Obamacare: Is There Any Bipartisan Compromise Possible?

On Friday afternoon, Speaker Paul Ryan pulled the so-called American Health Care Act shortly before a scheduled vote in the House of Representatives.  From reading the press over the weekend -- both liberal and conservative -- you would have to think that this is a huge disaster for Speaker Ryan, for President Trump, and for all Republicans.  The Republicans can't govern!  They're hopelessly divided!  Paul Ryan is a loser and should resign immediately!  Trump has suffered a huge defeat!

Time for a new narrative.  Seems to me like this is something that is complex and may take a few tries.  Meanwhile, here are a few points that should be obvious, but that nobody seems to be making:

  • This particular bill was carefully engineered to meet the tests for "reconciliation," so that it would be immune to filibuster.  A bill immune to filibuster can therefore pass the Senate with only 51 votes, not to mention not requiring any Democratic support in either house.  But that constraint severely limited the scope of what could be covered in this bill.  Here's a suggestion:  If the filibuster can be done away with for judicial nominations by a bare majority vote, then why not go a step further?  I suggest doing away with the filibuster for any bill that seeks to repeal prior legislation.  The filibuster was designed to slow the pace of new legislation that might have unintended consequences; but there's no reason to have a filibuster when the issue is getting rid of destructive prior legislation, of which Obamacare is just the most obvious example among thousands.
  • Meanwhile, without this bill, Obamacare lives for another day.  But for how long?  The failure to schnooker the affluent young and healthy into signing up becomes more painfully obvious with every passing day and month.  Result: soaring premiums on the Obamacare "exchanges," and an accelerating death spiral.  From Time Magazine (no enemies of Obamacare) last October:  "[F]or Americans who don't get insurance through work, and who make too much money to qualify for federal subsidies, the cost of health coverage is about to soar dramatically. . . ."  They report average premium increases for the 2017 year in various states as: Alabama 36%, Georgia 32%, Illinois 44%, Minnesota 50-67%, Nebraska 35%, Oklahoma 76%, Pennsylvania 33%, Tennessee 44-62%.  Is it any wonder that people are angry?  
  • It seems to be a given that no Democrat will support any effort to redo Obamacare, whether that means full repeal, or for that matter any significant reform in the direction of reducing federal control or spending.  Somehow, I can't find any article that even mentions this subject.  But without the passage of some Republican-backed reform, the law in place is the one passed by Democrats without a single Republican vote in support.  Is this where Democrats want to find themselves as premiums continue to accelerate?   

I for one will be very surprised to see Obamacare survive in anything like its present form all the way through to the next election in 2018.  What we just had is only round one.

But here's the interesting question:  Is it even remotely possible to come up with some reform that some Democrats will consider supporting?  There is nothing complicated about the partisan divide as currently constituted.  The Republicans (appropriately, in my view) are only willing to consider reforms that reduce government control and government spending.  The Democrats are only willing to consider reforms that increase government control and government spending.  There is literally no basis for compromise between those two positions.

So the Republicans have some tinkering to do before they can come up with a bill that will get the majorities that they need to pass it.  Meanwhile, isn't the real narrative the staunch refusal of even a single Democrat to participate in any way in a reform of Obamacare that might reduce, even slightly, government control or spending?