Congressional Democrats will soon likely be on the horns of a dilemma. It appears as of today that the Republicans in The House have finally understood their situation and, after making a minor adjustment to their repeal of Obamacare and replace it with Trumpcare bill relative to insurance for pre-existing conditions, are on the brink of passing their own healthcare legislation. The bill will then go to the Senate, which will produce its own version of the bill--or not--and then into consideration by a conference of Congressmen and Senators. It's the "or not" part that constitutes the dilemma.
For a bill to pass in The Senate, the Democrats have to refrain from filibustering, which they need only 40 of their 48 Senators to do. They could thus kill the bill and preserve the ACA...Obamacare, but if they do, the Republicans will capitalize on the filibuster and blame the Democrats for preserving what they have characterized as economically deleterious and violative of individual rights for the past seven years. Thus, a Democratic filibuster would afford the Republicans an opportunity to satisfy the remainder of their base that objects to the ACA while risking no consequences from passing a bill that threatens to deprive 24 million Americans of health insurance. The Russians call this trying to get out of the water dry. If they filibuster to protect the American people from a deleterious outcome on healthcare, they will be labeled obstructive by the Republicans. But if they don't, their own base will say that while the Democrats could have done something, they chose not to. The Democrats are going to get wet whether they go in the water or not. But there is one way out.
The Democrats have to convince 9 conservative Democratic senators to vote with the Republicans when the Democrats try to filibuster. Their attempt to do so will then be blocked, but all of the Democrats will have satisfied their constituents. The conservatives might even bolster their reelection prospects by joining the Republicans while at the same time, the liberals in the party will bolster theirs by standing for the principle that the plan that gives the most benefits to the most people is the one that should endure. And they could facilitate that tactic by getting just one thing struck from the bill: the provision that will allow states to take on the problem of insuring those with pre-existing conditions themselves. Under that provision, states could establish risk pools to subsidize the elevated premiums that insurers would be permitted to charge under the bill, but in almost half the states, they can't even get Medicaid expansion passed, so what's the likelihood of subsidies for those in need. If that provision were struck from the Senate version, even though the other objectionable provisions--subsidies for older people rather than needier people and repeal of minimum coverage requirements for all health insurance policies to name just two--the bill would go back to The House and face the "Freedom Caucus" all over again because if changes are made in conference, a new vote has to be taken in The House. Then, the Republicans could either pass a bill that would alienate those 24 million people, or they could scrap the whole thing and go back to square one.
So, in the end, this bill that we might as well call Trumpcare will be either one more tactical victory for the Republican Party or it will be the petard by which they hoist themselves, as Shakespeare would put it. Which it becomes will depend on the ability of the Democrats to find a way to escape the trap that is now being laid by the Republicans, and to be blunt about it, the Democrats have been tactically outmaneuvered by the Republicans over and over again since the 2016 election. What are the odds?
Your friend,
Mike
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