by Rod D. Martin
March 24, 2017

My quick takes on Ryan’s health care flop today.

1. As I’ve said repeatedly, the Republicans should have passed a one-sentence repeal bill on or about January 21, sunsetting Obamacare at some arbitrary point in the future (my preference would be October 1 “or sooner”). This would have been very difficult for the RINOs to oppose, would have given plenty of time for dealmaking, and above all would have kept Republicans’ longstanding and most central promise.

2. Having failed to do that (almost certainly Ryan’s fault, not the White House’s), Republicans got forced into this awkward three-stage deal. They might have had to do that anyway due to procedural hurdles in the Senate, but that just begs the question: McConnell should invoke the nuclear option on all legislation whatsoever, since we absolutely know we’re going to do it on Gorsuch, and the Democrats will do it the very next time they’re in the majority even if we don’t. That would have solved the problem, and given the right carrots and sticks, I believe McConnell could have pulled it off (and still can). It would have been tricky and may be trickier now (thanks to some of our RINOs like McCain), but it’s not impossible.

3. Honestly, the Freedom Caucus probably just screwed up. But if you saw the Open Letter I posted yesterday (and which I signed, along with the heads of assorted groups like Club for Growth and Heritage), you know that I agree with them in principle: we need to fight for a bill that includes interstate insurance, HSA enhancement and full repeal of the Obamacare insurance regulations and taxes. It just isn’t as obvious that all of that had to be in this particular bill.

4. Finally, I think the President was committed to all of those things. Why? Because he campaigned on them, and when he produced his budget proposal, his people carefully implemented every single promise he made last year. By contrast, the White House trusted Ryan to come up with the health care legislation — since already they’d done it repeatedly, and since that seemed a sensible division of labor — and Ryan proceeded to pre-concede tons of points (rather than demand what we need and compromise where we must), ending up with an unpassable bill.


Anyway, Trump threatened to let Obamacare stay on the books if these guys didn’t get their act together. I expect that’s a meaningful but not unbreakable bargaining position.

This isn’t over.

ONE FINAL NOTE: While I wanted and worked for (and will continue to work for) a better bill (as the Open Letter below makes plain), I just want to make clear what was in the Ryan bill. A lot of people are claiming it’s terrible, and it’s certainly not what I wanted. But consider what it actually achieves:

$1 trillion in both tax and spending cuts
Individual mandate abolished
EHB (“Essential Health Benefits”) mandates removed
50+ employee mandate removed
30+ hours/week mandate removed
More flexibility for the states
Work requirement for Medicaid
Planned Parenthood defunded

Oh, and that’s just Phase I, with Phases II and III coming behind, for procedural reasons only lawyers and legislators could love.

As I said, I agree with them, and I would have done all of this differently, but the Freedom Caucus probably just screwed up.

Open Letter From Conservative Leaders Supporting Necessary Principles to Repeal Obamacare