The World at Home: Charles Laffiteau's Bigger Picture
2017-08-15 -

Now that Republicans in the US Congress have admitted they cannot pass a new healthcare law, it’s worth looking at the prospects for Republicans working with Democrats on bipartisan revisions to the Affordable Care Act (AKA Obamacare) to address some of its shortcomings.


To say that the first seven months of a Republican-run federal government in Washington DC have been a disappointment for President Donald Trump and Congressional Republicans would be a massive understatement. The fact that Republicans departed our nation’s capital for their annual August recess with absolutely no legislative accomplishments to show for the first quarter of the 115th Congress’ two-year term is downright shameful. Furthermore, blaming Democrats and the Senate’s 60-vote filibuster rules ignores the fact that Senate Republicans can’t even muster a 50-50 vote tie on new legislation.


The healthcare law disaster comes on the heels of a decidedly underwhelming first 100 days in office, when the only real accomplishment to which President Trump and the Republican-controlled Congress could point was the appointment of Neil Gorsuch to fill the open seat on the Supreme Court. Moreover, during the past seven months, there have only been nine bills brought to the floor of the Senate that were debated and required a roll-call vote. Ironically, the only one of those bills that drew broad bipartisan support was the Russian sanctions bill that President Trump vehemently opposed.


It wasn’t supposed to be this way. The House of Representatives finally passed its version of healthcare reform by a slim two-vote margin on 4 May only after House Speaker Paul Ryan persuaded a few moderates to vote for the unpopular bill. Ryan pleaded with the so-called Tuesday Group to hold their noses and vote for it, and then trust that the Senate would eliminate the parts they didn’t like. Senate Majority Leader Mitch McConnell’s plan was to draw up a softer, kinder bill in secret and then get it approved by Senate Republicans before the general public found out what was in it.


The Republican leadership in Congress believed they could then push the Senate healthcare bill back through the House and get it to President Trump’s desk by the middle of July. With the healthcare issue finally behind them, the Republican controlled Congress could then move on to notch a few more wins on other issues, like getting spending bills approved for federal agencies. The most important of those spending bills are the National Defense Authorization Bill, which authorises funding for the armed forces, and reauthorisations of the Federal Aviation Administration and Food and Drug Administration.


But because the healthcare debate consumed virtually all of their time leading up to the August recess, Congress will now be under the gun on a number of fiscal fronts. In addition to authorising funding for the aforementioned federal agencies, Congress will also have to approve a new budget and an increase in the debt limit before the next fiscal year begins on 1 October. Since right-wing Republican conservatives won’t support an increase in the debt ceiling, Ryan and McConnell will have to negotiate a bipartisan budget compromise with Democrats to avoid a government shutdown and/or a debt default.


Even though Republicans in Congress are now planning to make tax reform their first significant legislative achievement, they can’t get their tax proposals approved without a budget to which the measures can be attached. That’s because the budget reconciliation process that Mitch McConnell and Senate Republicans tried to use to get their healthcare proposals approved by a simple majority, or 50-50 tie with Vice President Mike Pence as the tie-breaking vote, requires an approved budget. If Republicans want to pass a tax reform law, they will need to enlist the support of some Democrats.


As for the future of Obamacare, President Trump has been threatening to withhold the subsidy payments our federal government makes to insurance companies. These payments are designed to reimburse health insurance providers for reducing the out-of-pocket costs and deductibles of millions of low- and middle-income consumers who get their health insurance from the individual market, instead of group insurance plans sponsored by employers. If the president follows through on these threats, insurance companies will raise their premiums or withdraw from the individual market altogether. Such a move would be ludicrous, however, because many of the people who would lose their insurance in that case would be the very blue-collar workers in states like Kentucky who voted for him.


While some Republicans like Senator Ted Cruz and the right-wing members of the House Freedom Caucus have expressed support for the idea of destabilising the Obamacare marketplace by cutting off payments to insurers, others are seeking a bipartisan compromise. In the Senate, Lamar Alexander, the powerful Republican Chairman of the Senate’s Health, Education, Labor and Pensions Committee, urged President Trump to continue making subsidy payments in order to avoid throwing the insurance marketplace into chaos. Senator Alexander also announced that he would join his Democratic counterpart, Patty Murray, to hold hearings and work on legislation designed to “stabilise and strengthen the individual health insurance market”.


In the House of Representatives, Republicans Tom Reed and Charlie Dent likewise announced they would begin working with the bipartisan Problem Solvers Caucus to make tweaks to Obamacare that would reduce the costs for small businesses and consumers. They know that if they don’t do something to stabilise the insurance market, it is they, and not President Barack Obama, who will be blamed if it collapses.

Charles Laffiteau is a US Republican from Dallas, Texas pursuing a career in public service. He previously lectured on Contemporary US Business & Society at DCU from 2009-2011 and pursued a PhD in Public Policy and Political Economy.

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