Even the Republicans must realize the political fallout will be disastrous for them. They have no choice but to fix it or lose The House majority in 2018.
Imho There’s no going back. The public expects affordable health care coverage for everyone. The public won’t accept anything less.
You have a higher opinion of the public than I do. Many of them have seen their rates go through the roof and the quality of their insurance decline. Many of them voted for various Republicans, including Trump, in the expectation that the ACA would be repealed. I expect we’re going to see some major changes; not as much as the President wished for but enough to rename it to something other than Obamacare and life to go on in the general mess the United States often suffers from.
It’s a game of chicken now. The Republicans will wait for it to “explode” so they can say I told you so. The Democrats will blame the Republicans for failing to lead by letting it fail and will offer compromises/fixes if the repeal threat is taken off the table.
So now we wait for ACA to “explode”.
Does anyone know how the ACA is doing in states that embraced it? Is it in free-fall in California? New York?
Are the republicans going to be in the position of pointing to ACA failures only in the red states that didn’t cooperate with ACA while the democrats will be in the position of saying too bad for you folks?
I get that ACA isn’t doing as well as expected anywhere, but I don’t think it is collapsing in all areas of the country. Anyone know?
I created a new thread in GD without realizing this was here.
Personally I think there are enough of the more centrist Republicans, and those who actually care about their constituents, that a bipartisan bill to help the ACA to work better could pass both the House and the Senate, and if Trump vetoes he, and the GOP, then completely owns.
Lindsey Graham and others are certainly calling for that working together …
Trump and company will do everything in their power (and that is a lot, including failing to appropriate money to run it) to make it fail and then say, “I told you so”. As for enough Republicans who care enough about their constituents to actually do anything for them, the very idea is risible. Unless you are talking about their real constituents: the ones that contribute to their election campaigns.
For the sake of discussion let’s go with that. For this issue who are those ones and what do they want?
The insurance companies don’t want the public option to be sure but they do want a predictable market environment and for an exchange marketplace that has plenty of healthy people in it and thus premiums low enough that plenty are in it period, as opposed to uninsured. More covered means more profit.
Likewise big pharma wants the exchange marketplace to work as it gets more covered with those more covered getting more prescriptions.
Hospitals and medical groups also want to see the exchange marketplace work.
Oh the Koch brothers are funders who’d like to see the ACA completely collapse (and have promised to back those who voted against Trumpcare as it was, to them, Obamacare 2.0) but they are not backing these more centrist Republicans anyway. These are the 50 house members who make up the center-right “Tuesday group”, the so-called mavericks, those in districts that HRC won, and a few scattered others.
No, I don’t think the relatively moderates of the GOP will sign onto a public option (which would make the most sense), but trying to actually make the exchange system viable? Well those who contribute large to them will want them to. And on the Democratic side I think even the Warren/Sanders faction would accept that for now.
This first attempt clearly shows the Republicans are too divided on health care to pass anything alone. This is one of those times it’s going to require working with some of the Democrats.
I think Trump needs to pull a page from Bill Clinton’s Presidency. Create a bipartisan panel that includes members of Congress and experts from various areas, Doctors, Hospital Administrators, Insurance etc. Spend time studying health care and figure out what works in ACA and what is broken. Come up with solid recommendations to fix it.
Then publish it. Pointing out what works and what requires fixing. Build a PR campaign of support so Congress feels politically compelled to enact the new legislation.
Somewhere in all my old boxes of books, I still have the published book from Clinton’s health care panel.
Imho the key is to get a new plan thoroughly prepared and published. Get it on various web sites and explain it to the public. Get all the network commentators discussing it.
That way any scare tactics or other misinformation can be shot down. Here’s the report, here’s exactly what will happen.
Now contact your Senators and Representatives, tell them this is what we want enacted.
That should build enough bipartisan support to pass it over the hardliner’s objections.
I honestly don’t know. Trump likes working outside the system. Likes talking directly to the public. He could be very effective if he took this approach.
Trump may not even remember President Clinton’s health care panel. He may take an entirely different approach.
Clinton had a great idea. Might have worked if there had been anything to build on. They were trying to create universal health care from the ground up.
AHC has been in place for quite awhile. It’s a good foundation to build on. Fix what needs fixing.
Everyone is worried they’ll fuck it up. It’s going to be difficult building support for any new plan.
The Republicans will do what they can to get the individual market to go into a death spiral. It probably will. What happens after that is anyone’s guess and depends on who wins the political blame game.
On the other hand, the Medicaid expansion is likely to remain, and I can imagine a few states that haven’t yet expanded it might do so.