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Tag Archives: Health Care
There is an old saying that a week is a lifetime in politics. In most weeks, there is a lot happening either behind the scenes or at lower levels (e.g., committee hearings and markups on bills that nobody is watching). It is the rare week, however, that so much is taking place front and center competing for the attention of the American public.
The big story of the week was the non-vote on and the collapse of the Republican effort at major health care reform — the so-called Affordable Health Care Act (a name that in itself was an attack on the bill that it was trying to “repeal and replace,” the Affordable Care Act. There are several significant aspects to this non-event.
First, despite their efforts, Donald Trump and Paul Ryan could not get the sizable Republican majority in the House to pass a bill (forget the exact details of the last version of the bill, they could not get a majority behind any version) on one of the top Republican priorities of the past seven years. While Trump may have been a great negotiator, it is very easy to reach a two-sided deal. (Of course, it’s possible that Trump’s belief in his negotiating skill may be one of his great delusions. He may have just been offering the right deal at the right time and actually have been taken to the cleaners in his business negotiations.)When you have three or more sides to a deal, however, it becomes very difficult to keep everybody on board. This problem is particularly true in politics — when one faction thinks that a bill is too conservative and the other faction thinks that the bill is too liberal, there really isn’t any change that could make both sides happy. At that point, it’s not really about negotiating but selling.
While November was disappointing, the Democrats did gain seats in the Senate. As a result, the Republicans only hold a 52-48 majority. If three Republican Senators vote no on any confirmation or bill, it fails. We are already seeing signs that the next two years could get very interesting — even if the Democrats are more responsible in using the filibuster than Republicans were.
Right now, the Republicans want to repeal the Affordable Care Act. The Republicans have never been able to exactly what they don’t like about the Affordable Care Act other than that it was passed by a Democratic President and a Democratic Congress. For seven years, the Republicans have been asserting the need to repeal and replace the Affordable Care Act. While the Republicans have been relatively unified on their desire to repeal the Affordable Care Act, they have never been able to reach a consensus on how to replace it.
For the third time in four years, the fate of the Affordable Care Act rested with the United States Supreme Court. Early this morning, by a 6-3 vote, the United States Supreme Court kept the Affordable Care Act (and the health insurance industry) alive. If you look at all three case over the past four years, the key votes on the Supreme Court have belonged to the two pro-business conservatives (Justice Kennedy and Chief Justice Roberts). The remaining justices have been predictable — the liberals supporting the Affordable Care Act and the three ultra-conservatives opposing. If the past is any predictor for the future, any remaining challenges to the Affordable Care Act may rise or fall on what’s good for business.