Opinion: Spare me the ‘GOP has no Obamacare plan!’ drama

It’s January 10. Do you know where your Obamacare replacement bill is?

No? Well, don’t freak out.

Of course, you are being advised to freak out, mostly by people who don’t want Obamacare to be repealed. They want you to believe that disagreement within GOP ranks about how to go about repealing and replacing the little-lamented law demonstrates a Republican inability or unwillingness to govern. Maybe both.

President-elect Donald Trump leaves a meeting with Senate Majority Leader Mitch McConnell at the U.S. Capitol on Nov. 10. WHY DIDN'T THEY ALREADY HAVE A PLAN??!!?11?!? (Zach Gibson / Getty Images)

President-elect Donald Trump leaves a meeting with Senate Majority Leader Mitch McConnell at the U.S. Capitol on Nov. 10. WHY DIDN’T THEY ALREADY HAVE A PLAN??!!?11?!? (Zach Gibson / Getty Images)

This is, to quote a great man, pure applesauce. “The GOP doesn’t have a plan” might be the silliest talking point the left has about Republicans and Obamacare, and there’s a great deal of competition for that title. What the GOP doesn’t have is unity about which approach to take. This is — for those of you born yesterday — something that happens quite often in legislatures regarding contentious topics.

The aged among you may even recall that Democrats circa 2009 lacked unity about what Obamacare ought to look like in the first place. Would there be a public option? Or only a public option, the dread “Medicare for all”? Would there be an individual mandate? How should it be enforced? Even once these disagreements were mostly ironed out, there were holdouts among the Democratic caucus. There were the now-extinct “Blue Dogs” with concerns about abortion language. It took the “Cornhusker Kickback” to win over Sen. Ben Nelson of Nebraska, the “Louisiana Purchase” to secure the vote of that state’s Sen. Mary Landrieu, and various other carve-outs and slush funds to bring the likes of Sens. Bernie Sanders and Carl Levin on board.

Note that all of this took place months after the inauguration of a man who campaigned on making health reform a priority. I don’t recall any breathless “where’s the plan?” jeremiads before Barack Obama had even taken the oath of office.

Yet, 10 days before Donald Trump succeeds him, that’s what we’re getting about the lack of a concrete plan. The critics contend congressional Republicans have had seven years to come up with a plan, which is true as far as it goes. Then again, not all congressional Republicans have been in office the past seven years — and those who have been there, at least for part of the time, have come up with plans, some of which are still being considered. Let’s also not forget the biggest newcomer to Washington of all, the one who not only is essential to repeal and replace but whose approval of the eventual plan is mandatory because he will be associated with it until the end of time, is Trump himself.

There never was “a” Republican plan the past seven years because there was no Republican president. Whenever a Republican president was elected, that person was going to demand to have a lot of input into the process, and rightly so. There was never going to be “a” Republican plan without that person.

And that person, Trump, won’t be president for another week and a half. He campaigned on repealing Obamacare and replacing it, didn’t offer much in the way of details for how he’d accomplish that, and won anyway. It can hardly be shocking that he and the new Congress have not yet hammered out what they want to do.

Nor is it particularly surprising that those who are dedicated to stymieing Trump’s presidency are at pains to claim he and the GOP are already in disastrous disarray. Newsflash: If Trump and Congress did already have a plan, the very same critics would be saying it was a slapdash arrangement created in haste — and that this also proved Trump and Congress were incapable of governing.

It’s possible the president and Congress won’t be able to agree on a plan, which certainly would spell doom for the Republican Party. But the fact they don’t already have one as they’re just getting started is not cause for alarm.

Reader Comments 0

174 comments
ATLAquarius
ATLAquarius

Also are the Republicans truly willing to let the free market run its course with regards to healthcare? At the very least they should allow Medicare and Medicaid to start negotiating drug prices as a sign of good faith.  

ATLAquarius
ATLAquarius

Ok Kyle there's no bill...but there's no framework either...how can you take 50 repeal votes without even a framework for replacement? Then again the replace part was a newer addition to the equation anyway.  

Caius
Caius

So Trump is upset that someone is trying to question the legitimacy of his presidency by alleging he has secret ties to Russia. Kinda reminds me of the guy who spent 5 years claiming Obama was born in Kenya in order to undermine the Obama presidency.


Sympathy where art thou?


breckenridge
breckenridge

A former British intelligence officer behind an unverified dossier about President-elect Donald Trump fears for his safety, according to a new report.

Christopher Steele, 52, fled his home in Surrey, Great Britain Wednesday as his identify became public, The Telegraph said Thursday.

An unidentified source close to Steele said the former spy was “horrified.”


So it's not fake news? Hmm.  Somebody has some explaining to do.

AndyManUSA#45
AndyManUSA#45

READY FOR WAR 


US Army moves 2,500 tanks, trucks and military vehicles into Europe in the biggest troop transfer since the Cold War



Maybe obozo has gone crazy? Nah, he's just playing politics with the lives of our soldiers, when Trump pulls them back out, the treason media will get to call him a Putin stooge.
I'll be so glad when these children are gone.

https://www.thesun.co.uk/news/2590015/us-army-moves-2500-tanks-trucks-and-military-vehicles-into-europe-in-the-biggest-troop-transfer-since-the-cold-war/

breckenridge
breckenridge

@AndyManUSA#45 

If you would only keep your fingers off the keyboard, then people would only suspect that you are a fool.  However.......

Doom classical lib
Doom classical lib

I really appreciate the way you've screwed over the rest of us who have to pay for your gluttonous lifestyle. "


Ya left out the smokers, the drinkers, the drug abusers, the people who engage in promiscuous lifestyles, and on and on. Feel free to thank them also. 

breckenridge
breckenridge

@Doom classical lib 

Sounds like it's a sensitive issue for you, not to mention it's a feeble attempt at deflection.


The number of smokers has declined in the last 30 years; the number of heavy drinkers has remained constant; on and on and on.  But the number of fat, lazy, stupid southerners driving around rural south in their beat-up old pick-ups (many of which now sport Trump bumper stickers) has ballooned just as their waistlines have.

breckenridge
breckenridge

Well, with the current $6,800 deductibles on many bronze plans I wouldn't be surprised at all. Nor would I be surprised if families who make too much to get a tax subsidy but who can't afford $2,000 a month premiums would go bankrupt if a dread disease hits.

Yeah, dreaded disease.  Actually there is one -  and only one - dreaded disease that has been driving up health care premiums for 30 years.  It's called adult obesity, and 30% of Americans have this dreaded disease.  Nowhere is it more pronounced than in the south, and it is especially prevalent in the rural south.

Thank you some much you fat disgusting slobs.  I really appreciate the way you've screwed over the rest of us who have to pay for your gluttonous lifestyle.

CARMS
CARMS

So, what is the plan?

ByteMe
ByteMe

@CARMS Tax cuts for the wealthy followed by an increase in plague-like diseases among the poor (while telling them it's their own damn fault).

jhgm63
jhgm63

Regardless of what happens, I think we can safely assume that the number one cause of personal bankruptcy in this country will continue to be medical expenses.

Doom classical lib
Doom classical lib

@Starik @jhgm63


I dunno. Maybe you can provide us with facts regarding exactly how many of them owe their wealth to our system of medical care. Be specific, please. And if you can prove that their wealth came at the direct expense of others- zero sum fallacy, then please do so. I patiently await your proof. 

Starik
Starik

@jhgm63 I wonder... how many of the richest 5% in this country owe their wealth to the way this country handles medical care?

Doom classical lib
Doom classical lib

@jhgm63


Well, with the current $6,800 deductibles on many bronze plans I wouldn't be surprised at all. Nor would I be surprised if families who make too much to get a tax subsidy but who can't afford $2,000 a month premiums would go bankrupt if a dread disease hits. The irony of those people footing the bill for everyone else and then not being able to then afford insurance for their own families is quite amazing. 

Doom classical lib
Doom classical lib

@Starik @Doom classical lib @jhgm63


So should Doctors, pharmacies, pharmaceutical companies, medical equipment companies, and for profit hospitals all work for free? Is that your solution? Do they owe you their services at no cost? 

Starik
Starik

@Doom classical lib @Starik @jhgm63 No silly. They should make good money, established by bargaining with the single payer.  Reasonable salaries.  Insurance companies could survive to provide non-essential care, like nose jobs and Viagra.

jhgm63
jhgm63

@Doom classical lib Prior to the affordable care act, most if not all health plans had annual and lifetime caps. Also, this didn't start with ACA. In fact, it was one of the big controversies with the bankruptcy protection act of 2005.

Doom classical lib
Doom classical lib

@Starik @Doom classical lib @jhgm63


For profit hospital profit margins are only about 5%- way below margins for the average S&P 500 company. Big pharma's profit margins are also reasonable. Insurance companies are losing money and pulling out of ACA. So its hard to say they are reaming people if they are in fact losing money. And insurance companies do not provide nose jobs. 


Cosmetic surgery is generally not covered by insurance unless its the result of something like a burn victim. With all due respect you really don't know what you're talking about if you had the idea that insurance pays for non essential items like nose jobs. 


Salaries are in line with many other employment sectors. 


As for CEO pay I remember one time Jay posted a piece deriding the excessive money made by United Healthcare's CEO. He cashed out stock option that he had held for years and made something like 100 million. Excessive the progs screamed. But United insured 70 million members. If you made him give back all 100 million it would have returned a whole $1.50 to the premium paying members of United healthcare. Basically the cost of a soda. So blaming CEO compensation is plainly absurd when breaking down the numbers. And besides, his money was made via stock option appreciation over several years. Not a dime of the stock option money he made came at the expense of premium payers. 


When you look at the facts the CEO pay screwing the premium holders theme is patently absurd. 

Doom classical lib
Doom classical lib

@jhgm63 @Doom classical lib


"Probably".


That's just guesswork. 


From the data I remember a good number of those people already had significant debt before accumulating medical bills. So if you're the kind of person carrying a lot of debt then you're also probably more likely to simply not want to spend the money to buy health insurance. And back in those days if you had health insurance deductibles, coinsurance, premiums, and MOOPs were significantly lower than these days. So its unlikely that medical debt all by itself bankrupted many people- especially those who were carrying insurance. 

scooderpup
scooderpup

No they should not work for free. But we should cut out the middle man. Insurance bankers who take your premiums, extract obscene profits for their ceos, and pay much of your money to lawyers to find ways to not pay for your claims. Single payer like the rest of the world would be a great start.

bu22
bu22

@Doom classical lib @Starik @jhgm63 No, the United CEOs got caught screwing the policy holders and providers by fraudulently refusing to pay or simply making up numbers on what was "customary and reasonable."  They have been sued by a multitude of providers and states.

Doom classical lib
Doom classical lib

@jhgm63 @Doom classical lib


And whatever plan we go to will keep the provision for no lifetime caps. The insurance companies didn't have a problem with it because its negligible. Not all of the law was bad. Some provisions were good. Keep the good and reform what didn't work. 


One other thing. I did some reading on the medical bankruptcy thing. Fact of the matter is that much of the time when medical bills were cited as a cause there was also a great deal of other debt such as credit card debt in addition to medical bill debt. The idea that medical bills alone bankrupted large numbers of people is a myth. 

SGTGrit
SGTGrit

Shameful the attack on AG nominee Jeff Sessions. Cory Booker, a 2020 hopeful for the Democrat presidential nomination went on with nothing more than a senseless rant against Sessions without any substantive evidence to back up his words. He was followed by the old race baiter John Louis, who did nothing but lament segregation in the South and did nothing other than identify Jeff Sessions who grew up at the same time in the South as unfit only because Sessions is White. Didn't watch the third so called testifier against Sessions, because he started out even worse than his asinine predecessors. What trash these people are but were overshadowed by Black supporters who articulated their support of Sessions with facts and personal experience.

breckenridge
breckenridge

@SGTGrit 

Sessions is weak on the 1st Amendment Establishment Clause.  The last thing we need in this country is an AG who is sympathetic to the right wing evangelical manure and their traitorous agenda.

Doom classical lib
Doom classical lib

@SGTGrit


Yep. The Dems had absolutely nothing of substance to complain about Sessions. I was shocked that all they had was to complain about him being a white guy growing up in Alabama. The Democrats are absolutely shameless. 

stogiefogey
stogiefogey

I'm not an actuary, don't play one on TV and don't stay at Holiday Inn Express but I do have enough education and business experience to know that providing health insurance coverage for pre-existing conditions is an unworkable model. Try, e.g., filing a claim with Allstate for a car accident you had two years before becoming a policyholder.

Unless, that is, you unrealistically count on massive ad infinitum subsidies to support the program...which presupposes never ending "progressive" government...which in less than two weeks will be no more. 

MarkVV
MarkVV

@stogiefogey "Unworkable model:" Another expression for "let them go bankrupt or die."

Starik
Starik

@MarkVV @stogiefogey Unless we establish a nationwide health insurance system, or a government run system, where everybody contributes to the national medical expenses...

Doom classical lib
Doom classical lib

@MarkVV @stogiefogey


There's no free lunch Mark. When you have coverage for pre-existing conditions rates are going to be higher- much higher. There's no way around it. 

CARMS
CARMS

@stogiefogey You make no sense.  Someone with a pre-existing condition isn't trying to make a claim.  They are simply insuring themselves should something occur.  If I took insurance with BCBS, I would not be trying to make a claim, I would....now get ready......be getting insurance (not trying to get money for something that already happened).  

Doom classical lib
Doom classical lib

@CARMS @Doom classical lib @MarkVV @stogiefogey


Sorry but I've never seen someone dropped from their insurance retroactively unless they lied on their insurance application or if they had a pre existing condition for which a reasonable and prudent person would have known existed when they applied. Besides, the pre-existing clause is going to be kept anyway. The point simply is that its going to cost money and that there is no way around that. 

Starik
Starik

@CARMS @stogiefogey Pre-existing conditions means something has already happened, with worse to come - that's why the private sector doesn't want to insure you.

bu22
bu22

@stogiefogey Yep.  You're not an actuary.  A lot of the issue with pre-existing conditions is that people do have coverage and can't change jobs because of those conditions.  Its simply shifting the coverage from one plan to another.

MDK2014
MDK2014

@CARMS @stogiefogey People with preexisting condition/recent diagnosis purchase insurance when they find out the cost of drugs or surgery/treatment that is needed outpaces the cash they were willing to forfeit under the self insurance option. Totally not a workable model.  You can't buy life insurance to care for your family when you tell the company you are dying of cancer, you can't buy flood insurance when the weather report predicts floods in the next 30 days, you can't buy home insurance when the weather reports are warning of hurricanes...let's be real people!  Insurance works when everyone participates...the claim free pay for the claims...if the claims prone overuse, the insurance rates skyrocket or the coverage is cancelled. A fairly simple model.  I always ask if no caps and pre-existing conditions models are so good, why didn't the insurance marketing people see the benefit and do it before the mandate?  How does a company set rates without knowing the cap of how much they are offering to pay individuals or families?  Just about every other insurance product is rated by knowing the risk amount and the frequency of claims?  

SGTGrit
SGTGrit

Must commend Jay Bookman, whose been an unrelenting critic of president elect Donald Trump, but none the less condemned the false reporting of buzzfeed among others for their unverifiable hit on Trump's patriotism. This hit was also a hit on our country.

Starik
Starik

"Little lamented law?" Not by the people who wouldn't otherwise have insurance.

lvg
lvg

Andy Man a/k/a Putin lover :

"When Putin has done as much damage to this country as obama has, be sure to get back to me."


List  all the alleged damages the Black guy from Kenya is responsible for and then list all the accomplishments.




AndyManUSA#45
AndyManUSA#45

@lvg Dead troops at the VA is #1 on the list. Wasted lives in Iraq and Syria is #2. Putin hasn't killed nowhere near as many US soldiers as obama has.

Starik
Starik

@AndyManUSA#45 @lvg Most of the killing in Iraq and Afghanistan are the sole responsibility of Bush.  The VA either needs much more funding, or go back to restricting VA care to people with service connected problems.

AndyManUSA#45
AndyManUSA#45

@Starik @AndyManUSA#45 @lvg obozo surrendered in Iraq and left a void where Bush had left victory. isis filled the void left by obozo. End of story.


Barack Obama says VA budget has risen 85 percent on his watch


When Putin has caused as much damage to this country as obozo has, be sure to get back to me.

Starik
Starik

@AndyManUSA#45 @Starik @lvg Some victory. ISIS one the one hand and Iran and the other. ISIS began, under various names, when Bush-the Lesser abolished the Iraqi army.