ReportWire

Tag: trumpcare

  • Trump Repackages Random Ideas Into ‘Great Healthcare Plan’

    [ad_1]

    Out of the blue.
    Photo: X/@WhiteHouse

    For many years, dating all the way back to 2015, Donald Trump has promised he’d someday offer a health-care plan to replace Obamacare. For months Republicans have fretted over allegations that they are clueless or heartless about rising health-care costs, exacerbated by their refusal to extend expiring Obamacare-premium subsidies received by around 22 million Americans. They’ve tossed out a bunch of random conservative health-care panaceas, as has Trump, mostly revolving around health savings accounts and other individualistic measures for undermining Obamacare-style regulated insurance markets.

    Today, without any warning, Trump released a video claiming a bunch of these well-worn ideas represent the “Great Healthcare Plan” he’s been talking about for so long.

    It’s significantly less vague than most of his past maunderings on health care but hardly anything you could call a blueprint, as the New York Times observed:

    The plan was short on specific details and left much of the direction for how to finalize it up to Congress. It amounted to a few paragraphs on a webpage, released with a video of Mr. Trump promoting what he called “the great health care plan.”

    Trump’s video unveiling this “proposal” was an odd pastiche of boasts about what he’s already done in the health-care arena (particularly his jawboning of pharmaceutical companies to lower prices for some drugs), denunciations of the “Unaffordable Care Act” (a term he clearly considers a bon mot), and wild claims about how incredibly good and cheap health care will soon become. He talked of lowering prices by far more than 100 percent, which is a mathematical impossibility. He failed even to mention the biggest problem Obamacare was created to address: the refusal of insurers to provide coverage for people with preexisting conditions or inherently expensive treatments. And once again, Trump’s impulses led him in contradictory directions; despite his denunciations of Obamacare, one of his big ideas is to build on an Obamacare discount feature called “cost-sharing reductions.”

    It’s unclear what Congress is expected to do with this plate of spaghetti thrown against the wall. Not a single Democrat will support this “plan,” which whatever it is, clearly aims to blow up Obamacare, just as Trump and the GOP unsuccessfully tried to do in 2017. That means the only path forward is via the party-line budget-reconciliation procedure, like the one that produced last year’s One Bill Beautiful Bill Act. Going in that direction in an election year with a topic as complex and controversial as health care may please conservative hard-liners who have been longing to destroy Obamacare for many years. But it hardly seems doable in a Congress where Republicans have such tiny margins of control.

    More likely than not, the president is just engaging in some high-visibility pre-midterm “messaging” to show concern over a set of problems that have stumped him and his party for eons. Maybe it will eventually turn into a proposal that more or less hangs together, even if its enactment by Congress is the longest stretch imaginable. Unfortunately, Trump’s claim that he has a “plan” will almost certainly kill off the already languishing efforts to come up with a bipartisan fix for the Obamacare-premium spike that is just now beginning to be felt in pocketbooks everywhere. He should have kept his rambling thoughts to himself.


    See All



    [ad_2]

    Ed Kilgore

    Source link

  • Trump’s Healthcare Plan Is Just a Mirage

    [ad_1]

    Is Mike Johnson really telling Trump what to do on health care policy? Probably not.
    Photo: Andrew Harnik/Getty Images

    There was an enormous hullabaloo in Washington over the weekend when reports surfaced that Donald Trump was about to unveil a health-care deal without much in the way of advance consultation with his congressional Republican vassals. According to multiple accounts, the plan would include a two-year extension of the enhanced Obamacare premium subsidies due to expire at the end of the year with new (and fairly minor) eligibility limits and a “skin in the game” requirement of minimum premium payments. There would have also been some sort of Health Savings Account option in a gesture to conservatives who want to get rid of health insurance and encourage people to pay health-care providers directly. But by and large, the proposal as presented was very much along the lines of what was being discussed behind the scenes by both Republican and Democratic senators and was politically feasible, recognizing that some lawmakers in both parties won’t support any deal at all.

    But Monday came and went without the expected presidential announcement, and next thing you knew Trump was headed to Mar-a-Lago for Thanksgiving. It’s possible that the rollout of what would have inevitably been labeled “Trumpcare” was simply delayed until next week. But all along, the prospects of a presidentially brokered health-care deal depended on speed, stealth, and a my-way-or-the-highway declaration from Trump that his plan had to be backed by virtually every congressional Republican, much like his One Big Beautiful Bill Act. It sure looked like that sort of Trump blitz was in the works, until it wasn’t.

    According to The Wall Street Journal, the mouse that roared in putting a hold on Trumpcare 2025 was none other than House Speaker Mike Johnson:

    Speaker Mike Johnson (R., La.) cautioned the White House that most House Republicans don’t have an appetite for extending enhanced Affordable Care Act subsidies, according to people familiar with the matter, showing how hard it will be politically to stave off sharp increases in healthcare costs next year for many Americans.

    The message from Johnson, in a phone call with administration officials, came as President Trump’s advisers were drafting a healthcare plan that extended the subsidies for two years.

    The warning underscores the hurdles facing any deal in coming weeks.

    The narrative all but writes itself: House Republicans, emboldened by their successful defiance of Trump over the Epstein Files Transparency Act, are refusing to take orders from Trump to bless the signature health-care initiative of the much-despised 44th president. And instead of going into a hate-rage and ordering purges, the newly chastened 47th president is going back to the drawing board.

    That’s one interpretation of what’s happening. Another is that this version of “Trumpcare” is largely a feint — or to be less charitable, a scam. The only reason Republicans have even considered an Obamacare-subsidy extension deal is that the huge premium spike on tap if nothing is done could become a big issue in midterm elections already prospectively dominated by affordability concerns. They could have nestled an extension into the OBBBA but didn’t, which is a pretty clear indication of their underlying wishes. But for purposes of midterm “messaging,” lofting trial balloons and agitating the air over health-care costs is nearly as valuable as actually doing something about the problem. It’s possible that’s what Trump is doing before he manages to blame the failure to act on the Radical Left Democrats.

    Even if Trump is serious about the issue and has a come-to-Jesus meeting with the allegedly rebellious Mike Johnson to force support for a Trumpcare proposal, there’s a very convenient poison pill he could put into the mix to sabotage any actual deal that might divide his own party. Despite safeguards placed in the original Affordable Care Act to ensure no direct federal payments for abortion services, the anti-abortion lobby has long demanded more extensive prohibitions to make sure states don’t pony up the money to provide abortion coverage in Obamacare policies. The debate over the extension of subsidies provides a fresh opportunity for these people — who have felt marginalized ever since Donald Trump rejected their call for a national abortion ban — to prove they are still an indispensable element of the GOP/MAGA coalition. Senate Majority Leader John Thune, who has promised Democrats a vote on Obamacare-subsidy extensions by mid-December, is also on record demanding tighter restrictions on abortion coverage. Rejecting such restrictions is a red line for many Democrats, who will already be under pressure to make minimal concessions to the GOP on an issue that could otherwise represent midterm dynamite for the opposition party.

    So perhaps Congress and the White House are significantly farther away from a health-care deal than it appeared just yesterday. But let’s not credit Mike Johnson for too much courage or clout. If Trump really wants a health-care deal based on Obamacare-subsidy extensions with the conservative bells and whistles, he can get it with the appropriate ham-handed ultimatums combined with take-it-or-leave-it blandishments to Democrats. He really ought to do so, because health-care costs aren’t going away as an issue and Trump has no better plan for coping with them than he did when he took office in 2017 and “Trumpcare” became a joke.


    See All



    [ad_2]

    Ed Kilgore

    Source link

  • Trump Could Save Himself by Saving Obamacare

    [ad_1]

    Trump could again draw in all the congressional leaders and force them into a deal.
    Photo: Melina Mara/Getty Images

    This isn’t the first time that we’re reading stories about Republicans taking their first baby steps toward a post–Donald Trump future. Pundits, rivals, and opponents have been looking over the horizon for signs that Trump’s grip on his party would fade since 2016. But the combination of sinking presidential job-approval ratings, terrible off-year election results, occasional acts of congressional defiance, and more-deranged-than-usual Truth Social posts has revived talk of Trump’s mojo eroding. Add in the fact that the president has run his last campaign and you can understand why the “lame duck” label is beginning to stick to him. If his so-far-faithful servants on the Supreme Court let him down in a series of big cases between now and next July, a real jailbreak atmosphere could infect the GOP and the whole world of political observers who have had to live with this turbulent man every minute for a decade.

    This trend has to be excruciating for the president, who believes he has already saved the country and has earned the right to a perpetual victory lap in which he consolidates his lofty place in global history by ending wars and cutting big investment deals wherever he goes. Instead he’s having to deal with a rebellion in the very core of his MAGA movement over his relationship with the late Jeffrey Epstein, and cope with widespread public concerns over the “affordability” of life in America. This last problem clearly baffles and sometimes angers Trump, who has bought his own spin about the economy being better than ever and on the brink of new heights thanks to AI.

    There is, however, something he could do right now that would reestablish his relevance, confirm his mastery of Congress, and address affordability concerns while reducing the odds of a GOP midterm apocalypse. He could reengage on the issue of extending Obamacare subsidies and buy some time for his party to finally figure out what to propose on health care.

    As you may recall, the Democratic calculation immediately before and throughout the recent record government shutdown was that Trump would negotiate a subsidy extension deal and impose it on his party. But he refused to come to the table, and instead, began denouncing Obamacare itself as though it was still 2015. He also began encouraging Republicans to go back to the poisoned well of proposals to repeal and replace Obamacare with some sort of beefed-up individual health accounts instead of fixing the current system and heading off a huge insurance-premium price spike. It has sure looked like Trump was leading his party back to the agenda that bombed in 2017 and led to the loss of the House in 2018.

    But now there are Republicans in both congressional chambers trying to steer their party and their president back to a temporary Obamacare subsidy patch that can head off electoral disaster while letting them continue to talk about some wonderful Obamacare alternative that will appear a bit down the road (say, after the 2026 midterms). As Punchbowl News reports, the talented dealmaker Katie Britt seems to be front and center in this effort:

    Republican senators have been privately lobbying President Donald Trump to support a limited short-term extension of Obamacare subsidies, arguing it would save the GOP from a 2026 drubbing and buy time for Congress to pass a longer-term health care plan that mirrors the president’s preferences.

    Sen. Katie Britt (R-Ala.) has spoken with the president several times this week to pitch the idea, according to multiple sources familiar with the matter.

    Britt seems to have a special rapport with Trump based in part on her physical appearance. She’s also a shrewd politician who understands her party’s immediate needs:

    A short-term extension of the Obamacare subsidies could mean one, two or even three years, with strict eligibility crackdowns, such as income caps and anti-fraud provisions. A Trump-led push would provide political cover for vulnerable Republicans; it would also save Thune from having to deal with a divided conference.

    There’s activity in the House, too, where a bipartisan group that includes Democrats Tom Suozzi and Josh Gottenheimer and Republicans Don Bacon and Jeff Hurd have a two-year extension plan, per Punchbowl:

    The bill would add a new income cap, extending the enhanced credits for families of four earning less than $200,000 per year and phasing them out for families of four earning between $200,000 and $300,000.

    One other idea under discussion is a one-year subsidy extension with income caps and fraud-prevention changes, paired with a commission to negotiate a longer-term solution next year.

    Time’s a-wasting, though, since the Senate vote on health care that John Thune agreed to is coming up in weeks and the politics of a short-term Obamacare subsidy-extension deal are tricky. Some Democrats are fine with Republicans doing nothing and giving them a powerful midterm message. And again, there is zero way House Republicans allow a vote on, much less agree to, any Obamacare extension unless Trump calls them in and demands it, along with all sorts of rhetorical window dressing about his determination to kill Obamacare and atomize its remains sometime real soon.

    A deal is still a long shot. But Democrats need to retroactively vindicate their government-shutdown strategy, which fell short of its principal goal when Trump refused to play his part. Republicans need to get the Obamacare premium spike out of the news until November 2026. And Trump needs to show he’s still the Man, the straw that stirs every drink in American politics. The ingredients are there for the deal that has eluded everyone for so long.

    [ad_2]

    Ed Kilgore

    Source link

  • GOP Can’t Stop Touching Hot Stove of Obamacare Repeal

    [ad_1]

    We’ve seen this movie before.
    Photo: Sid Hastings/Alamy Stock Photo

    The big miscalculation Democrats made in handling the recent government shutdown was their belief that Donald Trump could be induced to force an extension of soon-to-expire Obamacare premium subsidies on congressional Republicans as part of a deal to reopen the government. He never even agreed to negotiate on the subject. So instead, the booby prize Democrats won was a guaranteed Senate vote on the Obamacare subsidies by the second week in December (huge premium spikes already announced by most insurers will go into effect on January 1 if no action is taken). The House promised nothing, and the Senate pledge is vague enough as to be potentially meaningless if a workable deal isn’t crafted in advance.

    There is a possible deal that would combine a minimal (probably one-year) extension on the subsidies with so-called Republican reforms (e.g., cutting off benefits at some fixed income point, measures preventing fake beneficiaries, and perhaps some GOP policy baubles like enhanced health savings accounts). But as health-care-policy maven Jonathan Cohn observes, it’s unclear how much of an appetite there is for compromise:

    Compromise requires meeting somewhere in the middle and already some members of the GOP are doing the opposite — taking this new round of debate as a cue to dust off ideas that would roll back or repeal big pieces of Obamacare. And these efforts seem to have attracted the interest of Trump, who has been posting messages like “Obamacare Sucks” on social media.

    Any bill will need 60 votes, just like the measure to reopen the government. And it would have a prayer in the House only if it’s truly bipartisan and if Trump comes down hard on conservatives who would vote against the Second Coming of Christ if it were in any way connected with the 44th president and his legacy health-care program.

    Unfortunately for the roughly 42 million people who depend on Obamacare policies for their health insurance, the White House seems less interested in a compromise on subsidies than in replacing them and perhaps undermining the entire structure set up by the Affordable Care Act, as Politico reports:

    Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said Monday that he’d spent “a good part of the weekend with the White House” working on a plan to replace ACA subsidies with a new policy.

    “We have lots of great ideas,” Oz said on Fox News on Monday. “But I don’t want to show our cards. As the president often says, why would I telegraph to you what we are going to do? …”

    “We want a health care system where we pay the money to the people instead of the insurance companies and I tell you, we’re going to be working on that very hard over the next short period of time — where the people get the money,” Trump said in the Oval Office on Monday.

    As Cohn notes, this sort of talk is the kind of thing we heard from Trump and his party when they were unsuccessfully trying to kill Obamacare during the president’s first term:

    Conservatives have long argued the best way to reform health care is by giving people more control over their health care dollars, which typically means scaling back insurance so that it covers only catastrophic expenses, and then having people pay for everything else out of their own pockets using money they’ve put into private accounts that get some kind of government assistance.

    Past versions of these proposals have, upon inspection, looked more like vehicles to give wealthy people a tax break. They have diverted money into broker and management fees. And as a practical matter, they have threatened to do what many other conservative proposals would — namely, to break up insurance pools so that people who are in good health spend less, while those who need medical care spend more.

    In other words, Republicans would prefer to return to the days of widespread age and health-condition discrimination by insurers and then encourage people to rely less on insurance to begin with. Many health experts warn that this approach would encourage younger and healthier people to bail out of risk pools and leave their less fortunate fellow citizens with reduced coverage at higher costs.

    If this is the direction Trump and the GOP are headed, there won’t be any feasible bipartisan deal in Congress in December — or at the next pressure point, January 30, when the current government-reopening measure expires. That might be why some Republicans have talked about abandoning bipartisanship altogether and pursuing another budget-reconciliation bill (like the recently enacted One Big Beautiful Act) to “reform” health care and achieve some other GOP legislative priorities on simple party-line votes. Trump himself, of course, would prefer to just “nuke” the filibuster and let Senate Republicans do whatever they want on health care or anything else they choose to address. Since that seems unlikely, we could enter a time machine to go back to 2017, when Republicans tried and failed to use reconciliation to “repeal and replace Obamacare.” Indeed, in a recent interview with Laura Ingraham, the president himself referred to Trumpcare — the term used generally for his repeal-and-replace legislation — for his vision of an improved health-care system.

    You get the sense listening to the president and his supporters that they are mostly focused on finding some rhetoric to show interest in the affordability concerns that are depressing Trump’s job-approval ratings and threatening GOP plans for the midterms. If that’s all Republicans care about, it’s very bad news for people losing health coverage, because they can’t afford the insurance that’s been keeping them alive.


    See All



    [ad_2]

    Ed Kilgore

    Source link

  • Shutdown Shows GOP Is Still Obsessed With Obamacare Repeal

    [ad_1]

    John McCain killing the GOP’s Obamacare repeal bill in 2017.
    Photo: C-SPAN/Youtube

    From the very beginning of the current federal government shutdown, the big question has been whether Democrats can convince Republicans to give them the trophy of an extension of soon-to-expire Obamacare premium subsidies that were enacted in 2021. Democratic optimism on this subject has been based on the belief that Republicans up for reelection next year really don’t want to get blamed for the huge spike in health-insurance premiums that would hit upward of 20 million mostly middle-class Americans if the subsidies expire (with the first flare-up occurring when open enrollment for Obamacare plans begins on November 1). And indeed, Punchbowl News’s soundings of the U.S. House indicate there are “somewhere between 20% and 30% of GOP lawmakers” who are “open to extending” the subsidies.

    But Punchbowl’s reporting also shows why bringing along the the rest of the GOP caucus (which aside from the ever-erratic Marjorie Taylor Greene aren’t going to split the party wide open over this issue) will be extremely difficult. An interview with the No. 2 House Republican, Steve Scalise, served as a reminder that the majority of Republicans don’t just hate the expanded subsidies enacted in 2021, but Obamacare itself, and will be loathe to lift a finger to make it work better:

    I know they’re [Democrats] trying to dump the problems of Obamacare off on everybody, other than the people that actually passed and voted for Obamacare. Those high premiums are a result of Democrat policies. If they really wanted to work with us on lower premiums, there are a lot of bipartisan ideas that you could come to the table and bring and do, and they’ve got to stop fighting the things that have been proven to work, as well.”

    Those bipartisan ideas that Scalise is referring to include association health plans, which allow employers to join together to buy insurance plans, plus health savings accounts.

    Long story short, the “bipartisan ideas” Scalise is touting are the same old tired proposals Republicans have been pushing for more than a decade that would make it easier for insurance companies to cherrypick young and healthy people while leaving older and sicker people a few ways to get really crappy insurance at terrible rates. Yes, Obamacare has gone from being a risky experiment that people happy with their health insurance feared to becoming a generally accepted and even popular way for government to make health care widely available and affordable. But many, perhaps most, Republicans haven’t changed their minds at all. Given half a chance, they’d try again to repeal Obamacare whether or not they had any workable replacement (pro tip: they still don’t!) to offer.

    So very much has happened in the past decade that it’s easy to forget that most middle-aged Republican lawmakers cut their political teeth in the Tea Party era when Obamacare was the Great White Whale for conservatives wrathful about big and intrusive government. The big federal government shutdown of that period, in 2013, was precisely over GOP efforts to blow up Obamacare by defunding its operations. It failed. So when Donald Trump took office with a Republican trifecta in 2017, the very first order of business was Trump 1.0’s version of the One Big Beautiful Bill Act, a budget package whose central feature was repealing Obamacare. That too, failed, which probably made a deep impression on Trump. He quickly turned his attentions to a tax cut and hasn’t tried to do a whole lot on the health-care-policy front since then, other than this year’s Medicaid cuts, which Republicans have denied are cuts at all.

    Trump’s bad experience with Obamacare repeal efforts is the big reason why Democrats think the president himself may impose an Obamacare subsidy deal that enables everyone to reopen the federal government. Nobody doubts his power to do so if he chooses. But no one should doubt that the bulk of Republicans will hate this like sin and won’t accommodate it on their own.


    See All



    [ad_2]

    Ed Kilgore

    Source link