The fist bumps coming from the GOP after passing the American Health Care Act in the House were plentiful. Republicans around the country were giving each other high-fives for having finally made the first real steps towards repealing Obamacare. Here’s the problem. We haven’t seen the beginning of the repeal of Obamacare. We’ve seen the seeds of Trumpcare being planted. Perhaps the better name for it would be “Obamacarelite.”

This a repeal in name only. Congressman Justin Amash revealed the truth about the AHCA in a Facebook post yesterday (emphases are mine):

This is not the bill we promised the American people. For the past seven years, Republicans have run for Congress on a commitment to repeal Obamacare. But it is increasingly clear that a bill to repeal Obamacare will not come to the floor in this Congress or in the foreseeable future.

When Republican leaders first unveiled the American Health Care Act, a Democratic friend and colleague joked to me that the bill wasn’t a new health care proposal; it was plagiarism. He was right.

The AHCA repeals fewer than 10 percent of the provisions in the Affordable Care Act. It is an amendment to the ACA that deliberately maintains Obamacare’s framework. It reformulates but keeps tax credits to subsidize premiums. Instead of an individual mandate to purchase insurance, it mandates a premium surcharge of 30 percent for one year following a lapse of coverage. And the bill continues to preserve coverage for dependents up to age 26 and people with pre-existing conditions.

I want to emphasize that last point. The bill does not change the ACA’s federal requirements on guaranteed issue (prohibition on policy denial), essential health benefits (minimum coverage), or community rating (prohibition on pricing based on health status). In short, Obamacare’s pre-existing conditions provisions are retained.

The latest version of the AHCA does allow any state to seek a waiver from certain insurance mandates, but such waivers are limited in scope. Guaranteed issue cannot be waived. Nobody can be treated differently based on gender. And any person who has continuous coverage—no lapse for more than 62 days—cannot be charged more regardless of health status.

Consider what this means: Even in a state that waives as much as possible, a person with a pre-existing condition cannot be prevented from purchasing insurance at the same rate as a healthy person. The only requirement is that the person with the pre-existing condition get coverage—any insurer, any plan—within 62 days of losing any prior coverage.

If a person chooses not to get coverage within 62 days, then that person can be charged more (or less) based on health status for up to one year, but only (1) in lieu of the 30 percent penalty (see above), (2) if the person lives in a state that has established a program to assist individuals with pre-existing conditions, and (3) if that state has sought and obtained the relevant waiver. Here in Michigan, our Republican governor has already stated he won’t seek such a waiver, according to reports.

So why are both parties exaggerating the effects of this bill? For President Trump and congressional Republicans, the reason is obvious: They have long vowed to repeal (and replace) Obamacare, and their base expects them to get it done. For congressional Democrats, it’s an opportunity to scare and energize their base in anticipation of 2018. Neither side wants to present the AHCA for what it is—a more limited proposal to rework and reframe parts of the ACA, for better or for worse.

In March, when this bill was originally scheduled to come to the floor, it was certainly “for worse.” The previous version provided few clear advantages over the ACA, yet it haphazardly added provisions to modify essential health benefits without modifying community rating—placing the sickest and most vulnerable at greater risk.

Over the last month, several small but important changes were made to the bill. The current version abandons that fatally flawed approach to essential health benefits (though the new approach includes new flaws), incorporates an invisible risk sharing program, and permits limited state waivers. These changes may slightly bring down (or at least slow down the increase in) premiums for people who have seen rates go up. Even so, the AHCA becomes only marginally better than the ACA.

Many have questioned the process that led up to the vote on May 4. I have publicly expressed my disgust with it. The House again operated in top-down fashion rather than as a deliberative body that respects the diversity of its membership. But it’s important to acknowledge that the bulk of this bill (123 pages) was released on March 6. Only about 15 pages were added after late March. Members of Congress were given sufficient time to read and understand the entire bill.

While an earlier version of the AHCA included a CBO score, the types of changes made to the AHCA in more recent stages render an updated score highly speculative and practically meaningless. For that score to be useful, the Congressional Budget Office would have to effectively predict which states will seek waivers, which waivers they will seek, and when they will seek them. This complex analysis of the political processes and choices of every state is beyond anyone’s capability. I weighed the lack of an updated score accordingly.

When deciding whether to support a bill, I ask myself whether the bill improves upon existing law, not whether I would advocate for the policy or program if I were starting with a blank slate. In other words, the proper analysis is not whether it makes the law good but rather whether it makes the law better. In this case, I felt comfortable advancing the bill to the Senate as a marginal improvement to the ACA. The House has voted more than 30 times to amend (not just repeal) Obamacare since I’ve been in Congress, and I have supported much of that legislation, too, on the principle of incrementalism. If it advances liberty even a little (on net), then I’m a yes.

Nonetheless, the ACA will continue to drive up the cost of health insurance—while bolstering the largest insurance companies—and the modifications contained in the AHCA cannot save it. Many of the AHCA’s provisions are poorly conceived or improperly implemented. At best, it will make Obamacare less bad.

The Framers of the Constitution understood that federalism—the division of powers between the national and state governments—would maximize the happiness of Americans. As long as Washington dictates health insurance policy to the entire country, there will be massive tension and displeasure with the system. I’ve always said, and I will continue to say, we need to start over: Fully repeal Obamacare, let the people of each state choose their own approach, and work together in a nonpartisan manner.

The Congressman is correct when he says that it’s his duty to decide whether or not a bill is an improvement on existing law. However, one should also consider whether it’s possible for the law to be dramatically improved with more effort put towards bigger or smaller changes. In this case, I believe Amash would have voted against the bill if he believed there was a full repeal possible. He and the Freedom Caucus weighed the possibilities and decided that this was the best they were going to get. It was right move from a legislative perspective, but it also reinvigorates the necessity for the Federalist Party to rise.

It’s a shame that small-government-minded representatives are forced to pick between the lesser of two evils. Millions of voters can relate to this circumstance as we’re often faced with picking between Mr. Big Gov or his opponent, Mrs. Bigger Gov. As long as the two-party system holds primacy over all potential challengers, we will always be faced with this obtuse binary choice. The time for change is now.

Lake Michigan at Evanston, IL. Is Puerto Rico’s present Illinois’ future?

By John Ruberry

If you believe that states–and commonwealths–cannot declare bankruptcy, you are technically correct. But last week a commonwealth, Puerto Rico, filed for bankruptcy in all but name, utilizing the Puerto Rico Oversight, Management, and Economic Stability Act, which President Barack Obama signed into law in 2016.

That bill of course was written for Puerto Rico in mind, but with Republicans in control of all levels of the federal government, similar bills can be proposed for the fifty states, or just some of them, including California, New Jersey, Connecticut, and Illinois. Those three are among the states that have fallen victim to what New York City Mayor Michael Bloomberg dubbed the “labor-electoral complex” in his farewell address four years ago.

What’s that? It’s when public-sector unions, consisting of workers on the taxpayer payroll, cajole politicians–almost always Democratic ones–to increase their salaries or defer their pay hikes by way of generous yet unaffordable pension plans.

And of course these pols are cajoled by these unions through campaign contributions.

Puerto Rican flag flies between two abandoned Chicago homes

Many local government workers don’t pay into social security and many of them have no other pension plans. In states like Illinois, if you work for the state government, funds deducted for your retirement only go to one place–an Illinois retirement plan. So far so good–unless the politicians neglect to properly fund those pension programs.

And that has been the sad case in those blue states I mentioned earlier, as well as Kentucky.

Now that Puerto Rico has declared, well, something, investors will very likely take a closer look at sinking cash into what may be sinking ships. Puerto Rico has negative population growth. So does Illinois. That means fewer taxpayers are participating in funding these failures. And it’s the productive citizens who are leaving Illinois and Puerto Rico.

Yesterday Puerto Rico announced it was closing 184 schools and there is speculation that commonwealth retirees may suffer a 20 percent cut in their pensions. Expect much more bad news from there.

John “Lee” Ruberry of Da Tech Guy’s Magnificent Seven

It doesn’t have to end up this way in states like Illinois–if corrective action is taken immediately. Let me define “immediately” for those politicians who may be reading this post.

Immediately means 2017, not ten years from now.

Ten years ago the financial situation in Puerto Rico wasn’t as dire.

John Ruberry regularly blogs at Marathon Pundit.

Norman: This is largely as I predicted except the Silly Party won, this was mainly due to the number of votes cast.

Monty Python’s Flying Circus, Election Night Special 1969

Less that 24 hours after the GOP house passed it’s version of Obamacare repeal then ending their not so splende inaction a professional prognosticator forecast doom and gloom for house GOP members for doing so.

Republicans’ 217-213 passage of the American Health Care Act on Thursday guarantees Democrats will have at least one major on-the-record vote to exploit in the next elections. Although it’s the first of potentially many explosive votes, House Republicans’ willingness to spend political capital on a proposal that garnered the support of just 17 percent of the public in a March Quinnipiac poll is consistent with past scenarios that have generated a midterm wave.

Not only did dozens of Republicans in marginal districts just hitch their names to an unpopular piece of legislation, Democrats just received another valuable candidate recruitment tool. In fact, Democrats aren’t so much recruiting candidates as they are overwhelmed by a deluge of eager newcomers, including doctors and veterans in traditionally red seats who have no political record for the GOP to attack – almost a mirror image of 2010

Their conclusion (with a caviet):

In light of the vote, we are shifting our ratings in 20 districts, all reflecting enhanced opportunities for Democrats. The major caveat is that 18 months is an eternity in politics and that as always, we will continue to adjust our outlook as events unfold and the landscape develops.

Naturally the MSM jumped all over this

and Cook was not alone among the prognosticators, Nate Silver joined em:

There could easily be an overall partisan swing of 5 to 10 percentage points against Republicans, therefore. It’s not quite clear how this partisan swing would interact with the AHCA penalty — whether you’d add them together or whether that’s double-counting — but it should be enough to make a lot of Republican incumbents nervous. There are 58 Republicans who won by less than 20 points in 20162 and who voted for the AHCA.

Naturally the MSM jumped

A top nonpartisan election analyst says Thursday’s House GOP vote to repeal and replace ObamaCare hurts the reelection chances of a number of House Republicans next year.

The Cook Political Report on Friday shifted its forecast for 20 GOP-incumbent or open districts to categories less favorable for Republicans.

and Jumped hard into the “GOP DOOM” meme

The Atlantic: What the GOP’s Health-Care Gamble Means for 2018

Vox: “I’ve never seen anything like this”: progressives see huge donation spike after AHCA vote

NYT: What Democrats’ Losses in 2010 Can Tell Us About G.O.P.’s Chances in 2018

Talking Points Memo: Hey Hey Goodbye

Politico: Red-state Dems pounce on Obamacare repeal bill

Mother Jones: These 24 Republicans Were Already Vulnerable—and Now They Just Voted to Repeal Obamacare

and of course the Washington Post: Did Republicans just wave bye-bye to their House majority?

It’s almost as if there was a single coordinated script that they all were reading from.

Now there are likely those who might get worried about these predictions and the media’s rush to support and amplify them, but before you do let me show you a blast from Cook’s past namely Nov 7th 2016:

And Nate Silver on Election day with a couple of state highlights thrown in

And then ask the question: Do they really think the American people to fall for this grift again? Or are they only expecting the pols in DC and their foolish consultants to do so?


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