We begin today’s roundup with Dan Balz at The Washington Post:
Thursday was supposed to be a glorious anniversary for President Trump and the Republicans. Seven years after President Barack Obama signed the Affordable Care Act, Republicans were poised to take the first concrete step toward repealing and replacing that law. Instead, Thursday produced an embarrassing setback that left the way forward far from certain.
Legislative sausage-making is never pretty, but what has been happening all week with the signature legislative priority of the GOP seems beyond the norms. Faced with possible defeat on the floor, House Republican leaders postponed a scheduled vote until Friday, hoping that another day of negotiations could produce what seven years of talking have failed to produce, which is a consensus bill that all factions of the party can support.
The difficulties Republicans are confronting are entirely of their own making. For seven years, Republican politicians have made one overriding bargain with their conservative constituency, which was that they would repeal Obamacare as their first order of business if they ever had the power to do so. Now that they have the power, they still haven’t found a way to make good on that promise.
Gary Legum at Salon:
A few hours later, the president, who is easily bored and has the attention span of a tsetse fly with a concussion, gave Congress an ultimatum: He was done negotiating. It was time to vote on Friday and live with the outcome. At last report, House leadership intends to hold a series of votes during the day on Friday, with a final up-or-down on the AHCA coming by afternoon, whether they have the votes or not. It’s conceivable Trump is now prepared for the bill to fail. On Thursday evening, the New York Times reported that the president has told people close to him he now regrets going along with Speaker Paul Ryan’s plan to put health care reform before tax cuts.
Meanwhile, the Democrats spent the day playing with puppies. Speaker Paul Ryan was certainly not about to try to get his first major piece of legislation through the chamber with Democratic votes, even if he thought there were any to mine.
Maureen Groppe and Deidre Shesgreen at USA Today run down some basic questions about process:
Why can’t Republicans put whatever they want into the health care bill?
Republicans chose an expedited procedural route to replace Obamacare in order to avoid a filibuster by Senate Democrats, which would require 60 votes to end. But that route restricts them to making changes affecting how much the government spends or collects in taxes. So if they want to change, for example, insurance regulations, that may not be allowed.
Who determines what can be in the bill?
Once the House sends a bill to the Senate, the Senate Budget Committee would consult with the Senate parliamentarian to come up with a list of provisions that might violate the rules.
Amber Philips at The Fix breaks down the new CBO score on the revised bill:
Basically the only difference this new bill will have on the federal government is how much it will cost: Instead of reducing the deficit by an estimated $337 billion over the next decade like the first version did, it will reduce it by about $150 billion. This CBO score is one of the reasons Republicans' last-minute delay on a planned Thursday vote on the bill is so damaging for their already slim chances of getting something passed: It gives every side opposed to this bill — and there are many — more time to digest what they hate most about it.
Sam Petulla at NBC has a great chart on Republicans who oppose or lean against the bill and Trump support in their district:
As of this moment, NBC News counts that at least 32 House representatives are against or leaning against the bill.
Russell Berman at The Atlantic:
Republicans were clearly short of votes heading into Thursday night’s meeting. The only question was by how many. Party leaders had postponed a vote they had long planned to hold on the Obamacare anniversary, unable to win over conservatives without losing too many moderate members who feared the bill’s impact on insurance coverage, Medicaid, and premium rates. Trump’s ultimatum may have come too late: About a dozen Republicans representing swing districts or Democratic states had already publicly announced their opposition and will have a hard time flipping based on so baldly political an appeal.
Adam Davidson at The New Yorker:
Sometimes the debates about health care in Washington can seem absurd, as if politicians have the ability to engineer our health economy with precision. The truth is that, no matter what insurance schemes are designed by Congress, we cannot avoid sharing the costs and benefits of health care. If we deny someone care today, we will be paying that cost later, in the form of more expensive treatment or lost years of productive employment. (This is most abundantly true with prenatal treatment and the care of young children, in which relatively modest expenditures today can pay off dividends for a lifetime.) If we make health care less available, we will all live in a poorer nation. Certainly, plenty of health-care dollars are wasted, and there are sensible changes to the system that would improve the cost-effectiveness of care. But, as a rule, abundant access to decent, essential health care is an investment with some of the greatest returns.
Which brings us to Ryan Cooper’s piece at The Week on why Democrats should push “Medicare for all” now:
ObamaCare did not finish the job of achieving universal health care, and this is a good chance to move the ball forward. The AHCA is extraordinarily unpopular because it takes coverage and subsidies away from people, and a majority believe that it should be the government's responsibility to make sure everyone is covered. Fundamentally, Medicare is very popular, a fact only partially covered up by generations of red-baiting and duplicitous austerian propaganda. If Democrats had simply bulled ahead with a single payer-esque plan in 2009, instead of the complicated and heavily means-tested ObamaCare, they almost certainly would have done better than they actually did in the 2010 election.
And even for people who are skeptical of going full-bore all at once on single-payer, it still makes an excellent opening bid. Start with single-payer for all during the next bite at the health-care apple, and you could end up with a plan of combining Medicare and Medicaid, enrolling all people under 26 and over 55, and putting a Medicare buy-in on the ObamaCare exchanges. (That might begin chipping away at the employer-based system and be a somewhat more gradual route to single-payer.) Just witness the original opening bid for ObamaCare, which was far more generous before it got badly whittled down by conservative Democrats.
On a final note, Jennifer Epstein at Bloomberg explains how Democrats plan to “weaponize” the bill against House Republicans:
Democrats seized on the House health-care vote as an opportunity to inflict political damage on vulnerable Republicans.
The Democratic National Committee has begun blanketing the districts of roughly 50 House Republicans with targeted emails and robocalls about the bill, urging recipients to call the lawmakers to express opposition to the bill.
“House Republicans are attempting to take away health care from 24 million people with a disastrous bill that would make Americans pay more for less care or lose their coverage,” Democratic National Committee Chairman Tom Perez says in the call. He directs listeners to contact information for members of Congress on the DNC website.
It’s the first time the DNC has carried out this kind of campaign since Perez became chair of the party last month and reflects the committee’s efforts to be a hub of anti-Trump activity.