Washington is a city whose favorite parlor game is recriminations. Last week saw several waves of them. Still, as time passes, everyone begins to move forward. For the Trump Administration and the Republicans on the Capitol Hill, this means that they have to figure out a way to move forward successfully on the Obamacare repeal and replace effort. The brief flirtation of massaging the American Health Care Act (AHCA) and finding the six more votes they need to pass the bill has subsided. This is good because they need a lot more than six votes now to pass the bill.
News on Friday that Anthem is looking to pull back from the ACA's individual insurance markets only solidifies the fact that Obamacare is collapsing. Something will have to take its place because it will not be there in the future to provide health care to Americans.
Let's look at a few of the basics:
* The ACA is not long for this world,
* All Republicans in Washington want to change from the government controlled ACA to a market driven patient-doctor system,
* No Republican has tried to explain to people what a new system of market care based on patient-doctor relationships will look like,
* A reset of the health care message is a prime requisite of moving forward successfully for the White House and Republicans,
* Only President Donald Trump can enunciate this policy,
* Legislation developing this new policy will have some of the features of the AHCA, but will have some distinct differences,
* Since ACA passed in two pieces of legislation, a reconciliation bill and a bill done under regular order, it cannot be repealed and replaced by a single reconciliation bill; it will take some legislation done with 60 votes in the Senate to repeal ACA and develop a new system.
House Republican Members are having informal conversations about the types of ideas that will draw together the 216 or more votes needed to pass the two pieces of legislation needed to repeal and replace the ACA. A more likely scenario for the timing of repeal and replace is by the Fourth of July. Democrats who want to join Republicans in this effort will have to support the fact that the growing government control imagined in the ACA will have to give way to a new market driven, patient-doctor system for health care for all Americans. Look for discussions to continue informally for the next few weeks.
Judge Neil Gorsuch will get a vote on his nomination This week in the Senate. It is still not clear if enough Democrats will join Senators Joe Manchin and Heidi Heitkamp in voting for cloture so that current Senate rules will be followed and Judge Gorsuch will get an up or down vote on his nomination the way all other Supreme Court Justices in the history of the country have been given. If Senate Minority Leader Chuck Schumer and the Democrats in the Senate are successful in the first partisan filibuster of a Supreme Court Justice, then Senator Majority Leader Mitch McConnell and the Republicans will reluctantly take a step to change the precedent in the Senate and allow Supreme Court Justices to have debate ended on their nominations by a simple majority vote – known as the 'nuclear option.' Judge Gorsuch will then be confirmed and take his place on the bench as a Justice of the Supreme Court of the United States.
The big issue facing Congress and the White House upon return from the Easter recess will be funding the government for the last five months of the fiscal year. Discussions are beginning on how to complete that process by midnight on Friday April 28. It may take a couple of short-term CR extensions to get the job done without a government shutdown. Senator Schumer is threatening to shut down the government if he doesn't get his way. Additional supplemental funding for defense and more money to build the border wall will be two of the major issues in dispute.
David Hoppe was Speaker Paul Ryan's Chief of Staff and left his post in the Speaker's Office in January 2017.
