Obamacare

Trump Says Republicans Are Working on a New Health Care Plan. Somehow, Mitt Romney Is Involved.

The new plan is likely to resemble an old plan that was barely a plan at all.

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John Angelillo/TNS/Newscom

Obamacare repeal is back…sort of.

Although Republicans failed to repeal and replace the health care law in a months-long push in 2017, and have signaled in recent months that they were ready to move on—especially since Democrats ran successfully on maintaining Obamacare's pre-existing conditions rules in last year's midterm—President Donald Trump has put repeal back at the center of the GOP's domestic policy agenda.

In a tweetstorm last night, Trump announced that Republicans "are developing a really great HealthCare Plan," that will be voted on after the next election, once Republicans "win back the House."

Trump's tweets follow last week's decision by the administration not to defend any part of the health care law in court, and reports that the White House is working with several conservative think tanks to develop a new health care plan, and that Mitt Romney is also involved in "preliminary discussions."

You may now be thinking to yourself: Mitt Romney? That Mitt Romney? To which I can only answer: Yes, that Mitt Romney.

We all remember how Romney, who, as governor of Massachusetts, passed RomneyCare, a state-based health care system built around an individual mandate, a health insurance exchange, and subsidies for regulated health insurance. At the time, Romney said the plan should be a national model for health care reform. Then Democrats under the Obama administration used the Massachusetts system as a model for their own health care legislation, Mitt Romney ran for president and denied that he actually wanted it used as a model—and, well, here we are, about a decade later, with a national system of subsidies that can be used to purchase regulated insurance on an exchange, known as Obamacare, which Trump is pushing to repeal, with, apparently, Mitt Romney's help. If this were a serialized television show, people would complain that the plot is too complex, and the lore contradicts itself, the characters aren't consistent, and that despite tons of activity, the story never really goes anywhere…and they would be right.

Trump says Republicans are developing a plan to vote on right after the 2020 election. But, as with any of Trump's promises, some skepticism is in order.

The first problem is that Trump's plan doesn't exist. Not only has the White House never put forward a health care plan of their own, Trump has never offered anything other than the barest, briefest explanation of what he would like to see a health care plan do. In his tweets last night, Trump simply says that it will lower premiums and "support Pre-Existing Conditions," which, like "HealthCare" itself, have apparently risen to capital letter status in Trump's mind.

In many cases, it's reasonable for the White House to hang back from the legislative process, letting Congress take charge. But one of the reasons that the repeal effort failed in 2017 was that Trump was utterly clueless about the various plans and processes; without presidential leadership to guide them, Republicans couldn't rally around an idea or even begin to attempt to sell it to the public. But Trump couldn't be bothered to learn the most basic details about the health care legislation the GOP was attempting to pass, so, again, here we are.

That dynamic, and the perception amongst congressional Republicans (including and perhaps especially leadership) that the biggest factor contributing to the party's midterm losses was Democrats campaigning on pre-existing conditions, is one reason why there now appears to be a huge split between Republicans on Capitol Hill, who are wary of putting health care back into play in 2020, and the White House, which is gung-ho about doing so.

On the election merits, Hill Republicans are probably right: A 2020 election about whatever replacement plan the Trump White House dreams up will probably ensure that Republicans remain a minority in the House, rendering this whole exercise moot.

Which bring us to the second problem: The plan the Trump administration settles on, assuming it does, will most likely be a bad plan that pleases almost no one. According to Mitt Romney (yes, still, that one), the new idea that is currently being cooked up is not a new idea at all, but a modification of an old one: Romney told Buzzfeed the forthcoming GOP plan will likely be based on Graham-Cassidy, a last-ditch plan introduced in 2017 that was, itself, only sort of a plan. The short version is that it would eliminate Obamacare's mandatory coverage requirements and take the money that is currently being spent on subsidies and Medicaid under the law and split them up between the states. States could then use that money to fund something like Obamacare (most blue states, presumably) or something else that they come up with later (most red states, presumably).

Almost everyone will hate this plan, including, probably, some people who say they are fine with this plan.

Liberals and defenders of Obamacare will hate it because it dismantles some of the regulatory infrastructure of Obamacare. In particular, it eliminates the health law's essential health benefits—which include things like maternity care—and therefore undermines the law's pre-existing conditions regulations.

Republicans running for reelection in 2020 will hate it, though many will admit this only in secret, in anonymous quotes attributed to "leading Republicans" and terse refusals to discuss the plan at length on the record, because it puts pre-existing conditions back on the table (see above), and Republicans in tight races don't want to run re-election campaigns built around pre-existing conditions.

Republicans from states that expanded Medicaid under Obamacare will hate it because it will almost certainly penalize states that did so by taking that money and splitting it (more or less) equally among states, meaning states that chose not to expand Medicaid would get more, and states that did expand would get less. These Republicans may be coy about the precise reasons, but they will be there, looming in the background of the debate.

Or perhaps the foreground. Among the Republicans who represent an expansion state are Senate Majority Leader Mitch McConnell and Sen. Rand Paul of Kentucky. In 2017, the last time a Graham-Cassidy style block grant was proposed, Paul said he opposed the plan because "It just means you're keeping all the money we've been spending through Obamacare, most of it, re-shuffling it, taking the money from Democrat states and giving it to Republican states. I think what it sets up is a perpetual food fight over the formula."

He's not wrong. Which is why critics of Obamacare are also likely to grumble about this idea as well. A Graham-Cassidy style block grant would merely take the money that's already being spent and redistribute it a different way, to politically powerful states who would lobby not only for more money for themselves, but more money overall. It's not a plan to improve the quality of health care in America so much as a politically contrived policy dodge, allowing Republicans in Washington, who don't agree on much of anything about health care, to say they took down Obamacare while leaving current spending in place—and redirecting a bunch of it toward Republican states.

For all of these reasons, it's hard to imagine that something like this passes, even if Republicans do retake control of the House in 2020, and hold control of the Senate and the White House. In other words, there's no reason to think the underlying dynamic that kept a repeal bill from passing in 2017, when the GOP held all of Congress and the White House, would be different.

This is quite likely to go nowhere, anyway. As Trump ramped up the health care chatter last week, The Washington Post reported that administration insiders knew it was just for show: "White House aides acknowledge that there is no specific plan and that when Trump has said the Republicans need to be the party of health care, it is more of a branding exercise." A branding exercise! Why, it's almost like Trump is someone specializes in sticking his name on hacky, low-quality products he doesn't actually create himself.

But to recap: Trump promises a great new health care plan is on the way, but there's no plan yet, and when there is a plan, it will probably be a bad plan that can't pass. And somehow Mitt Romney is involved.

NEXT: Bad Math and Worse Policy Ideas on Equal Pay Day

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  1. This will be politically popular for Trump and takes away healthcare talking points from Democrats. Any government health care plan is a mistake.

    Health care is a huge industry that would benefit so much from 100% free market.

    Cash for minor medical stuff and catastrophic health insurance for major medical stuff. Americans would save over $1 trillion a year in Medicare, Medicaid, and Obamacare taxes and fees.

    1. Force health care facilities to publicly post their prices for all facilities. Force pharmacies and hospitals post their prices for drugs. Force competition. Allow all medical transactions and insurance policies to go beyond state borders.

      We do not have an insurance or coverage problem. We have a cost problem. Nobody wants to address the underlying issue with anything but government price controls, which will accomplish absolutely nothing and be controlled by the health care industry anyway.

      1. True. The preferred sol’n pretty much worldwide is some combination of redistribution & rationing. Nobody wants to look at actual costs, rather than who pays the bill like a hot potato.

      2. Some healthcare providers due post procedure costs. Cash-only surgical centers are an example.
        Also, Direct Primary Care physicians post their prices so you know what your monthly will be on the first day you decide to go with a given doctor.

        This is the way it should be.

        We do have an insurance problem of sorts and it deals with the fact that we have become a nation of believers in not paying the first dollar – big mistake. Medical insurance as we know it today is not insurance, it is a payment system. First dollar should come out of the pocket of the patient, the consumer. Insurance needs to go back to being insurance which means it pays for unexpected catastrophes in exactly the same way home insurance pays for your house when it burns to the ground. The main point here is that the patient needs to be the consumer of medical services, not the government, the employer or an insurance company (at least until a catastrophe kicks in.

        The best way for the patient to have access to funds is via an HSA. Employers, the government, charities, Mom, Pop, etc. pay into an individuals fund which stays with that person for a lifetime and is also part of that person’s estate to will to the accounts of others or give to charity or ….?

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    2. Health care is a huge industry that would benefit so much from 100% free market.

      This is the argument that real libertarians make.

      Leftards who make a living as Professional Fake Libertarians, like Pete MacAdoodle Suderweigel, worship central planners and regulators and attack those who don’t have a comprehensive enough central plan for their liking.

      1. ^+1000
        This this this.

        Eliminate every single regulation related to health care and health insurance at the state and federal level.

        yes this also would end the drug war. Win win.

        1. ^EXACTLY! Keep LOCAL matters LOCAL…

    3. Even a “pilot program” where we can demonstrate that a free market will fix the problems would be an improvement.

  2. “…and when there is a plan, it will probably be a bad plan that can’t pass.”

    As opposed to an even worse plan that was deemed and passed?

    That’s change I can hope for.

    1. How about we wait and see what plan they produce before judging it based on assurances Sudderman is pulling out of his ass?

      1. Because they have a history of producing vaporware on this topic for the last decade.

        1. So no worse than Barrycare then.

          1. Nope. In 2009 and 2010 Democrat legislators did the hard work of actually coming up with a plan and passing it. It’s been implemented for almost a decade now. It is, quite obviously, not vaporware by the common definition.

            1. ” It’s been implemented for almost a decade now.”
              And fucked up, worse, an already pretty fucked up system.

      2. I don’t have to wait and see, I have a COMPUTER and I know EVERYTHING.

      3. You disagree that – whatever happens – it will not be as bad as Obamacare was???

  3. “As opposed to an even worse plan that was deemed and passed?”

    Ummmm, how do you know that the plan that was deemed and passed was worse when you don’t have anything to compare it to?

  4. They will have had a decade to come up with something so you know it will be well developed.

  5. It would be funny if they propose everything Obamacare has just to watch the dems vote against it.

    1. Generally speaking, if you’re going to tear down a house or building you should rebuild something better. If you’re just rebuilding the same thing, then it’s a waste of time and money.

      So no, if it’s just Obamacare under a new name, then it would be correct to oppose it because it’s a waste.

      1. At the time of passing, Obamacare had the same level of support as Trump’s border wall does now. You’d never know it. People think I’m lying when I say 35 Democrats voted against it. Like, they have literally rewritten history to absolve Obama any blame for anything.

        1. Eight scandal-free years!

        2. The obamacare moment was a total wakeup call to me about how the media operates. It was the first time I was both politically aware and internet literate enough see what a bunch of mendacious liars they were and how far they would go to carry the establishment dems water. Their should be whole college classes in journalism about that chapter in our countries history.

        3. … and? That doesn’t say a damn word about the wisdom of wasting money to rebuild an identical system with a new name.

      2. “”So no, if it’s just Obamacare under a new name, then it would be correct to oppose it because it’s a waste.””

        If you are for what it does, why oppose it?

        You use the term waste as if it’s something government tries to avoid.

        1. If you are for what it does, why oppose it?

          I didn’t think I was subtle, but apparently I need to make my point far more explicit.

          There are set-up and tear-down costs. As such, even if you are replacing a house valued at $200,000 with an identical house valued at $200,000. by tearing it down and replacing it, you are losing money, even if the house you have at the end is exactly the same as the house you had at the start.

          This means that quite obviously a repeal and replace program that replaces the ACA with something exactly the same with just the names swapped, would be a huge waste of money.

          1. How much does it cost if I take a rule book, change the name, place it back on the table and have a vote?

            If you support it the first time, you should support it the second time if it’s what you supported the first time.

            The house is a bad analogy since it requires physical demolition, removal and disposal of garbage from the demolition, new permits, the cost of new materials to rebuild, and the cost of new labor.

  6. Even before Obamacare the instances of people being denied insurance because of legitimate pre-existing conditions were incredibly, incredibly rare. It’s amazing how the press let Obama get away with making that the best thing about Obamacare after all the other promises and lies about it failed to appear, as if tens of thousands of people were denied coverage every year.

    1. Why is it amazing?

    2. Nonsense, I am reliably informed that, prior to Obamacare, dead bodies were piling up in windrows on the streets, and the stench of the carnal pits in every major city was choking.

      And my failure to personally remember these events is probably due to early senility.

  7. “Welcome back to the fold, Mitt! I have a gift for you right over here….”

  8. April fools.

    1. No shit. Suderman bit that bait like a fish that hadn’t eaten all winter.

  9. Romneybot is actually a great resource. Do the exact opposite of what he says, combined with the experience of his own failures, and you’re sure to create a solution through process of elimination. Also your hands will be warm.

    1. You do know that a lot of “Romneycare” was passed by overriding his vetos, right?

  10. Mitt looks pained.

    1. Mittens is probably feeling a bit self-conscious groveling to Trump because his craven desperation for power and influence, bereft of any morality or guiding principle, has been on full display for the past few years. First, by attacking Trump in the same underhanded way that Reid went after Romney (unreleased tax returns), then begging Trump for a position in his admin, then running for Senate in a state he’s never lived for any extended periods and campaigning as an anti-Trumper, now wanting to work closely with him.

      Fuck Romney.

      1. We should all be very glad Romney never won the election back in 2012.

        Obama was bad but the Republican Congress blocked most things during Obama’s second term.

        Trump might not have won a presidential election if Romney served a term or two. Republicans would have been blamed for Romney being a disaster like Bush and Obama.

    2. One thing I never understood was Senator Romney’s running against the ACA. The logical path was for him to embrace the idea and point out that he had overseen a similar program in Massachusetts. Make the case that he could better administrate the ACA than President Obama. In that way he would have been playing to a strength. It also would have solved the Republican’s problem of creating an alternate plan.

      1. It isn’t that complicated: If he’d done that the GOP voting base would have thrown up their hands and walked away. It’s not “playing to your strength” if most of the people who you’re counting on voting for you regard your supposed strength as your worst weakness.

      2. But “Romneycare”, mostly passed over his vetos was a disaster.
        If only by the metric that ER visits increased dramatically, when they were supposed to drop.

  11. One of the better sub-headlines one Reason.com.

    1. No.
      REASON, dot, com should not be worrying that a new plan will resemble an old plan that was barely a plan.
      It should be advocating no plan.

  12. Is this plan gonna be better than a fifth grader’s book report?

  13. I haven’t been paying attention in the past week or so – has Suderman apologized yet for two-plus years of hyperventilating over Russia?

    1. The memory hole is your friend. Just like robby suddenly rediscovered due process and presumption of innocence when the “credible” accusations fell apart.

    2. He still isn’t convinced Trump is in the clear. WE HAVE TO SEE THE REPORT!!!

    3. They ran out of statutes and war memorials to tear down otherwise that would still be a thing Reason staff would still support.

  14. Do we trust political operatives who think going after healthcare again will kill Republicans again in 2020, or do we go with Trump’s gut? If you’ve seen him in tennis attire, you know that’s one fucking enormous gut.

  15. Somehow, Mitt Romney Is Involved.

    RomneyCare Part Deux / O’Care Part Three. ///BadTrump

  16. It would be nice to think this was on the principle that you “Keep your friends close, and your enemies closer.”, but I’m not that optimistic.

    The GOP hasn’t had much interest in actual free market reforms in decades. And it’s a pity because health care is so horribly warped by regulation that the field is just lousy with low hanging fruit.

    Give health insurance the same tax status no matter where you obtain it, to break the linkage between employment and health insurance.
    Require that prices be published and charged the same to all comers, so that you don’t have to be part of a “plan” to avoid insanely inflated prices, and can do comparison shopping.
    End the state by state balkinization of the health insurance market.

    It’s easy to come up with a plan that would be an improvement. But they won’t, because the one thing that wouldn’t occur to them is deregulating.

  17. Here’s an idea.

    Get the fucking government out of our lives.

    Signed
    George Washington

    Also – Obama is a fucking asshole.

  18. President Trump should go big in the run up to 2020. Not only should he promise a new plan to be revealed after the election, he should double down saying that Mexico will pay for the healthcare. It worked once why not try it again.

  19. Terrifying polls or fake polls/news:

    A. 70-80 % of Americans (from both political parties) want to implement a euro-style single payer system, and this is the most important issue going into 2020.
    B. 60-70% of Americans and their employers love their private, employer based health insurance as it is and don’t mind paying 100% maternity costs, child health costs for migrants and medicaid recipients.

    Both cannot be true. If A. is true Sanders or a Medicare for All Dem will win in 2020 (this song “when the levee breaks”). If B. is true, Creepy Uncle Joe or a “save” Obamacare will win 2020.

  20. There is no great great plan. This is just more Trump talk and he is already backing down.

  21. There is no great great plan. This is just more Trump talk and he is already backing down.

    1. Yeah, McConnell called him, and let him know that the Senate GOP caucus had lost all interest in replacing the ACA, so forget it. So he’s basically handwaving right now.

      It’s another one of those issues where it doesn’t matter whether he meant it to begin with or not, he can’t do squat without the backing of the GOP establishment. I’m not sure he realized just how completely opposed to most of the Republican platform the GOP establishment really were.

      Well, except for taking the position that the ACA is unconstitutional in court, and hoping that Roberts has had second thoughts about saving it. THAT he can do, and is doing.

  22. “The new plan is likely to resemble an old plan that was barely a plan at all.”

    Sounds good to me. Gov’t plans tend to suck.

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  24. A Scientific Alternative to Politically-Based Medical Delivery

    Like many others, President Trump claims that he has a politically-based medical delivery (aka/”healthcare”). Alternatively, consider a scientifically-based plan designed by a physician with expertise in the Science of Human Behavior and delivery of clinical programs ? a plan that should be acceptable to Democrats (D) and Republicans (R), characterized by the following, eleven benefits for every citizen:
    01) Single payer, universal coverage for basic services (D);
    02) Private sector with competition (R);
    03) Optional extended benefits (D, R);
    04) Simplicity;
    05) Straightforwardness;
    06) Affordability to the nation (R);
    07) Freedom from special taxes (R);
    08) Minimal regulations (R);
    09) Minimal bureaucracy (R);
    10) Freedom from fraud at taxpayers’ expense (D, R); and
    11) Acceptance by insurance companies (R).

    For a scientifically-oriented discussion, visit …
    https://www.nationonfire.com/healthcare-reform/ .

  25. A Scientific Alternative to Politically-Based Medical Delivery

    Like many others, President Trump claims that he has a politically-based medical delivery (aka/”healthcare”). Alternatively, consider a scientifically-based plan designed by a physician with expertise in the Science of Human Behavior and delivery of clinical programs ? a plan that should be acceptable to Democrats (D) and Republicans (R), characterized by the following, eleven benefits for every citizen:
    01) Single payer, universal coverage for basic services (D);
    02) Private sector with competition (R);
    03) Optional extended benefits (D, R);
    04) Simplicity;
    05) Straightforwardness;
    06) Affordability to the nation (R);
    07) Freedom from special taxes (R);
    08) Minimal regulations (R);
    09) Minimal bureaucracy (R);
    10) Freedom from fraud at taxpayers’ expense (D, R); and
    11) Acceptance by insurance companies (R).

    For a scientifically-oriented discussion, visit …
    https://www.nationonfire.com/healthcare-reform/ .

  26. The more complicated the law, the more likely it is to have unintended consequences. Simple laws allow regulation and testing in multiple ways as long as the met the basic concept of the law. Laws should be written that allow local adjustment to meet the need outcome. Without that liberty, built into the law, you cannot adjust to a changing world. The laws should define goals, provide funding, and let state and local governments work out the usage.

  27. The more complicated the law, the more likely it is to have unintended consequences. Simple laws allow regulation and testing in multiple ways as long as the met the basic concept of the law. Laws should be written that allow local adjustment to meet the need outcome. Without that liberty, built into the law, you cannot adjust to a changing world. The laws should define goals, provide funding, and let state and local governments work out the usage.

  28. The more complicated the law, the more likely it is to have unintended consequences. Simple laws allow regulation and testing in multiple ways as long as the met the basic concept of the law. Laws should be written that allow local adjustment to meet the need outcome. Without that liberty, built into the law, you cannot adjust to a changing world. The laws should define goals, provide funding, and let state and local governments work out the usage.

  29. The more complicated the law, the more likely it is to have unintended consequences. Simple laws allow regulation and testing in multiple ways as long as the met the basic concept of the law. Laws should be written that allow local adjustment to meet the need outcome. Without that liberty, built into the law, you cannot adjust to a changing world. The laws should define goals, provide funding, and let state and local governments work out the usage.

  30. The more complicated the law, the more likely it is to have unintended consequences. Simple laws allow regulation and testing in multiple ways as long as the met the basic concept of the law. Laws should be written that allow local adjustment to meet the need outcome. Without that liberty, built into the law, you cannot adjust to a changing world. The laws should define goals, provide funding, and let state and local governments work out the usage.

  31. “Romneycare” is in place in Massachusetts. It’s what the ACA was based on. Maybe Trump can adopt it, call it “Trumpcare”, and replace that nasty “Obamacare” with the same thing. His base will love it.

  32. This is the peak of the “swamp” of Washington! It is time that our elected leaders put aside political aspiring, and get together and do what is right for the American People.

  33. Please get big government loving Romney out of the discussion.

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