Rehash and Retain

Well, the House passed a bill related to Obamacare. Now it goes to the Senate.

I look forward to the Senate’s interminable, agonizing pomposity while Senators express their angst over doing something they’ve been promising for 7 years. The doing of which doesn’t even fulfill the promise.

Added to this will be the sublime pleasure of President Trump’s feckless tweeting about legislation he doesn’t understand, while mismanaging a process of which he is ignorant.

My joy about the inevitable House/Senate conferences to reconcile what’s been passed by the House with the dog’s breakfast the Senate will produce is inexpressible.

A cynical nod toward pseudo-federalism

It’s not the Freedom Caucus preventing repeal, it’s GOP “moderates” and the President.

The New GOP Health Care Bill Shows Republicans Have Given Up on Fully Repealing Obamacare

Republicans in Congress have given up on fully repealing Obamacare.

Instead, they have decided they want to leave pieces of it in place, along with a system of tweaks and opt-outs that require federal permission and may never be used. And even that may be too much for some GOP moderates.

“GOP moderates” = Democrats Light.

The Freedom Caucus has been blamed for blocking repeal of Obamacare. President Trump said they would “hurt the entire Republican agenda.” They were pilloried as “extreme right wing” by the press.

It turns out they’re the only ones who want to keep the promise of Obamacare repeal.

It turns out Trump is the cuckservative.

Obamacare as a pre-existing conditionAKA – a now intractable entitlement

A large part of Donald Trump’s successful campaign for the Presidency derived from a promise to repeal Obamacare.

Unfortunately, he also promised universal health care under the most wonderful health insurance plan we’d ever seen. He promised to keep, and even expand, the popular parts of Obamacare while repealing the unpopular parts – and at lower cost.

Consistent with those inconsistent promises, the post-election policy proposal was to keep the most costly popular parts of Obamacare. For example, coverage for pre-existing conditions, coverage for 26 year olds under their parents’ family plan, and federally decreed coverages many insured neither want nor need.

The bill that Paul Ryan delivered was an attempt to satisfy Trump’s promises.

“Moderate” Republicans wouldn’t vote for a bill that removed pre-existing condition protection, etc.. The Freedom Caucus stood firm for repeal, and wouldn’t vote for a bill with Obamacare holdovers. Trump said, “Take it or leave it.”

So, is it Trump who’s at fault for the bill’s failure? Ryan? The Freedom Caucus?

I think it’s the “moderate” Republicans in the House, but give Trump an assist. The core sin of Obamacare was to further insert government control into the health insurance market. By accepting Obamacare’s core principle, Mr. Trump encouraged GOP House “moderates” to insure “repeal” would degenerate into tinkering about the edges.

Tax reform next?

American Health Care Hacked

Instead of mandates and fines for not buying health insurance the American Health Care Act provides a 30% increase in premiums. Instead of means based subsidies there are age based tax credits.

Left in place are mandated coverage for pre-existing conditions and extension of coverage to 26 year old ‘children’. Because these are popular. So are unicorns. The cosmetologists behind the GOP health insurance plan can’t be bothered to point out any connection between these policies and insurance premiums. Because insurance premiums are not popular.

The President promised health insurance would be made available across “the [state] lines.” Trump’s website said he would “ask Congress to immediately deliver a full repeal of ObamaCare” on day one. So much for those promises on day sixty three.

A few of the Obamacare decreed coverages, like maternity insurance for males, are removed, but only after strong objection from the Freedom Caucus; people who know how to spell ‘repeal.’

This bill, in all its superficial wordplay, is capitulation to the core principles of Obamacare. It puts the GOP stamp of approval on policies the GOP derided as socialist as recently as six months ago.

Now, the Great Negotiator, who insists this is a “wonderful” health care bill, has said “take it or leave it” – after threatening those who are trying to get him to keep his promises.

If anything good is to arise from this debacle it will only come from the courage of a handful of people who still believe in a free market. Better to take the President up on his offer to do nothing than to accept this travesty.

Trumpcare Phase III, Title XX/XY

The FDA does not allow 23andMe to offer medical interpretations of its $199 human genetic mapping service. Oh, you can get ancestry information, but no information about your own genetic tendencies or disease markers unless you yourself decode the raw data. Because you, or 23andMe, might misinterpret it.

Meanwhile, a Republican Member of the US House of Representatives (Virginia Foxx [R-NC-5]) has introduced H.R. 1313, a bill which would allow your employer sponsored health plan access to your genetic profile under the pretense heading of “employee workplace wellness programs, including programs that utilize a health risk assessment, biometric screening, or other resources“.

This started under ObamaCare, where employers are allowed to add up to 30%, or more, to your health insurance premium if you don’t “volunteer” for their “workplace wellness program.” These programs typically look for, and monitor, health conditions such as weight, smoking and blood glucose.

H.R. 1313 takes the pre-existing condition question to the next level – pre-existing tendencies – and with the added heredity information, one can also imagine employer diversity programs based on your DNA inheritance. The good news is Elizabeth Warren might not have been counted as a minority on the Harvard faculty, no matter which boxes she checked. Every other application I can think of is bad news.

Outrageous.

“The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated…”

Cosponsors:
Rep. Walberg, Tim [R-MI-7]
Rep. Stefanik, Elise M. [R-NY-21]
Rep. Mitchell, Paul [R-MI-10]

Leave Obamacare alone

Just let it crash and burn on its own. That is at least preferable to the GOP proposal to place it under new ownership being pushed by Paul Ryan and Donald Trump.

The Trump supporters who railed against the ‘GOPe’ should be angrier than the rest of us, since the Art of the Trumpcare Deal strongly suggests the GOPe is still in charge.

Actually, following the script of redefining subsidies into tax credits and claiming there’s a real difference, maybe we should rename GOPe. Call it GOPino. Actually, it’s arguable that there is nothing significant left of the GOP, anyway.

Here’s a partial list from Jeffrey Tucker of things health care reform should accomplish. Not one of them is in the GOPino proposal.

  1. Government should not be determining what is or must be insured. That should be up to the consumers to decide.
  2. Government should not interfere in contractual relationships between providers and purchasers of insurance, whether individuals or businesses.
  3. Prices for medical services need to be completely decontrolled, and the convoluted market-rigging by a conspiracy of providers, insurers, and government welfare bureaucracies must be ended.
  4. Government should not mandate coverage by employers or privilege employer-provided coverage over individually purchased coverage. Third-party payment should be an option.
  5. Government should not mandate that insurers accept all comers at the same price; that system makes a mockery of the whole idea of insurance itself.
  6. Discrimination for “pre-existing conditions” should not be a criminal act but rather a rational consideration for determining premiums.
  7. Government should not restrict who gets to try their hand at providing insurance; entry and exit need to be competitive too.
  8. Government should never force anyone to pay for a service that he or she does not want. You say coverage is a human right? It’s a human right for a person to refuse coverage.
  9. If you want to get serious about fixing the system, the byzantine pharmaceutical system has to go. Again, let the consumers decide, and, while we are at it, there should be complete free trade in medicine.
  10. The 100-year old medical credential monopoly that has so severely restricted entry into the profession should be dismantled. The market is fully capable of assuring quality, and remember too that there is not one definition of quality.

Those are all fixes to problems big government created. Rather than address that, Trump and Ryan are saying if we don’t pass Trumpcare it will hurt Republicans. Ryan:

“I do believe that [2018 will be a “bloodbath” for Republicans] if we don’t keep our word to the people who sent us here, yeah,” Ryan told CBS News’s “Face the Nation,” when asked if he agreed with Trump’s reported comments about the 2018 midterm elections.

Who cares?

I do believe he’s right, but not in the way he thinks. This only makes sense in a Clintonian world where the definitions of “keep” and “word” depend on the meaning of the word “is.”

Trump’s Voters Have Been Betrayed on Healthcare, Bigly.

So has everyone else.

Joe Wilson Day

Before a September 9th, 2009 joint session of Congress, President Obama declared, “Now, there are also those who claim that our [Obamacare] reform efforts would insure illegal immigrants. This, too, is false,” Obama said. “The reforms I am proposing would not apply to those who are here illegally.”

In response, Republican U.S. Rep. Joe Wilson of South Carolina shouted “You lie!” at the president. Joe Wilson was right, so today is “Joe Wilson Day” at TOC:

Wall Street Journal, Mar 2016, Illegal Immigrants Get Public Health Care, Despite Federal Policy.

Since that article is paywalled, I’ll direct those of you without a WSJ subscription to Forbes’ account of it:
Because Of Obamacare, Illegal Immigrants Get Taxpayer-Financed Care

[N]o honest person can deny that because of Obamacare, more taxpayer resources at the state and local level are being spent on health care of illegal immigrants than would have been spent otherwise…

And they’re moving to formalize it:
California Moves Toward Extending Obamacare to Illegal Immigrants