Ending Congress's Two ObamaCare Abuses Drains Part Of The Washington Swamp

During the first week of August, 1981 Congress passed the Economic Recovery Tax Act of 1981 & presented it to President Reagan on August 12 who signed both it & the Omnibus Budget Reconciliation Act of 1981 into law on August 13.  Below is the famous photo of the signing ceremony @ Reagan's ranch in California in front of reporters with his dog Millie @ his side.  At the time Reagan was so happy @ the prospect for advancement & economic growth for the nation that I remember him saying on TV that "after the events of yesterday I don't know who is happier Prince Charles or me" – Prince Charles had just married Lady Diana Spencer on July 29.  Both bills were passed with bipartisan support: 282 to 95 in the Democrat controlled House for the tax bill & 232 to 193 for the budget bill;  the vote for the tax bill was by Voice Vote in the Republican controlled Senate so no record of individual votes was made & the budget bill passed 80 to 14. 

 

Trump does not enjoy the same type of legislative cooperation & happiness @ this same August point in his presidency.  The Senate adjourned for summer recess on Thursday without repealing ObamaCare, with no plan to reform the tax code, no legislation to fund the government beyond September 30, & no plan whether or not to raise the debt ceiling that will be reached in September.

 

click on photo to enlarge

 

The aforementioned 1981 tax & budget bills were based on Reagan's 1980 campaign priorities to rejuvenate the then lackluster American economy – principally income tax rate cuts & reductions in domestic spending & the size of government & its claims on earned income – many similarities with Trump's current tax & budget plans which have not even started the legislative process. 

 

To illustrate the increased prosperity & wealth creation the country may be missing by Congress's delay & inability to get to Trump's tax reform plan please consider the following graph comparing the quarter to quarter annualized real GDP change for Reagan's & BO's presidencies starting in the 3rd year of each presidency.

 

click on graph to enlarge

 

But as we all know Congress has been bogged down in healthcare reform – the House went home for the August recess on July 29 & the Senate followed last Thursday after saying they would work until August 12.  McCain left Washington on July 28 &, after undergoing treatment for brain cancer, will supposedly return in September when the Senate reconvenes.  Without McCain Republicans don't have enough votes to reopen debate on healthcare reform even if they wanted to which, other than Trump, they don't.

 

See graphic below that shows the tabulation of 13 key senators who voted "No" – some for good reason - @ least once along the way regarding passing a bill that would unwind or start to unwind ObamaCare.

 

  click on graphic to enlarge

 

The "No" votes in all three columns for Collins & Murkowski indicate they are for keeping ObamaCare.  The "No" votes in the first column for Corker, Cotton, Graham, Lee, Moran, & Paul indicate they are for repeal-only or keeping the discussion alive by voting for the skinny-repeal.  Heller is for keeping the issue alive.

 

The "Yes" vote in the first column for McCain, Alexander, Capito, & Portman indicates they want to replace Democrat control of your healthcare with Republican control of your healthcare. 

 

Six senators in the second column, not including Collins, voted "No" for the repeal-only alternative after voting "Yes" to repeal ObamaCare in January 2016 – these are the senators who betrayed their electorates with their January 2016 vote when they knew BO would veto any such repeal bill.  Collins voted "No" in January 2016 so she is not one of the betrayers @ least on this issue.

 

Collins, Murkowski, & McCain cast the three "No" votes, shown in column 3, that killed any healthcare reform @ all for the foreseeable future unless Trump forces another vote – see below.

 

Pence broke a 50 – 50 tie after Collins & Murkowski voted "No" on the procedural vote to allow debate in the Senate to even begin.  Without the 51 – 50 vote to proceed the three alternatives shown in the above graphic would never have taken place thereby shutting the healthcare reform debate down without a whimper after seven years of bluster.  It is important to remember that in 2016 the Republicans did not win the Senate – they held the Senate while losing two seats from their previous 54 to 46 majority.

 

When it was announced in the middle of July that McCain underwent surgery to remove a blood clot over his left eye McConnell acted like McCain was such a hero that there would be no Senate healthcare vote "without John McCain being present" – this sounded overly praiseworthy to me when I first heard it.  Come to find out McConnell knew that without McCain the Republicans would lose any vote 50 to 49 – McConnell needed McCain as a "Yes" vote to have a 50 – 50 tie for Pence to break.

 

Then to make matters worse Trump made the following tweet. 

 

click on tweet to enlarge

 

A strong case can be made that McCain got satisfaction voting "No" because the Tea Party members of the Senate, who he had previously called "whacko birds", wanted a clean repeal bill & of course nothing but ill feelings could exist regarding Trump for his comments about McCain's POW captivity.

 

Both McConnell & Trump had plenty of reason to believe that McCain would have been a "Yes" vote.  See campaign poster below from McCain's 2016 Arizona Senate race.

 

 

  click on poster to enlarge

 

 

There was plenty of outrage in the aftermath of the Senate's miserable failure to fulfill a campaign promise to repeal ObamaCare - made over seven years & four consecutive election cycles.

 

My favorite outrages involved the voters who do not know, & have not made it their business to know, the people who have control of their lives & their healthcare who said "we'll have to vote them out the next election".  Collins term does not expire until 2020 & Murkowski's & McCain's not until 2022 so their next election is not in the near future.  Collins, who says she did not vote for Trump, won her 2014 election with 68% of the vote & when she returned to Maine after the final healthcare vote she was met with applause @ the airport so she has no reason to change her ways.

 

But Trump does not take losing easily & he has two ways to force Congress to repeal ObamaCare.

 

First –  Government payments to the insurance companies as reimbursement for the so-called cost-sharing subsidies are not permanent appropriations - meaning that Congress in effect lets cost-sharing subsidies lapse if they do not make an annual appropriation.  In fact Congress has not authorized cost-sharing funds since 2014.

 

Accordingly, Trump is not authorized to make these cost-sharing payments – the next one is due later this month.

 

Cost sharing is a term used to cover out of pocket healthcare insurance costs such as deductibles, co-payments, & co-insurance.  Cost sharing expenses are made directly to insurance companies while the subsidies that reduce ObamaCare premiums are made directly to the insured in the form of reimbursable tax credits.  About 85% of people who buy ObamaCare on the exchanges qualify for subsidies that reduce premiums & nearly 60% of them have low enough incomes (below 250% of the federal poverty level) to qualify for cost sharing.  It is the other 15% of people who buy ObamaCare on the exchanges who get no financial help in paying premiums or medical expenses – these are the people you hear about that are hard pressed to meet the major ObamaCare insurance costs – premiums & deductibles.  People above the 250% federal poverty level but below 400% get some relief in paying premiums but no help with deductibles.  Healthcare costs are relatively small or nonexistent for people who qualify for cost sharing or Medicaid under ObamaCare.

 

Now Trump is constitutionally correct to require Congress to either authorize the cost-sharing subsidies or repeal ObamaCare – both being subject to his veto.  Pointing out that cost-sharing payments cannot be made to all the people described above gives a large incentive for Congress to act.

 

The House initiated a lawsuit against BO's White House for usurping Congress's constitutional power of the purse when BO made cost-sharing subsidy payments without proper appropriation authority from Congress.  A federal judge ruled in the House's favor but allowed the cost-sharing subsidies to continue while the litigation continues - the case is under appeal but being stayed while healthcare reform is being debated in Congress. 

 

Nevertheless, Trump made his own oath to support the Constitution so no matter what the court system does or decides on this clear case Trump should withhold cost-sharing subsidy payments until Congress rectifies the situation.

 

Some insurers have based their premiums for 2018 on the assumption that cost sharing subsidies will continue – without them they will either pull out of some markets or raise premiums accordingly – further abusing those who don't get premium help while leaving those who do only marginally affected.

 

Second – Heather Higgins recently reminded us that Members of Congress & their employees have been playing loose with the rules regarding their own healthcare insurance coverage.  Specifically, ObamaCare originally required members of Congress & their employees to buy healthcare insurance coverage under the ObamaCare exchanges meaning these people relinquished their generous plans under the Federal Employees Health Benefit Program. 

 

But not so fast – this meant congressmen & senators would suddenly be required to pay most if not all of their healthcare insurance costs – premiums & deductibles - & many of their employees would move to inferior plans @ added cost making their employment not as attractive as before.  Some congressional staffers could suffer the indignity of being thrown onto Medicaid – not a good image.

 

To spare themselves a self-serving embarrassing vote that would have highlighted their problem Congress & their employees appealed to BO who worked a deal with the Office of Personnel Management (OPM) – who had no legal authority regarding the matter.  OPM approved the whopper that both the House & Senate are small businesses with each having less than 50 employees.  Accordingly, the staffers were exempted from ObamaCare & stayed on their old healthcare insurance plans & members of Congress & designated official office staff have been covered through the District of Columbia's small business exchange – where they receive a special government subsidy from their employer (tax payers) of up to $12,000 per year.

 

Trump can right this deceitful contemptible abuse by instructing OPM to end the subsidies for Congress & their office staffs & the exemption for their employees.

 

Trump combined both of the above points in the following tweet:

 

click on tweet to enlarge

 

Trump knows of the ObamaCare bailout abuses, & now we know that he knows.  Trump can use this information as leverage to get Congress to pass legislation repealing ObamaCare that is suitable for him to sign into law – if successful this solves the original problem @ hand.  But one way or another Trump has to end these two ObamaCare bailout abuses because there is no surer way to honor another campaign pledge – namely to drain this portion of the Washington swamp.