involve McConnell’s implementation of Rule 14, which will speed repeal along by eliminating committee hearings at which the Democrats would like to engage in the usual sanctimonious posturing combined with portentous predictions of death and destruction. Indeed, the posturing has already begun. Last Thursday, Missouri Democrat Claire McCaskill attacked HHS Secretary Price and Senator Orrin Hatch over the absence of transparency that has allegedly accompanied Republican repeal efforts. McCaskill even had the crust to compare the repeal and replace effort unfavorably to the Obamacare deliberations whose success Jonathan Gruber famously (and accurately) attributed to a premeditated lack of transparency.

Let me just say, I watched carefully all of the hearings that went on [when the Affordable Care Act was crafted]. I was not a member of this committee at the time, although I would have liked to be. [Republican Sen. Chuck Grassley of Iowa] was the ranking member. Dozens of Republican amendments were offered and accepted in that hearing process.

The “news” publications that gleefully reported this melodramatic performance made much of Senator Hatch’s “befuddled” expression. It isn’t difficult to see why Hatch was confused. The Obamacare deliberation process that Senator McCaskill described has no connection with what actually happened in 2009 and 2010. Her remarks constitute a work of exceptionally bad fiction. The reality, of course, is that the big government boondoggle that she calls the “Affordable Care Act” was deliberately crafted behind closed doors in the vain hope that the voters wouldn’t find out about corrupt bargains like the “Cornhusker kickback” and the “Louisiana purchase.” Finally, she turned her well-rehearsed outrage on Secretary Price:

And when you say that you’re inviting us — and we heard you, Mr. Secretary, just say, “We’d love your support” — for what? We don’t even know. We have no idea what’s being proposed. There’s a group of guys in a back room somewhere that are making these decisions. There were no hearings in the House. I mean, listen, this is hard to take… We’re not going to have an opportunity to offer a single amendment. It is all being done with an eye to try to get it by with 50 votes and the vice president.

Senator McCaskill, having thus demonstrated that Majority Leader McConnell was right to invoke Rule 14, closed her remarks with a lament about his alleged failure to follow “regular order.” That will no doubt bring copious tears to the eyes of everyone whose health insurance premiums have skyrocketed under Obamacare. Meanwhile, McCaskill and the rest of the Democrats face a far more ominous threat — Republican “moderates” are finally developing spines. Roll Call reports, “Moderate Republicans on Thursday said they were getting closer to supporting an emerging Senate health package.” The major issue for these Republicans is the speed at which Obamacare’s Medicaid expansion is tossed onto the ash heap of history.

In other words, the Republicans are only a few modified provisions from a bill that will satisfy the concerns of the party’s moderates and meet the requirements of the Senate parliamentarian. Next week they will seek a score from the Congressional Budget Office. When that largely symbolic exercise is complete, the Senate leadership will start counting the votes. When the whip count reaches 50 or more, as it probably will before July 4, the Obamacare repeal and replace bill will go to the floor where no Republican senator will risk her career by casting the vote that prevents it from reaching President Trump’s desk. There will be no braying about “Obamacare Lite,” only a struggle to get in the shot when he signs the bill into law.

David Catron
David Catron
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David Catron is a health care consultant and frequent contributor to The American Spectator. You can follow him on Twitter at @Catronicus.
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