There are precisely nine people standing between you and emancipation from Obamacare’s most reviled and destructive provisions. They consist of an ideologically motley crew of Republican senators who refuse to support the Better Health Care Act of 2017 (BCRA) unless the GOP leadership accedes to demands that are probably procedurally or politically impossible to meet. We’ll call them the “Goldilocks Caucus” because their positions on BCRA are all variations of the “too soft, too hard” principle. Each has stated that, if the final version of the bill isn’t “just right,” they will leave you to the tender mercies of Obamacare.
And the consequences if they remain intransigent? You will continue to pay an annual tax of up to $2,000 if you decline to buy government-approved insurance. You will pay a tax on high medical bills (Obamacare decreed that you can’t deduct medical expenses unless they exceed 10 percent of your adjusted gross income). Your premiums and deductibles will continue to skyrocket. Premiums have doubled under PPACA, while the percentage of Americans forced into high-deductible health plans has jumped by 50 percent. Meanwhile, your plan choices will continue to evaporate as they have since Obamacare was enacted.
These outrages are merely the tip of the iceberg, of course. Yet the members of the Goldilocks Caucus are willing to allow them to continue if BCRA isn’t “just right.” Who exactly are these people? Shelley Moore Capito (R-W.Va.), Susan Collins (R-Maine), Ted Cruz (R-Tex.), Dean Heller (R-Nev.), Ron Johnson (R-Wis.), Mike Lee (R-Utah), Jerry Moran (R-Kan.), Rand Paul (R-Ky.), and Rob Portman (R-Ohio). Because every one of these people is a Republican, it goes without saying that each has repeatedly promised to do anything within his or her power to put a halt to the above-noted outrages, not to mention Obamacare’s countless other depredations.
Indeed, with a Democrat in the Oval Office committed to vetoing repeal, and an election looming on the horizon, all but one of these people (Collins) voted for a partial repeal bill (H.R. 3762). Yet, now that we have a Republican in the White House who is not merely willing but impatient to sign any reasonable Obamacare repeal bill that reaches his desk, the timorous members of the Goldilocks Caucus are prodding BCRA gingerly and gravely pronouncing it too hard or too soft or too big or too wide or too hot or too cold or… whatever they can think of to avoid honoring the pledge they made to their constituents about repealing Obamacare.
Which brings us to their purported reasons for failing to support BCRA. Let’s start with Senator Capito, whose first excuse for balking was BCRA’s inadequate funding for the “Opioid crisis.” When Majority Leader Mitch McConnell addressed that objection, Capito suddenly developed concerns about the bill’s Medicaid funding, none of which seemed to trouble her when she voted for the bill she knew President Obama would veto. Capito announced her refusal to support BCRA in a joint statement with Senator Rob Portman, who has also discovered several concerns that failed to cost him any sleep when he voted for H.R. 3762.
Another member of the Goldilocks Caucus with a newfound concern about Medicaid that failed to bother him when he voted for H.R. 3762 is Senator Dean Heller. The Medicaid funding in the vetoed bill was far more abstemious than BCRA provides, yet Heller cited that as his primary reason for withholding his support for the latter: “This is all about Medicaid expansion… I cannot support a piece of legislation that takes away insurance from tens of millions of Americans and hundreds of thousands of Nevadans.” Kansas Senator Jerry Moran also refuses to support BCRA, but his explanation is a virtually meaningless word salad.
While Heller, Capito, Portman, and Moran regard BCRA as “too hard,” other members of the Goldilocks Caucus regard it as “too soft.” This is “Grandstand Rand” Paul’s position. When President Trump’s understandable frustration with the glacial pace of repeal and replace prompted him to issue this tweet, “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date,” Senator Paul tweeted, “I have spoken to @realDonaldTrump & Senate leadership about this and agree. Let’s keep our word to repeal then work on replacing right away.”
This sentiment was echoed by Senator Ben Sasse (R-Neb.) in this tweet: “Glad you agree, Mr Pres. If no agreement next wk, 2 steps: 1. Repeal 1st; then 2. Spend August full-time on replace.” The problem with this strategy is, if you can’t get 50 or more votes on BCRA, you don’t have a prayer of getting a majority by going nuclear on the filibuster and getting full repeal passed. This seems to be the consensus among senior GOP aides. Presumably, this is why AP is reporting that the Senate Majority Leader is committed to staying the course: “McConnell says the current health care bill remains challenging but ‘we are going to stick with that path.’”
Interestingly, one member of the Goldilocks Caucus whose past relations with McConnell and the GOP leadership has sometimes been less than cordial may be the guy who drags BCRA across the finish line. Senator Ted Cruz has offered an amendment that would allow insurers to finesse Obamacare’s community rating and essential health benefit requirements. These requirements, combined with the “reform” law’s mandate that insurers cover patients with pre-existing conditions, are widely regarded as responsible for the skyrocketing premiums and deductibles discussed above. According to the Blaze, the amendment would work thus:
Cruz’s amendment would let insurers escape these mandates for most of their policies so long as they continue to offer a plan that still adheres to them. This would allow people with pre-existing conditions to continue purchasing insurance at a reduced price (relative to what they would otherwise have to pay), but it would also free up insurers to offer much-cheaper options for those people who are relatively healthy, especially younger people, who have been forced under Obamacare to pay increasingly higher health insurance prices.
If this passes muster under the rules of reconciliation, the arch-conservative Cruz could emerge as the most sensible member of the Goldilocks Caucus, and conservatives like Senators Lee and Johnson would be hard put to undercut the Texas Senator and retain their credibility. Assuming the conservatives fall in line with Cruz, only “moderates” like Capito, Heller, Moran, and Portman can kill BCRA. Either way, the fate of Obamacare and your health care future will be decided by the Goldilocks Caucus.