Healthcare: Next Steps

We had our day of glee over the abject failure of the GOP. And let’s recap: they had SEVEN YEARS to come up with a replacement and chose not to. It’s critical to understand why they didn’t, because it affects what we do moving forward. The Republicans never developed a replacement because they don’t want government to have any part of healthcare (or social services of any sort). Their goal is to dismantle not just the ACA, but Medicaid, Medicare and then Social Security. As a side dish – public education, environmental protection, etc. That’s their goal. And when your goal is death, you’re never looking to develop a treatment plan.

The AHCA bill was a tax bill, plain and simple. Its thrust was to create a trillion dollars in savings so that Ryan and crew could enact the tax cut bill they want: without the savings, it will be harder to decrease monies paid by individuals making over a million a year. They’ll likely make some progress, however, on corporate tax dismantling. More on that below.

It went down in flames for several reasons: yes, the protests certainly gave cover to Republican in moderate districts, especially those that Hillary Clinton carried last year. Don’t underestimate that, and DON’T STOP!!! But the overarching reasons are all on the Republican side: they have to do with the Freedom Caucus which stood en bloc in the face of direct threats from the White House. They couldn’t care less what their party thinks of them, they’re not afraid of Trump and Bannon, they don’t even care that much about their constituents. They are ideologues with no understanding of how government functions, only how to stop it. Their goal is NO government, and they’re too stupid to understand that “NO government” is synonymous with “Failed State” and “Anarchy”. In our planning, we need to consider the best ways to leverage them. Remember, this was never going to pass the Senate, and we suspected that when the first draft was published in early March. (See paragraph six in this link.)

We need to understand what they’ll do next to determine what we’re going to do. First, we’ve got time because they’ve got a few other things taking precedence. The debt ceiling passed on 16 March. They only have through 28 April to come up with a new continuing resolution, or government shuts down. This is the next priority because if government shuts, it’s a Republican thing. The GOP always gets, and deserves, the blame, but this time they can’t even last out at the Democrats since they hold majorities. Remember, essential functions don’t stop, so checks still go out, and we can still fly in airplanes…but everything else grinds to a halt. In case you’re ever asked, when the government shuts down and then reopens, employees normally get back pay, and it costs MORE to have shut it down than had they kept it open.

#NotMyCheeto wants to work on tax reform. It’s going to be a heavy lift for him because of the information that comes out daily from the Fourth Estate regarding Deutsche Bank, the bank of Cypress, collusion with the Turkish government and then there’s Russia. Further, missing that trillion from the AHCA kills a lot of what they want to do. But they’re going to go for it because it’s who and what they are.

Back to the main topic. They have some institutional things that they can do relative to healthcare. Remember that legislation isn’t legislation in action until the departments write and implement related rules. Thus, Tom Price has some leverage for what HHS can do relative to rules related to implementation of the current law. It’s normally not that hard to track because they’re required to publish in the Federal Register, allow time for comments, and then have some public discussion. Whether they follow the rules is anyone’s guess. However, I assume that the Fourth Estate will stay on top of this, and there will be an opportunity for all of us to comment. And yes, when the time comes, I’ll tell you how to do so. But that’s the first action item on the agenda: track HHS.

Then, there will eventually be another piece of legislation, and we know what to do about that. We can only do what we can do in our own districts, so one of the things to do at this point is to find areas of agreement on ANYTHING with our local Republican reps to show them we’re willing to work together. That’s how government USED to work. So, for example, Ryan Costello has come out with a list of concerns he has about the upcoming budget — it pays to send nice notes supporting his opposition to changes to education and climate change. It helps later on when you’re on record not singly in opposition to everything he is thinking about. Yes, I’m still committed to seeing him ousted next year, but he is our Congressman in the 6th district. Sending a note saying “thank you” for saying he would have voted against the AHCA is also a good idea (and yes, I’ve sent my note because I don’t ask others to do what I won’t.)

For today, the ACA is still the law of the land, and we should feel great about that. But it’s not the end of the resistance because there are too many other things we need to watch out for. So — keep reading the legitimate press, do some research, keep up with your daily Action Items, and keep up the great work!

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