Mike Lee: If Senate Approves Cruz/Lee Health Care Amendment, 'Then I Can Get to a Yes. If They Can't Then I Won't.'
In interview, the Utah senator signals a make-or-break moment for the Obamacare revamp, while Mike Rounds tries to bridge the moderate-conservative gap.

By most reported accounts, the Republican Party's attempt to convince 50 of its 52 senators to agree on what to do about Barack Obama's signature Affordable Care and Patient Protection Act is hanging by the thinnest of threads. With Sen. Rand Paul (R-Kentucky) continuing to sound like a "no" vote—today he told reporters, "At this point, I cannot support the bill….I don't see anything in here really remotely resembling repeal"—that leaves the leverage in the hands of two of the other three senators who joined Paul in opposition after the first Better Care Reconciliation Act (BCRA) was introduced last month: Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah). Yes, the guys most responsible for shutting down the government over Obamacare funding in 2013 are the ones now widely considered to be the swing vote in President Donald Trump's first major legislative effort.
Over at Slate, Jim Newell assesses the latest political status of the Cruz/Lee "Consumer Freedom" amendment (which Peter Suderman preliminarily addressed on policy grounds here last month), noting that "as currently proposed, [it] would cause too many moderates to flee, since it would undermine pricing protections for those with pre-existing conditions." And yet, as Lee told me in an interview Monday, if the bill doesn't include the amendment, he will definitely vote against it:
Look, the fact is that we as Republicans, basically every Republican, with very, very few exceptions that I can think of, who have campaigned for any federal office over the last seven years, have done so with the promise that we would repeal Obamacare. And I can't look my constituents in the eye and tell them that we've done that or even made substantial progress toward doing that, unless at a minimum we allow people to choose a health care plan that works for them, and we allow them to pay for it with pre-tax dollars using a health savings account. And that's what we're trying to do with our amendments. If they will include those amendments in a variation of this bill, then I can get to a yes. If they can't then I won't; it's that simple.
"Since this amendment is what Cruz and Lee have named as their price," Newell writes, "Senate leaders have to find a way to let them have it—but with some adjustments to ensure that it doesn't scare off moderates." So what does that look like?
One option that's gaining steam, because it sounds like it could work in the abstract, is being pushed by South Dakota Sen. Mike Rounds. Though nothing's been put to paper yet, the idea would be to link the prices of the compliant and noncompliant plans by a ratio to prevent the ACA plans from spiraling in cost while the "Cruz plans" remain nice and cheap.
"I talked to Sen. Cruz a couple of weeks ago about it and told him I would support it as long as there are provisions built into it so long as there is a ratio, a specific ratio, between the least expensive plan and the most expensive plan that any insurance company offers," Rounds told reporters Monday afternoon. "And if [insurers cut the price on a cheaper] pool, they have to cut the price on the most expensive pool as well." In other words, Rounds wants to keep the sicker pools tethered to the healthier pools, so insurance companies couldn't keep premiums low for the plans healthy people want to buy while allowing premiums to skyrocket for the Obamacare plans sick people need.
The idea quickly gained traction among desperate Senate leaders trying to count votes.
Meanwhile, a new USA Today poll puts public support for the Senate bill at a mind-bogglingly low 12 percent.
More Mike Lee quotes about the Senate's Obamacare exertions after the jump:
MW: On a process basis alone, how would you describe the Senate's work here? I would imagine that, as someone who likes transparency in the operations of government and open hearings and these kind of things, it would be disappointing, to put it mildly, to the point of being maybe even inadmissible. How would you describe the process, and whether we should, as American consumers of politics…be able to accept an end result of a process that looks this kind of lousy, to be honest?
ML: Well, I've found it incredibly frustrating. Look, transparency is important, especially when you're talking about tinkering with one-sixth of our nation's economy, and involving the federal government as heavily as it has been. It's one of the problems I had with Obamacare from the beginning, as it was passed in secret, behind closed doors, members of Congress were told when it was passed by then-speaker of the House Nancy Pelosi they had to vote for it in order to find out what's in it.
There is no greater transparency than that which occurs with the American people in an open, honest dialogue with them, one in which we say, "We're going to repeal this law. You give us a chance to control the political branches of the federal government, we will repeal this law." There's nothing more transparent than that, there's nothing more simple than that. That's what we should have been doing all along. The further we deviate from that, the more difficult it is to maintain that same kind of transparency. We've compounded it by having the bill drafted largely in secret, having a fair amount of complexity in it. I still think there is way to get it to the point that it's good enough that it can garner my vote, but there are conditions attached to that, which I have outlined.
MW: And…if that all falls apart, are you of the kind of Rand Paul school of "Let's just repeal it, and then have a promissory note to replace later"? Is that something you would get behind?
ML: It is not only something that I would get behind, it's what I've been advocating all along. It's what I've been talking about all year and ever since the election—is that what we need to do is go ahead and repeal it, put a delayed implementation measure in there, so that it's delayed a few months or a year perhaps down the road, and then that ups the ante for us to get something else passed, to figure out what comes next, what fills in in the interstitial spaces that have to be filled by the federal government. That's what I've advocated all along, and I'm pleased that President Trump and Rand Paul and others are now on board with that.
A month ago I asked the immortal question, "Which Republican Will Play Gandalf to Trump's Balrog of a Health Care Bill?"
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a new USA Today poll puts public support for the Senate at a mind-bogglingly low 12 percent
You misspelled "unsurprisingly."
Yeah, that isn't that surprising to me but at the same time 12 percent? Why should I trust this number when every statistician was busy telling everyone Hillary was absolutely going to win the election?
No offense, but these polls are horse shit and everyone with even two brain cells to rub together should realize that by now.
Not every statistician was saying that, liberal media outlets played up the ones who were. As the election got closer, I saw a lot of liberal commentators turn against 538, because their model gave Trump a reasonable chance (I think they had him at about a 30% chance on election day) in favor of HuffPo and Sam Wang that gave Clinton >90% odds of winning.
Also, models estimating outcomes from polls are different from the polls themselves. And the US presidential election is extra complicated because of the electoral college. At a national level, the polling average gave a Clinton a lead of about 3-4 points by election day. She ended up winning the popular vote by 2 points. An error of 1-2 percentage points isn't all that big (if the USA Today poll cited had such an error, it would be inconsequential). Where the fucking up happened is a) the polls were less accurate in some key states (particularly Wisconsin, and to a lesser extent Michigan and Pennsylvania) and b) models like Wang's and HuffPo's drastically overestimated the accuracy of polling averages and underestimated the probability of a correlated polling error in key states that would result in tipping the election - to me, that's more of an indictment of the model than the polls themselves.
In summary, I'm not saying polls are infallible, especially one off ones. I'm saying that nationally, a polling average can give you a pretty good general idea of where things stand - but in a presidential race, it should be kept in mind that small differences can have a huge impact. And there's more potential for error when you consider the 50 states are all having their own separate elections. I think that's where the overconfident analysts failed. In the context of a discussion about the popularity of the Senate health care bill, even a 5 to 10 percent error doesn't really change things much in the big picture. The true number probably isn't 12%, but that doesn't mean it's drastically higher either. I think the polls had the House bill at less than 20% popularity, so it's not unfeasible. You have virtually universal opposition from Democrats, as well as opposition from moderate Republicans and Independents who think it goes too far, in addition to opposition from conservatives who think it doesn't go far enough. When you put it that way, it's not that hard for me to see the bill having
Got cut off at the end. I mean to say "having less than 20% support."
What fraction oppose the bill? Do the other 88% mostly oppose it or are they mostly indifferent to it?
RE: Mike Lee: If Senate Approves Cruz/Lee Health Care Amendment, "Then I Can Get to a Yes. If They Can't Then I Won't"
What a marvelous example of thinking for yourself.
Wouldn't would wouldn't would would would wouldn't wouldn't wouldn't wouldn't would wouldn't wouldn't wouldn't would.
It's a good amendment. Doesn't make the bill good but it's something.
It is. People hate it because it would make the cost transparent rather than obscuring it through inefficiency-creating cross subsidies.
It absolute does not make it more expensive; it merely makes it transparent how expensive it already is.
In other words, Rounds wants to keep the sicker pools tethered to the healthier pools, so insurance companies couldn't keep premiums low for the plans healthy people want to buy while allowing premiums to skyrocket for the Obamacare plans sick people need.
NO NO NO NO NO. Don't do this. What will happen instead is, insurance companies will RAISE the prices of the Obamacare policies, because the customers get subsidized for it and don't respond to the high price signal, leading to raising the prices of the cheap policies in order to match the ratio.
The Cruz/Lee plan seems to be to shrink ObamaCare into basically a federal high-risk insurance pool, with only the real sick people in it. Which is not great, but it's better than expanding ObamaCare into single-payer.
They got to tinker. I've come to the conclusion that just as astrologers love having calculators and programs and tabes of charts and books full of stupid lookup tables, because it seems so scientific, so do politicians love to bark orders and tell people what to do and spout mumbo jumbo, because that's how Hollywood portrays business. Hollywood never shows the hard work, the long hours, just the "Where's that refinery report?" crap which never happens.
So they gots to tinker with market rules to make it look like they are replacing the failed market with a real successful working market, when all they are doing is dropping more bullshit in the way for the market to dodge.
>>> the guys most responsible for shutting down the government over Obamacare funding
fourteen seconds of "shut down" doesn't count, ladies. mass fail.
It's funny. I just want the damn thing repealed, and I want all government interference in all markets repealed. Yet at the same time, the Cruz amendments and what Mike Lee talks about are far better than raw Obamacare. It's like when I was a kid and read the rules of Monopoly and discovered the rule that if an owner doesn't notice within two (?) turns that you landed on his property, he can't collect rent, it was an awesome trick. Not really meaningful, but still awesome, made you feel so smug when you got away with it and laughed in their faces.
That's what the Cruz/Lee amendments means. Almost nothing in reality, but a helluva lot in making this crap easier to swallow.
So fucking retarded.
Yes you are. Self-awareness is the first step.
There's some Tony-quality thought.
To paraphrase John Cochrane, why not deregulate healthcare and just use tax-funded subsidies/vouchers for the poor or sick to mitigate whatever 'social inequities' you perceive? Why does the state have to fuck everything up by getting involved in pricing and provision of services and create a host of unnecessary bureaucracies?
It's almost as if it's not really about helping the poor or sick (in which case a standard tax and redistribute entitlement would be do just fine); it's actually about embarking on another idiotic experiment in nationalizing industries. Leftists seem to just want to vindicate their unfailing support for centrally planned economies, despite rather than for the sake of the poor and sick.
Repeal ObamaCare [period]
"Healthy people leave the ACA plans in droves, ACCELERATING the death spiral in ACS plans. duh."
No, they cause the "sick people" ACA plans to be accurately priced (and therefore much higher prices, because insuring sick people really is much more expensive), and the insurees with pre-existing conditions get bigger subsidies to compensate them, since the subsidies would be tethered to the ACA plan prices.
What you can't get your febrile mind around is that the "ACA plans" (that is, the pre-existing condition ones) *should* be more expensive. They must be more expensive in any competitive market. Any attempt to suppress the true cost via mandates or regulations simply does the *exact same thing* as increasing subsidies for sick people (only instead by increasing premiums on healthy people rather than simply through taxation) while introducing new distortions.
You cannot fix prices without leading to highly inefficient cross-subsidies. Cruz's plan just forces us to acknowledge that, one way or the other, what everyone is asking for is a redistribution to people with pre-existing conditions; with his amendment it's just through subsidies (and on the books) instead of roundabout regulations.
Go read John Cochrane's blog post on it. Frankly I'm tired of explaining this shit to you. You should pay a fee for Christ's sake.
"Transition EVERY dollar of Medicaid spending (including bureaucracy to ...., wait for it Gomer ...
rebuilding and maintaining the private charity infrastructure that provided universal treatment ... voluntarily funded in a free market for the uninsured (until Medicaid)"
Medicaid isn't voluntarily funded, genius; if by "transition" you mean the government uses the money it taxes to pay hospitals to provide universal healthcare, then what you're talking about is a single payer system mediated by merely nominally private hospitals, and it will require *a lot* more money than what Medicaid currently gets, as it would go from covering 20% of the population to 100%
If by 'transitioning' you mean eliminating the taxes used to fund medicaid altogether, allowing them to spend it on medical care as they please (if you don't mean this, then look up the word 'voluntary' in the dictionary again), then what you're talking about is abolishing medicaid, and you're about as much an 'anti-gubmint goober' as anyone in this country.
"Only to a RIGHTWING statist ....who knows NOTHING of free market outcomes ... just anti-gubmint slogans and soundbites."
It's pretty clear at this point that you're having a stroke.
'BREAKTHROUGH! Welsh admits (in effect) that the Cruz amendment is bullshit -- INTENDED to make ACA plans look even worse."
Read: to make the ACA plans reflect the actual price of insuring sick people.
God forbid the public ever be made aware of how much the entitlements they're clamoring for actually cost.