Horowitz: New CBO Score Deals Mortal Blow to House Healthcare Bill

Tuesday, May 30, 2017

Rob Horowitz, GoLocalWorcester MINDSETTER™

Rob Horowitz

To no ones ‘surprise the Congressional Budger Office (CBO) score of the tweaked so-called American Healthcare Act, better known as either RyanCare of TrumpCare, which narrowly passed the House of Representatives several weeks ago, was similar to the CBO score of the original version, which died in the House without a vote. This is because the new and supposedly improved version, contains some useful political fig leafs that worked to garner the necessary votes, but little substantive change.

The revised legislation, designed to repeal and replace Obamacare would leave 23 million more people without health insurance as opposed to the 24 million people who would lose health insurance in the original bill. As with the original bill, these cuts in health insurance would pay for a giant tax cut for the wealthiest Americans, along with a small amount of deficit reduction. There would also be steep premium increases for older and sicker Americans.

No wonder, Senator Majority Leader McConnell (R_KY) told Reuters, "I don't know how we get to 50 [votes] at the moment.”

If McConnell continues to work to pass Healthcare legislation with only Republican votes, he will probably never get to 50 and if he does, it will be for something so politically toxic, that he will end up wishing he didn’t succeed.

But there remains a way forward, still open to McConnell, Ryan and President Trump. As I wrote several weeks ago, it requires abandoning repeal and replace and making the goal the reform and repair of Obamacare. It means building a completely different legislative coalition that includes Democrats, along with moderate Republicans and pragmatic conservatives.

Contrary to the Republican attempts to declare Obamacare unsustainable or in Trump’s exaggerated description “dead," objective analysis demonstrates that it is by and large still working fairly well and can be put on sound long-term footing with common sense fixes. For example, restoring more competition can be accomplished by minimizing risks for health insurance companies and increasing—not lowering-- government subsidies. This can help put the brakes on big premium increases. These common sense fixes can be combined with experimenting with allowing health insurance to be bought across state lines and permitting small businesses to join large health care purchasing pools to give them more leverage in the market.

Additionally, repairing and reforming Obamacare is a political winner for the Republicans, especially when compared to passing some version of the current Republican legislation. A majority of Americans now approve of Obamacare and strongly disapprove of the Republican alternative.

Republican Senators Bill Cassidy (R-LA) and Susan Collins(R-ME ) have proposed legislation that retains more features of Obamacare and does so by forgoing the giant tax cut. This bill could potentially serve as a starting point for a bi-partisan effort that would be good for the nation and actually good general election politics for the Republicans.

It would mean, of course, standing up to the far right elements in the party. That will take leadership, but it is leadership of which Senator McConnell, if not the President or the Speaker, is more than capable. Let’s hope for the nation’s sake, the Senate Majority Leader chooses this all around better way.

Rob Horowitz is a strategic and communications consultant who provides general consulting, public relations, direct mail services and polling for national and state issue organizations, various non-profits and elected officials and candidates. He is an Adjunct Professor of Political Science at the University of Rhode Island.