HIGH STAKES POKER FOR TRUMP, RYAN AND THE REPUBLICAN AGENDA
The Republican Leadership's idea of a repeal and replace bill on the 7th anniversary of Obamacare (today) wasn’t the best hatched plan as it boxed them into a timeline that wasn’t doable given the amount of work that needed to be done to the bill. A vote on the AHCA was originally scheduled for 7 PM tonight, and that vote has been delayed. The House Rules Committee will charge ahead with a vote tonight potentially setting the framework and the stage for a vote tomorrow morning - or even early next week according to our sources. Notwithstanding the delay, Freedom Caucus Chairman Mark Meadows and his colleagues appear to be holding all the cards (and the Republican party hostage) and as of this writing has displayed optimism that a deal will get worked out.
The question remains is where does House Leadership go from here? Based on Meadows’ recent statement and given the framework under which he is operating there needs to be a safety net for the vulnerable populations while lowering premiums at the same time - a significant move in the right direction and certainly the language moderate Republicans need to hear to stanch the hemorrhaging from that wing of the conference.
If, as we suspect, the final bill will include repeal of Essential Health Benefits, the conventional wisdom is that its inclusion will doom the bill under the Senate rules. The influential Heritage Foundation whose members advised the Trump campaign and worked on the transition team has argued that repeal of all the insurance mandates, including the Essential Health Benefits, can survive because the SCOTUS decision of King v. Burwell virtually requires it. The Heritage Foundation may be wrong but it is worth considering that they are right.
There is a mandatory meeting of the entire Republican conference at the same time as the AHCA vote was to have taken place and you can almost hear the clarion call to all factions of the party to rally around the first major legislative jewel in the Republican crown. We underscore that the implications for Trump’s agenda, Speaker Ryan and the Republican party and the individual health market are so significant that failure isn’t an option. We think Trump, Ryan and McCarthy will find the votes to get them over the finish line - then the hard work begins in the Senate.
Our Senior Health Policy Analyst Emily Evans wrote two pieces today and you can find them both below.
LET'S MAKE A DEAL! ACHA CONTINUES ITS RIGHTWARD PATH AS TRUMP MAKES CONCESSIONS TO FREEDOM CAUCUS: You can find the link here.
ANOTHER QUICK AHCA PRIMER - MEDICAID BLOCK GRANTS TO STATES: You can find the link here.
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