One of the more ridiculous knocks on the Congressional Budget Office's score of Trumpcare is that the score is so bad because it didn't consider that there were going to be two more "prongs" of reform, one legislative and one regulatory. Neither had been written down on paper, so it would have been pretty impossible for CBO to evaluate them. So to try to soften the blow of that dismal CBO score—mostly to try to get wavering Republicans on board—House Speaker Paul Ryan is looking at tacking on that second prong to sweeten the deal on the bad first bill.
House Republicans are working on a companion to their bill replacing "Obamacare," a legislative second act that would ease cross-state sale of health insurance and limit jury awards for pain and suffering in malpractice lawsuits. […]
Skeptics abound. Republican Sen. Tom Cotton of Arkansas called it "mythical legislation" in an interview Tuesday on the Hugh Hewitt radio show. In a tweet, conservative Rep. Thomas Massie, R-Ky., suggested "Easter basket" might be a better description.
Yet Speaker Paul Ryan, R-Wisc., has said he wants to move a companion bill through the House alongside the main GOP legislation that rolls back key parts of Barack Obama's health care law and limits federal spending on Medicaid for low-income people.
Here's the thing—selling insurance across state lines can still happen. There's nothing anywhere that says it can't, or that federal government can really affect. It's up to states and their insurance regulators to decide what the rules are that allow insurers to dip across into their markets. It's not really going to make a difference in the healthcare markets, but it has been a thing that Republicans have obsessed over forever, so it might attract some more votes. The same goes for the second piece—tort reform. That's been a Republican shibboleth forever because they think all the malpractice lawyers are Democrats. There's little to suggest that limiting malpractice awards will really bring down the costs of insurance for all the people. It'll make doctors happy, though.
But here's the real problem for Ryan, besides the fact that it’s unlikely the CBO will find it does much to help: that sidecar bill, as it's known in Congress-speak, would have to get 60 votes to pass in the Senate. It's not directly related to the budget, so it can't be pushed through under budget reconciliation like prong No. 1. And it's not going to get eight Democratic votes—not when it's part of a push to repeal Obamacare.
Meanwhile, it seems that Trump is wooing conservatives with a "manager's amendment" to go along with the first prong—a legislative package to slip in on the floor to make the core Trumpcare bill worse. Since it probably would end Medicaid sooner, that makes it harder to keep all the Republican senators on board for the 51 votes it needs.
TrumpCare is a travesty: It cuts taxes for the rich, kills Medicaid expansion for the poor and defunds Planned Parenthood. We can defeat it in the Senate, if you call the Capitol Hill switchboard at (202) 224-3121 and contact your Senators.