OK, so this has come to pass – Trump has won the election and the Republicans have kept the Senate and the House.
I stand by my earlier position:
If the House Republicans pass a bill to repeal the ACA and it goes to the Senate (and is expected to be signed by Trump), what should the Democrats do to stop the progress? I think they should vote against the bill, but not filibuster, not shut down the government, not do anything drastic.
I say this because elections have consequences and this election was a dramatic repudiation of Obama and his policies. The Republicans and Trump have promised time and again to repeal the ACA, so let them do it. It was one of Trump’s main promises.
With luck, some states will continue to provide exchanges and will maintain the essence of the ACA – everyone has to have insurance, you can’t be turned away for existing conditions, subsidies for those who need it. California, maybe NY, would probably go that way.
Maybe the Republicans will also provide some sort of replacement in the form of tax-deductible HSAs and removing state barriers. Those won’t help many of the people who now rely on the ACA, but it’s better than nothing (barely).
Any further thoughts now that we’re living in the hypothetical that I started this thread with?
Sorry, that’s not how politics work anymore. Obama won, overwhelmingly, in 2012, on the strength of his health care policies, but that didn’t stop the Republicans from trying to overturn it for the next four years. Why should Democrats behave any differently here? What does puling their punches get them, other than more body blows from the Republicans?
The problem is, states depended on the federal money to fund the subsidies and Medicaid expansion. I’m not sure states are going to have an easy time finding the money to continue to keep these plans accessible. I’ve paid anywhere from $56-$123 for my plans through the state exchange, but if I had to pay full price I’d simply have to go without.
Susan Collins has cautioned that this is going to be a very formidable process to do right. If we’d won in 2012, it would be a lot simpler, but now there’s a system in place and there will be serious losers, many of them our own constituents, if we act rashly.
I still favor repeal of ACA, but we have to keep our promises on the replace part and avoid huge disruptions. This should probably be a step by step, bill by bill approach, starting with repealing the insurance coverage requirements. I don’t mean things like lifetime limits or preexisting conditions, but telling insurance companies they have to cover this or that, or that some things have to be free. That would immediately give consumers more choices at less cost, although with the understanding that they get less coverage.
It lets Americans actually experience what they’ve voted for. Did everyone reliant on the ACA vote for Clinton? Unlikely. For some people, it’s literally a matter of life and death, and I’m pretty sure many still voted for Trump. (Genuinely curious – I wonder if there’s a way to track that down)
Sixty million people voted for each candidate. Twenty million people gained coverage because of the ACA (maybe half are eligible to vote? No idea, really).
Another benefit is that maybe the Democrats can break the cycle of obstruction. For the last 20 years, one party ups the obstruction, then the other one matches it, then it gets upped again, then matched again. At some point, the Democrats will again have the House or Senate or Presidency, and if they could point to a real record of bipartisanship, maybe things will go back to more recent historical norms.
(usedtobe, I would love to keep this out of the Pit if possible)
This is a remarkably well-timed thread for me. I just got off a conference call with my partners in a startup. We’re game developers, scattered all over the world- some are in LA, I’m in SLC, and we’ve got others in Germany, Canada, and China. Part of our agreed-upon benefits for everyone in the company is healthcare, but since we’re do spread-out, we’re going to have to set it up so we all buy our own insurance and then get reimbursed for the cost.
One of my partners, though, brought up this point- “If the ACA is repealed, how will those of us with pre-existing conditions get insurance again?” The only answer we could come up with was, basically, “Move to a civilized country.”
Making sure people with preexisting conditions still get health insurance is a high priority for Republicans, although it doesn’t really matter since they can’t legally repeal that part of the law using budget reconciliation.
I think your first sentence is better placed in the other ACA thread, although if you want to make that statement over there, I’d love to see it backed with a cite.
Regarding your second sentence, the point of this thread is whether the Democrats should filibuster any repeal attempts. If they don’t filibuster, the Republicans could pass repeal with a simple majority.
I’m not asking whether they will (they will), I’m asking whether they should filibuster, and how much further should they go – should they shut down the government to prevent repeal, for example?
I think the odds of the Pubs asking the Dems for advice on how to fix the ACA are as close to zero as the difference between 1 and 0.999…, so that’s recommending that the Dems should filibuster.
We disagree on that – at some point, voters have to see the consequences of their actions. But, on this prediction, you’re definitely spot on – the Dems will filibuster.
They have to, otherwise all the sacrifices they made to get ACA into law were for nothing. They’ll lose, but they have to go down fighting, show voters that they stand for something.
Republicans won’t ask them for advice, but assuming McConnell keeps Senate rules what they are supposed to be, they will be free to propose amendments, so some Democratic input could end up as part of the process.