The GOP does not know what the hell they are doing at the moment. The old-guard leadership still thinks they can get a lot of Democrat votes with an Obamacare Lite package. But they won't, and such a package has zero chance of passage since the libertarian wing of the Republicans won't vote for it. On the other hand, the libertarian ideas don't seem to be gaining much traction with the new populist base. And there's the problem that the Democrats will filibuster any Republican bill no matter what's in it, so nothing is going to pass without breaking down the filibuster, which Boehner and Ryan have said they won't do. Which side Trump is on depends on which reports you read.

I know this: not repealing Obamacare, lock stock and barrel, will not sit with either the libertarian base or the populist base. If the GOP leadership refuses to entertain that, Trump will have to replace them if he expects the party to hold onto Congress in 2018.

I know this: not repealing Obamacare, lock stock and barrel, will not sit with either the libertarian base or the populist base.

That isn't going to happen. It can't happen without a filibuster proof majority.

ObamaCare is like that reinforced concrete building from the 60s: it's hideous to look at, nearly impossible to renovate, and completely painful to demolish.

And until there are 60 votes to say yes in the Senate, demolition will have to wait.

This cracks me up, Minnesota had a system in place that worked well for people to obtain healthcare and insurance when they couldn't get it privately - prior to the ACA (now even MN Care/the MN Sure marketplace is a mess). Where was the Mayo clinic and their lobbyists when the ACA was being pushed through? Did they support it inadvertently?

One of the things that used to work for lots of people was to be part of an association that had an insurance policy you could buy. For example, artists could band together, and with thousands in the pool you could get a deal as good as at a company (though without the company contribution). Obamacare banned this.

"And until there are 60 votes to say yes in the Senate, demolition will have to wait."

All they have to do is make a Senate rules change. But John Boehner won't allow a resolution to do that to come to the floor. That's what I meant by the Trump reference. If the GOP leadership pushes a "compromise" bill which only nibbles around the edges, and then it still doesn't get any Democrat votes in the Senate, I think Trump will be forced to allow the caucus to replace him.

I dont have the whole sordid picture by any means but one of the main features of Obamacare was greatly expand medicaid.

One of the reasons for this, is medicaid funding is partially the duty of the states.and the percentage the feds pay is calculated state by state.

This was a two fer for the Obamacare mess as it shoved a lot of the working poor onto the medicaid roles, relieving the feds from having to provide policy subsidies for them, and also took the expense of their care and pushed it to an area that was partially funded by the states, which also made it easier to massage the hell out of the CBO numbers

This is why a number of states refused to expand their medicaid eligibility or establish an Obamacare exchange. It was a win win for them. The working poor in those states with tight eligibility for medicaid were eligible for the Obamcare policies and the state itself wasnt picking up part of the cost of the expanded eligibility or the state exchange.

In the states that expanded their medicaid, it was always going to be difficult to impossible to unring that bell and get people off of medicaid.

and of course now that there is a republican president in office, the horror stories about people dying in the steets without insurance or medical care will be front page news again.

I would not want to be a congressman trying to pick this mess apart. It may indeed take another election, and a supermajority to get it done.

John Boehner is House Majority Leader. Mitch McConnell is Senate Majority Leader. Mitch is the one refusing to change senate rules. Which only requires 51 votes. An easy threshold to pass right now. Boehner has no control over senate rules.

All they have to do is make a Senate rules change. But John Boehner won't allow a resolution to do that to come to the floor. That's what I meant by the Trump reference. If the GOP leadership pushes a "compromise" bill which only nibbles around the edges, and then it still doesn't get any Democrat votes in the Senate, I think Trump will be forced to allow the caucus to replace him. ~ Cousin Dave at March 17, 2017 11:36 AM

John Boehner is the former Speaker of the House. He has nothing to do with Senate rules. Paul Ryan is the current Speaker of the House.

As Ben points out, Mitch McConnell is the current Senate Majority Leader. And he's trying to avoid the mistakes Harry Reid made when he changed the rules on filibusters of non-SCOTUS appointments, a rules change the now-minority Democrats are ruing today. Making a rule change to benefit your party when you're in power can backfire when the other party is in charge, as Democrats found out.

Trump's idea seems to be to let Obamacare drown under its own weight and ride to the rescue with a new program. Repealing it will save trillions, but open the GOP to charges of being heartless and hand the Democrats an issue for 2020.

What the GOP seems to be missing is that they're dealing with a health insurance program, not healthcare. Fix the cost and competition issues in healthcare and Obamacare will die quickly as the bloated bureaucratic nightmare that it is.

I still say McConnell is a moron Conan. He wants to go back to the days before Reid broke most of the filibuster. But it doesn't work that way. He should just end the 60 vote cloture requirement and settle on 51. After both sides have bloodied themselves enough that they are willing to work together and be reasonable the 60 vote requirement can be reintroduced. But right now there is no good reason for the Democrats to play nice. McConnell is just being a chump. But what else is new.

You may be right and McConnell may be a moron, Ben, but he's at least smart enough not to repeat Reid's arrogance and stupidity.

Reid wanted to get Obama's appointments confirmed without any hinderance by the Republicans, so he destroyed the minority party's only weapon. Then, his party became the minority party (and looks to stay that way for a while).

If Democrats want to know why they're powerless today, they can thank Harry Reid. McConnell at least isn't leaving the Republicans in the same boat someday in the future.

You'll never restore the 60-vote threshold once destroyed. No majority party is ever going to give a minority party power, even with the threat of one day becoming the minority party. They'll use other means in their power to attempt to diminish the minority party so it never becomes the majority party.

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Republicans need to avoid repeating the Democrats' mistakes on Obamacare by including the Dems in the process. A law passed by only one party will not outlast the passing party becoming the minority party. Forcing an Obamacare replacement on the Dems only means that when they're in power again, they'll force a replacement and we'll have a revolving cycle of battling healthcare initiatives, leaving us broke and sick.

The thing the Republicans (and the Democrats) need to remember about repealing and replacing Obamacare is that the Republicans were elected to do just that. That was a big part of the campaign and Republicans won the House, the Senate, and the presidency on promises to repeal and replace Obamacare.

Hillary promised to amend Obamacare, but to keep the framework. Trump promised to blow it up. Who won? Trump.

Interesting Conan, so you're saying that the majority of Americans want Obamacare...

Interesting Conan, so you're saying that the majority of Americans want Obamacare... ~ Tony K at March 19, 2017 1:30 PM

WTF? That's the opposite of what I said. The Republicans won the presidency, the House, and the Senate - on the promise of repealing Obamacare.

And don't try the "Hillary won the popular vote" argument because the election wasn't held that way and we don't know how the majority would have voted had that been the election criteria. With a popular vote election, Trump would have campaigned in states he ignored (e.g., California) and voters in one-party majority states might have gone to the polls in greater numbers (i.e., Republicans in California or Democrats in Texas).

Keep in mind, she lost Wisconsin, Michigan, and Pennsylvania, all three of which were presumed to be hers without a fight. Get the "my vote doesn't matter so why bother" Trump voters to the polls in Massachusetts, New York, Illinois, and California and you might have a fight.

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Perhaps Mitch McConnell isn't such a moron after all.

"CBO announced that the repeal bill reduces taxes by almost $900 billion and reduces federal spending by $1.2 trillion over the next decade. This reduces deficit spending by $300 billion over the next 10 years. Thus the CBO, as official umpire, announced that the GOP Obamacare repeal plan may be enacted through "reconciliation," the process that requires a simple majority in the House and only 51 votes in the Senate. No filibuster allowed." ~ Grover Norquist

CBO announced that the repeal bill reduces taxes by almost $900 billion and reduces federal spending by $1.2 trillion over the next decade. This reduces deficit spending by $300 billion over the next 10 years.

All of which means jack shit as the deficit still runs to hunderes of millions and the debt isnt paid down at all

Conan said, "Hillary promised to amend Obamacare, but to keep the framework. Trump promised to blow it up. Who won? Trump."

Not arguing who won. That's clear. Only saying that the majority of votes for the presidency wanted to keep Obamacare. Feel free to make up a story for how the votes would have been different if the rules were different.

No, Tony.

First, the voters installed a Republican government (House, Senate, and presidency) and promises to repeal Obamacare made at all levels were a major part of that.

The Democrats passed Obamacare on a strictly partisan party-line vote, blowing past any Republican concerns or objections with an "I won, get over it" arrogance. Now that the Republicans are in charge, they're repealing a law they thought was a bad one. No surprises there. Republicans, however, are in danger of making the same mistake with the Obamacare replacement by shutting out the Democrats. If you want your program to last beyond your party's majority, you need to include the opposing party in the passage of the program.

Obamacare was never as popular as the Democrats like to pretend it was. It has reached a 54% approval rating only as it is facing extinction. Until then, it never reached 50%. The surge in popularity is most likely because Obamacare is a known commodity, not a loved one. And that surge in popularity reflects the public's fear of the unknown - with the total effects and cost of the replacement bill not known at this point. Keep in mind that Obamacare suffered from the public's fear of the unknown as it was poised to replace the existing health insurance structure, which was suddenly very popular at the dawn of Obamacare.

Second, I'm not saying the results would have been different if the rules were different. They might have been different. I'm saying that you can't make up a story and say they would have been the same under different rules.

"Republicans need to avoid repeating the Democrats' mistakes on Obamacare by including the Dems in the process."

That only works if both parties are working in good faith. The Democrats have made it clear that any Republican change to Obamacare will be opposed.

"A law passed by only one party will not outlast the passing party becoming the minority party."

So you don't replace you just repeal. Or as Ryan is doing you make it irrelevant. There is little good that the Republicans can pass on health care or even health insurance. Let this default back to the states.