I've seen better rollouts than the one House Republicans gave us last week on the bill to replace ObamaCare. It pleased almost no one, and left a lot of people totally confused about the process that has to happen over the course of the coming months.
One thing Republicans have to remember is that the media will not help them by explaining to the public what they're doing. If they leave out a detail, the media will not fill it in for them. Quite the contrary, the media will be only too happy to present the public with an incomplete, confusing, misleading picture of what the Republicans are doing and let them twist in the wind dealing with the consequences.
What Kathleen Sibelius had the power to do, Tom Price now has the power to undo
That's what happened with the House GOP's unveiling of the American Health Care Act. They forgot to tell us it's only the first phase of the process, so conservatives were left to wonder what in the world happened to free-market reforms, selling insurance across state lines and all kinds of other things the Republican Party has been saying for years it would do with health care if given the chance.
Where were any of these things? The ObamaCare taxes and subsidies were gone, which was good. But without the other market reforms, how we were we going to afford these tax credits they wanted to put in place?
As Dan explained a few days ago, the House bill is only the first step--the legislative changes that can be done via the reconciliation process. There is only so much that falls under that category. They can do the actual repeal of ObamaCare, and they can address spending and tax issues. That's because Senate rules allow a simple majority vote on these issues.
There are other elements of ObamaCare that were accomplished via regulatory edicts of the Secretary of Health and Human Services, which at the time was Kathleen Sibelius. What Sibelius had the power to do, Tom Price now has the power to undo. And he will. That will be Phase 2.
Phase 3 will be the hardest phase to accomplish. Assuming the filibuster remains in place in the Senate
Phase 3 will be the hardest phase to accomplish. Assuming the filibuster remains in place in the Senate, it will require at least eight Democrat votes to pass the reforms contemplated in this phase--and that assumes all 52 Republicans hold together. That's going to be hard to get.
You might be able to get eight Democrats to support, say, selling insurance across state lines -- since it's hard to see why anyone really objects to that. But if you want to eliminate regulations on, say, pricing of policies for people with pre-existing conditions . . . that's going to be a very heavy left.
Some of this might get done in ways conservatives don't like. A wavering red state Democrat who's up for re-election in 2018 (and there are a lot of those) might be persuaded to go along in exchange for train station or a beautiful new park in a big city in his state. These are the kinds of deals that make conservatives' guts wrench. But when you need 60 votes, you might have to choose between that type of shameless giveaway and leaving a very bad element of our health care system in place.
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What matters is not how fast we do it. It's how well we've done it once it's all done
The more Republicans want to deregulate the health market, the harder it gets to make that succeed in Phase 3, which is why we should all hope Secretary Price can accomplish as much of this as possible in Phase 2.
But for the moment, people need to take a chill pill about this. As much as we'd love to transform American health care from the big government nightmare of ObamaCare to a free-market dream in a matter of a few weeks, it's simply not possible for it to happen all at once like that.
Settle in. Pay attention. And try not to overreact when you hear things. What matters is not how fast we do it. It's how well we've done it once it's all done. And that will take awhile. It's simply the nature of these things.
