# What is the GOP's endgame with the American Healthcare Act? **URL:** \ **Category:** Politics & Elections\ **Created:** [March 10, 2017, 9:20pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904 "2017-03-10T21:20:45Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [March 12, 2017, 6:07pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/41 "2017-03-12T18:07:03Z")
> [@DinoR](#): > > IMO the endgame is to walk the line between the “repeal and replace” talking point and the fact that they can’t get anything too extreme through a Senate filibuster. Filibuster? I thought the ACA repeal was a “reconciliation bill”(\*) not subject to filibuster. I agree that having their great effort fail due to a Democratic filibuster would be the win-win situation for the R’s. Keep their promise and rely on the D’s saving them from their own inanity. _If_ a filibuster opportunity arises, what should the D’s do? One might imagine a very high-stakes game of “chicken” playing out. - - I don’t understand what a “reconciliation bill” is or why it’s not subject to filibuster. I think budget bills that cut spending are given this privilege — is it up to the Majority what add-ons can be included in such a bill? Is there a long history of such filibuster-proof “reconciliations” or is this a new abuse? But I suspect **DinoR** is right: the R’s will drop the “reconciliation” pretext, encourage D’s to block the repeal (or parts of its replacement), then say “We tried to save the country but the DemocRats wouldn’t let us!” ---
**Author:** ![TreacherousCretin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/treacherouscretin/32/476_2.png) [@TreacherousCretin](https://boards.straightdope.com/u/TreacherousCretin)\ **Post date:** [March 12, 2017, 6:58pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/42 "2017-03-12T18:58:28Z")
> [@ThelmaLou](#): > > I think it’s crystal clear that their endgame is for the rich to get as rich as they possibly can, and for old, sick, poor, and disabled people to stop being so much trouble and die already. Preferably BEFORE they have any expensive medical procedures or nursing home care. This goes for sick babies, too. Unwanted babies who are born because of no affordable birth control or abortions-- well, they’re no problem, as long as they die AFTER they’re born. Dying before they’re born-- BIG no-no. That must be prevented no matter what! Conservatives believe that life begins at conception and ends at birth. (Barney Frank) ---
**Author:** ![Johnny\_Ace](https://avatars.discourse-cdn.com/v4/letter/j/6bbea6/32.png) [@Johnny\_Ace](https://boards.straightdope.com/u/Johnny_Ace)\ **Post date:** [March 13, 2017, 3:25am UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/43 "2017-03-13T03:25:12Z")
> [@septimus](#): > > - > - I don’t understand what a “reconciliation bill” is or why it’s not subject to filibuster. I think budget bills that cut spending are given this privilege — is it up to the Majority what add-ons can be included in such a bill? Is there a long history of such filibuster-proof “reconciliations” or is this a new abuse? Reconciliation bills are compromise bills between those that are passed in the House and those in the Senate. Bills are often passed in different forms (for instance, with different amendments) in each house, so they need to be ‘reconciled’ into one which both houses can agree to. The ACA wasn’t subject to filibuster because it was activated via executive order. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 13, 2017, 3:57am UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/44 "2017-03-13T03:57:44Z")
That’s not reconciliation, that’s a conference committee. Reconciliation is a process by which bills can be passed with a simple majority as long as they only affect the budget, and the bill must not increase the deficit outside the 10-year window. That’s why the Bush tax cuts sunsetted after 10 years. Since you can’t have the GOP ACA replacement sunset, their bill cannot add to the deficit at all. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [March 13, 2017, 5:39am UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/45 "2017-03-13T05:39:04Z")
> [@TreacherousCretin](#): > > Conservatives believe that life begins at conception and ends at birth. (Barney Frank) Shortly thereafter, when they got big enough to follow you around begging for food and money. ---
**Author:** ![septimus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/septimus/32/410_2.png) [@septimus](https://boards.straightdope.com/u/septimus)\ **Post date:** [March 13, 2017, 3:06pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/46 "2017-03-13T15:06:12Z")
> [@Johnny\_Ace](#): > > Reconciliation bills are compromise bills between those that are passed in the House and those in the Senate. Bills are often passed in different forms (for instance, with different amendments) in each house, so they need to be ‘reconciled’ into one which both houses can agree to. The ACA wasn’t subject to filibuster because it was activated via executive order. That may have been the original definition of “reconciliation bill,” but it seems extended beyond that. In your model, the ACA repeal would have to pass the Senate (presumably with 60 votes) before it could be “reconciled.” But I see on the 'Net that this ACA-repeal “reconciliation” will bypass any Senate filibuster. My question is: How recent is the development of such “reconciliations” to pass a bill with 50 votes instead of 60? As for the 2009 Affordable Health Care for America Act itself, I thought it was rather famous that it passed on Christmas Eve, _ **needing 60 Senate votes** _. (Al Franken was kept from voting until July due to GOP malice. By the time Franken was sworn in, Ted Kennedy was too ill to cast the 60th vote. The GOP departed from tradition and insisted that Kennedy would not be “paired” — if he wanted to cast his vote, he’d need to be taken by ambulance to the Senate floor.) ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [March 13, 2017, 4:23pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/47 "2017-03-13T16:23:20Z")
> [@ElvisL1ves](#): > > The OP is curious about the GOP end game. I don’t think they have one. It’s all about getting re-elected, and that means pandering to ignorance and hate, such as by demonizing and opposing any Democratic initiative. They’ve never before thought about anything more than that, and certainly not what they would do instead. This is what happens when the barking dog finally catches the car. > > So, they’re trapped now into having to follow through on enough to keep both their electoral base and their corporate employers happy, and Republicare (Trump has had nothing to do with it so far; don’t put his name on it yet) is the result. Worse, their electoral base wants to both have and repeal health care, so what are they gonna do? _Lead_? 🙂 > > No new chapters of _Profiles In Courage_ are being written today; that’s for sure. Yes, this is it. ACA or single payer is basically the only real way that healthcare can work. Everyone hates the mandate, even Obama ran against Hillary on a platform rejecting the mandate but changed his mind when he took power and realized that that was the only way it could work. Depp down the Republicans know this is true but saw political advantage in railing against it. By doing so they achieved their goal of taking all branches of government. At this point what they would really like would be for healthcare to simply disappear as an issue, but unlike Obama they made their opposition the center piece of their campaign and so they can’t ignore it and hope their constituents would forget about it. So their endgame now is to tread water to keep their head above water for as long as possible. There is no plan that the Republicans can unite behind because the right wing of the party won’t accept anything that even resembles government involvement in healthcare while the moderate side won’t accept anything that starts killing off their constituents. So the best they can hope for is to try to look busy. Best case scenario, they debate the issue at length but can’t get anything passed and so Obamacare sticks around as the status quo and they continue to rail against Democrats for its failure to change the laws of economics. Worst case scenario, is that in an effort to look like they are doing something they unite around the one goal that they all agree on (at least rhetorically) and repeal Obamacare, with perhaps a 2-4 year delay to get them through the next election, with a hope that in that time they will figure a way out of this mess. They might even play it up like they did with the sequester saying that giving themselves a countdown to doomsday is just what they need to reach a consensus. But as with the sequester, when that time expires, and no passable alternative is identified the poor and sick are all up shit’s creek. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [March 13, 2017, 4:54pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/48 "2017-03-13T16:54:57Z")
They will have access to a paddle. No one will stop them from buying a paddle. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [March 13, 2017, 6:05pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/49 "2017-03-13T18:05:45Z")
GOP’s endgame with respect to healthcare: 1. Ensure wealthy donors get to keep more of their money 2. Pay for this by removing “entitlements” to healthcare from greedy poor and middle class 3. Make up crap about the new plan - you just need 25% of the public to believe you 4. When it all blows up, find a convenient scapegoat. Blame Obama. Trump’s endgame with respect to healthcare: 1. Make more money for Trump 2 There is no #2 ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [March 13, 2017, 6:43pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/50 "2017-03-13T18:43:44Z")
I think the Republicans in Congress got caught by surprise. They were expecting Hillary Clinton would win the Presidential election. Then they could have just enacted a plan that benefited the special interests. And when the bills arrived, they’d have told people “Don’t blame us. All the stuff you don’t like is Hillary’s fault.” But Trump won and now they don’t have a scapegoat at hand. They have to come up with a plan that will actually work and that plan doesn’t exist. They can’t give their voters the low cost health care coverage they feel entitled to while also giving their donors the profits they feel entitled to. Especially when both the voters and the donors want their taxes cut. ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [March 13, 2017, 6:47pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/51 "2017-03-13T18:47:24Z")
> [@Buck\_Godot](#): > > Depp down the Republicans know this is true but saw political advantage in railing against it. By doing so they achieved their goal of taking all branches of government. At this point what they would really like would be for healthcare to simply disappear as an issue, but unlike Obama they made their opposition the center piece of their campaign and so they can’t ignore it and hope their constituents would forget about it. So their endgame now is to tread water to keep their head above water for as long as possible. > > There is no plan that the Republicans can unite behind because the right wing of the party won’t accept anything that even resembles government involvement in healthcare while the moderate side won’t accept anything that starts killing off their constituents. So the best they can hope for is to try to look busy. I suspect a lot of Republican lawmakers are secretly hoping for something like a natural disaster or a terrorist attack; something that will divert public attention. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 13, 2017, 7:34pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/52 "2017-03-13T19:34:51Z")
I think it’s more the case that this would have been easy had they won the 2012 election. At that point, very little of ACA had taken effect and we would have had a competent, good leader in Mitt Romney who could have actually led and gotten Congress to produce a bill, or even do a straight repeal since no one’s benefits would have been taken away. Once Obama won the 2012 election, this became a lot harder. Electing Donald Trump makes the problem doubly hard, because he’s not leading. This crap bill is a consensus document among the GOP leadership. It’s a compromise that literally no one likes. That doesn’t mean it’s a good compromise in this case either. At this point I almost wonder if they shouldn’t just repeal it totally, stick their middle fingers in the air, lose Congress and the Presidency, and dare Democrats to try to pass something again. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [March 13, 2017, 7:52pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/53 "2017-03-13T19:52:47Z")
It seems to me this bill isn’t designed to be successful on its own, that it would cause disruption is a feature that would be leverage to push other changes. That’s the 3rd part of Ryan’s presentation. ---
**Author:** ![Count\_Blucher](https://avatars.discourse-cdn.com/v4/letter/c/c5a1d2/32.png) [@Count\_Blucher](https://boards.straightdope.com/u/Count_Blucher)\ **Post date:** [March 13, 2017, 8:07pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/54 "2017-03-13T20:07:33Z")
Well, this Administration (and some of the people who support it in Congress) is childish, silly as hell, but dangerously destructive. It acts without thought to its actions… and with no accountability. [TL;DR version](https://www.youtube.com/watch?v=H1uh13Ebzjk) ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [March 13, 2017, 8:35pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/55 "2017-03-13T20:35:56Z")
My favorite moment from the recent confirmation hearings, relevant to the new healthcare bill. > **[Tom Price, Like Everyone, Is Totally Confused About Trump’s Supposed Health...](https://slate.com/news-and-politics/2017/01/the-strangest-moment-from-tom-prices-second-confirmation-hearing.html)** > > Is the Trump administration working on its own Affordable Care Act legislation? Is Trump’s nominee to lead the Department of Health and Human Services,... Ohio Democrat Sherwood Brown, during his questioning time, asked Tom Price whether it was true that " President Trump says he is working with you on a replacement plan for the ACA, which is nearly finished and will be revealed shortly after your confirmation." To which Tom Price replied “it’s true that he said that, yes.” ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [March 13, 2017, 9:17pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/56 "2017-03-13T21:17:11Z")
> [@adaher](#): > > I think it’s more the case that this would have been easy had they won the 2012 election. At that point, very little of ACA had taken effect and we would have had a competent, good leader in Mitt Romney who could have actually led and gotten Congress to produce a bill, or even do a straight repeal since no one’s benefits would have been taken away. > > Once Obama won the 2012 election, this became a lot harder. Electing Donald Trump makes the problem doubly hard, because he’s not leading. This crap bill is a consensus document among the GOP leadership. It’s a compromise that literally no one likes. That doesn’t mean it’s a good compromise in this case either. > > At this point I almost wonder if they shouldn’t just repeal it totally, stick their middle fingers in the air, lose Congress and the Presidency, and dare Democrats to try to pass something again. But the reason the ACA was enacted was because the American health care system was already dysfunctional by 2010. The ACA, while far from perfect, has improved things. If the Republicans try to set the clock back to 2009, they’re just going to demonstrate to the country that they’ve been on the wrong side of the health care issue all along. The Republicans have backed themselves into a corner by essentially promising to deliver a program that will: 1. Provide cheap adequate health care to everyone 2. Allow everyone complete choice on how they participate 3. Generate high profits for everyone involved in providing health care 4. Have minimal government involvement 5. Cost significantly less than past or present programs Sure, those features sound great. But they’re impossible. But by promising them, the Republicans have set themselves up so that anything they deliver will look like a failure. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [March 13, 2017, 9:24pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/57 "2017-03-13T21:24:13Z")
> [@Little\_Nemo](#): > > 1. Provide cheap adequate health care to everyone > 2. Allow everyone complete choice on how they participate > 3. Generate high profits for everyone involved in providing health care > 4. Have minimal government involvement > 5. Cost significantly less than past or present programs > > Sure, those features sound great. But they’re impossible. But by promising them, the Republicans have set themselves up so that anything they deliver will look like a failure. It’s typical of Republicans, though. They want all of the goodies, but they don’t want to take the responsibility to pay for them. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [March 13, 2017, 9:56pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/58 "2017-03-13T21:56:09Z")
This is the problem with not just the party, but the right as a whole. Not enough people really thinking about policy in any deep way. Even the think tanks have been absent on major issues like health care. They are fine on tax policy and education, but if a policy problem leads to an unconservative solution they just wave their hands and say, “private sector”. ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [March 13, 2017, 9:59pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/59 "2017-03-13T21:59:47Z")
**GOP Health Care Bill Could Leave 24M More Without Coverage By 2026, CBO Says** > [@](#): > > The Congressional Budget Office has released a report on the potential impact of the House GOP health care bill. It estimates that the bill would reduce the federal deficit by $337 billion between 2017 and 2026. It also estimates that compared with current law, 14 million more people would be uninsured by 2018, and 24 million more would be uninsured by 2026. > > Just over 28 million Americans were uninsured in the first half of 2016, according to the latest data from the Census Bureau. The CBO estimates that in 2026, there would likewise be 28 million uninsured Americans if the current healthcare laws remained in place. However, 52 million would be uninsured under the Republican repeal and replace plan thus far, also known as the American Health Care Act. > **[GOP Health Care Bill Could Leave 24M More Without Coverage By 2026, CBO Says](https://www.npr.org/2017/03/13/520031463/gop-health-care-bill-could-leave-24m-without-coverage-by-2026-cbo-says)** > > Republicans' plan to replace the Affordable Care Act would reduce the federal deficit, though, according to a report from the Congressional Budget Office. ---
**Author:** ![nate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nate/32/13085_2.png) [@nate](https://boards.straightdope.com/u/nate)\ **Post date:** [March 13, 2017, 10:00pm UTC](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904/60 "2017-03-13T22:00:56Z")
> [@Little\_Nemo](#): > > But the reason the ACA was enacted was because the American health care system was already dysfunctional by 2010. I think people often forget this. It really wasn’t a partisan issue until the democrats started to try to fix things. Everyone agreed that prices were growing and out of control. That people without insurance were using the emergency rooms all medical issues, that people with insurance were going bankrupt due to shitty plans. The democrats stuck their neck out to do something about it and got no support from republicans who felt it would be a political win for them to oppose everything obama planned to do. And unfortunately it was a political win, and now they look like fools trying to come up with a conservative replacement. [Previous page](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904.md?page=2) [Next page](https://boards.straightdope.com/t/what-is-the-gops-endgame-with-the-american-healthcare-act/781904.md?page=4)