Tag Archives: Health Care

The Path Forward

Looking at the Republican debacle over Health Care, I was constantly reminded of two things.

First, I keep on thinking of a classic Saturday Night Live skit from their third season portraying Richard Nixon as a vampire-like figure who keeps coming back.  Like Nixon in that skit, just when we think that the Republican efforts at gutting health care are done, they find a way to resurrect the bill.  Since the Senate never actually voted on the final bill (which was put back on the calendar after the substitute amendment failed), it could be brought back to the floor at any time.

Second, I am reminded of Representative Pelosi’s comments while the Affordable Care Act was pending that we would not know what was in the bill until it finally passed.  While Republicans made a lot of hay out of this comment, she was expressing the reality of the legislative process.  Until the vote on the final version of the bill, it is possible that legislators will add new provisions and delete others.  Normally, however, under ordinary process, there is a core of the bill that stays relatively the same.  With this bill, the Republicans have treated the bill as a placeholder.  The message in the House and the Senate has been just pass this bill whatever its flaws and we can decide on the real terms of the bill later.  The concept that the conference committee would write an entire bill from scratch as opposed to merely reconciling the disagreements between the two houses is mindboggling. Continue Reading...

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A June to Remember/Fear?

There are times when, through the normal cycle, and discretionary decisions, events start to come in rapid procession.  June is shaping up to be one of those month between elections (both in the U.S. and abroad), the end of the Supreme Court term, and the matters currently on the plate of Congress.  We have already had the first major event of June — the decision by the Trump Administration to make America weaker by playing to his misinformed base on climate change and withdrawing from the Paris Accords.  It’s almost impossible to count the reasons why this decision is wrong,  here are a few:  1) the agreement was non-binding; 2) being a signator gave us a seat at the table in future discussions; 3) withdrawing makes China and the European Union more powerful; 4) state laws requiring an increasing percent of energy to come from renewal sources are still in effect and will contribute to the U.S. meeting its pledge anyway; 5) the federal courts have held that greenhouse gases are a pollutant requiring federal action under the Clean Air Act (even though the precise terms of the regulations to reduce greenhouse gases are not yet final) which means that we may have to meet or exceed the pledge anyway.

Moving to the Supreme Court, June is looking like immigration month.  May ended with a decision in the first of four immigration cases heard this term.  The case involved what types of sexual offenses against a child trigger deportation hearings for authorized immigrants (e.g., permanent residents).  The Supreme Court narrowly interpreted the statute, meaning that — for some sexual offenses (those that can be committed against a 16 or 17-year old — the first offense will not trigger deportation.  Two of the other three also directly or indirectly concern deportation.  In addition, with the lower courts having barred enforcement of the travel ban, the Trump Administration is asking the Supreme Court to stay those injunctions.  (The real issue is the enforcement of the restrictions on visas and entry.  It is likely that the Supreme Court will grant relief to some overbroad language in those bars that could be read as suggesting that the Trump Administration can’t begin work on revisions to the vetting process.)  There are 22 other cases to be decided this month, so immigration will not be the only big news this month.  And, even aside from the decisions in cases already argued, the Supreme Court will be deciding what cases to take next term and there are some potentially major issues that could be on the agenda for 2017-18.

Moving to U.S. elections, there are still three special elections — all of which will occur this month.  Two — in Georgia and South Carolina — involve vacancies created by the Trump cabinet appointment.  The other — California — arose from a vacancy created by filling the vacancy in the California Attorney General position created when the former AG won the U.S. Senate election last fall.  Because California uses a “jungle primary” (i.e.  one in which all candidates from all parties run in one primary with the top two advancing to the general election), we already know that the Democrats will keep this seat and the only question on Tuesday is which Democrat will be elected.  For the most part, both parties in choosing members of Congress to fill vacancies have followed the rule of only choosing people from “safe” seats.  As such, while the Democrats have so far — in the first round in California and in Montana and Kansas — run around 10% ahead of 2018, this success has not changed the winner of any seat. Continue Reading...

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The Week in Review

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. Continue Reading...

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Easier Said than Done

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.

Continue Reading...

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Pro-business Conservatives and the Affordable Care Act

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.

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