Republicans’ Spending Dilemma, In One Tweet

Most of official Washington woke up apoplectic on Sunday, when a tweet from President Trump invoked “the Swamp’s” most dreaded word: “Shutdown.”

Put aside for a moment specific questions about the wall itself—whether it will deter illegal immigration, how much to spend on it, or even whether to build it. The Trump tweet illustrates a much larger problem facing congressional Republicans: They don’t want to fight—about the wall, or about much of anything, particularly spending.

Voting for the Mandate after They Voted Against It?

Take for instance an issue I helped raise awareness of, and have helped spend the past several weeks tracking: The District of Columbia’s move to re-establish a requirement on district residents to purchase health insurance.

As I wrote last week, Sen. Ted Cruz (R-TX) offered an amendment in the Senate that would defund this mandate. The amendment resembles one that Rep. Gary Palmer (R-AL) offered in the House, and which representatives voted to add to the bill. If a successful vote on the Cruz amendment inserted the provision in the Senate version of the bill, the defunding amendment would presumably have a smooth passage to enactment.

So what’s holding it up? In a word, Republicans. According to Senate sources, Republican leaders—and Republican members of the Appropriations Committee—don’t want to vote on Cruz’s amendment. Several outside groups have stated they will key-vote in favor of the amendment, and the leadership types don’t want to vote against something that many conservative groups support.

Are Democrats Running Congress?

In short, because Democrats might object. Appropriations measures need 60 votes to break a Senate filibuster, and Democrats have said they will not vote for any bill that includes so-called “poison pill” appropriations riders. The definition of a “poison pill” of course lies in the eyes of the beholder.

Politico wrote about the spending process six weeks ago, noting that new Senate Appropriations Committee Chairman Richard Shelby (R-AL) and Ranking Member Pat Leahy (D-VT) “have resolved to work out matters privately. Both parties have agreed to hold their noses to vote for a bill that they consider imperfect, but good enough.”

That “kumbaya” dynamic has led Senate Republican leaders and appropriators to try and avoid the Cruz amendment entirely. They don’t want to vote against the amendment, because conservatives like me support it and will (rightly) point out their hypocrisy if they do. But they don’t want the amendment to pass either, because they fear that Democrats won’t vote to pass the underlying bill if it does. So they hope the amendment will die a quiet death.

Conservatives Get the Shaft—Again

At this point some leadership types might point out that it’s easy for people like me to sit on the sidelines and criticize, but that Republicans in Congress must actually govern. That point has more than a grain of truth to it.

On the other hand, “governing” for Republicans usually means “governing like Democrats.” Case in point: The sorry spectacle I described in March, wherein Republican committee chairmen—who, last I checked, won election two years ago on a platform of repealing Obamacare—begged Democrats to include a bailout of Obamacare’s exchanges in that month’s 2,200-page omnibus appropriations bill.

The chairmen in question, and many Republican leaders, feared the party will get blamed in the fall for premium increases. So they decided to “govern” by abandoning all pretense of repealing Obamacare and trying to bolster the law instead, even though their failure to repeal Obamacare is a key driver of the premium increases driving Americans crazy.

With an election on the horizon, bicameral negotiations surrounding the spending bill could get hairy in September, because two of the parties come to the table with fundamentally different perspectives. Republican congressional leaders worry about what might happen in November if they fail to govern because they stood up for conservative policies. Trump worries about what might happen if they don’t.

UPDATE: On Wednesday afternoon, the Senate voted to table the Cruz amendment blocking DC’s individual mandate. Five Republicans who voted to repeal the individual mandate in tax reform legislation last fall — Louisiana’s Bill Cassidy, Maine’s Susan Collins, Alaska’s Lisa Murkowski, Alabama’s Richard Shelby, and Utah’s Orrin Hatch — voted to table, or kill, the amendment.

Because the vote came on a motion to table, senators may attempt to argue that the vote was procedural in nature, and did not represent a change in position on the mandate. Shelby, the chair of the Appropriations Committee, said he supported the underlying policy behind the Cruz amendment, but voted not to advance the amendment because Democrats objected to its inclusion.

This post was originally published at The Federalist.

The Binary Choice Behind a “Skinny” Health Care Bill

Are you for The Swamp—or are you against it?

It’s really that simple. Text of the supposed “skinny” bill—or the “lowest-common denominator” approach, if one prefers—has not yet been released. But based on press reports, it appears the legislation will repeal the individual and employer mandate penalties, along with the medical device tax, and little else, so the House and Senate can set up a conference committee to re-write the bill—if the House does not decide to pass this “skinny” bill outright.

  • It will embolden Senate leadership to keep bullying rank-and-file members on future pieces of legislation, pulling bait-and-switch moves at the last minute and daring members to vote no;
  • It will move the health-care debate from an open Senate floor process into a conference committee, where after one token public meeting most legislative work will occur behind closed doors;
  • It will concede that the “world’s greatest deliberative body” cannot deliberate as an institution, and instead empower unelected leadership staff in a secretive process to cobble together a new bill that can pass both chambers;
  • It will continue a process that Republican staffers themselves have described as “making it rain” on moderate senators through various backroom deals and spending sprees—bringing parlance heretofore used in strip clubs to the U.S. Congress;
  • It will raise premiums an estimated 20 percent, by eliminating the individual mandate penalty, but leaving all of Obamacare’s regulations intact;
  • It will all-but-guarantee a future Obamacare bailout, destabilizing insurance markets such that carriers will come running to Congress demanding corporate welfare payments to keep offering exchange coverage; and
  • It will prioritize K Street lobbyists who have fought for years to repeal the medical device tax, virtually guaranteeing that provision will remain in the final legislation, while raising premiums on hard-working American families.

If senators support the above scenarios, then they should vote for the bill. If not, perhaps they should consider another course.

Blast from the Past

Conservatives have seen these games played before—and rejected them. In 2015, House Republican leaders initially offered a bill eerily similar to the rumored “skinny” legislation. That bill repealed the individual and employer mandates, the medical device tax, the “Cadillac tax,” the Obamacare prevention “slush fund,” and a few other ancillary provisions. Conservative groups could have supported it—just to keep the process moving, and continue the momentum for a broader repeal—as leadership is asking them to do right now. They did not because:

The bill would not restore Americans’ health care freedom because it leaves the main pillars of Obamacare in place, nor would it actually defund abortion giant Planned Parenthood. This bill violates an explicit promise made in the budget, which ‘affirm[ed] the use of reconciliation for the sole purpose of repealing the President’s job-killing health care law.’

That statement comes from Heritage Action, which key-voted against passage of the “skinny” repeal bill in 2015. Likewise, in the fall of 2015 conservative senators Mike Lee (R-UT), Marco Rubio (R-FL), and Ted Cruz (R-TX) said publicly they could not support what they viewed as an insufficient attempt at repeal:

On Friday the House of Representatives is set to vote on a reconciliation bill that repeals only parts of Obamacare. This simply isn’t good enough. Each of us campaigned on a promise to fully repeal Obamacare and a reconciliation bill is the best way to send such legislation to President Obama’s desk. If this bill cannot be amended so that it fully repeals Obamacare pursuant to Senate rules, we cannot support this bill. With millions of Americans now getting health premium increase notices in the mail, we owe our constituents nothing less.

The bill does not even touch Obamacare’s main two entitlement expansions: The Medicaid expansion and the Exchange subsidies. The bill leaves all of Obamacare’s new insurance rules and regulations in place. It also leaves many of Obamacare’s taxes in place….

The Obamacare repeal movement has been successful in the last 5 years in keeping full repeal intact. It has recognized that it will be much easier to repeal Obamacare as a whole if all of the mandates and entitlement expansions are repealed at once, since we know that the law is vastly unpopular when taken as a whole. The threat is that ‘repeal’ is defined-down to simply mean repealing a couple high-profile provisions, while allowing the main pillars of the law to continue untouched. This package threatens that very outcome: defining down ‘full repeal’ and jeopardizing the entire repeal effort. [Emphasis mine.]

Need for Consistency

In the past several days, conservatives have attacked Senate moderates—rightly—for flip-flopping on a full repeal of Obamacare, voting for it in 2015 but opposing it now. Those who face a similar situation from the Right—that is, those who opposed a “skinny” bill two years ago—should not fall into the same trap as those from the center. On both policy and process, conservatives should reject the minimalist approach floated by leadership, and continue working to repeal Obamacare.

This post was originally published in The Federalist.

Sen. DeMint Op-Ed: We Must Stop Obamacare Before It Becomes Hazardous to Our Health

New York’s famous 42nd Street will offer natives and visitors a new sight later this week: a mammoth, six-story billboard with a striking message: “Warning—Obamacare may be hazardous to your health.”

It’s part of The Heritage Foundation’s continuing public education campaign to inform the American people about the dangerous side-effects of this unfair, unaffordable and unworkable law, and how it can be stopped.

How will Obamacare—a 2,700-page law passed by a single vote over bipartisan opposition— harm Americans’ health?

Well, here are five of its worst side effects.

First, many Americans will lose their current health coverage. That’s what’s happening to Rod Coons and Florence Peace, a married couple in Indianapolis. Rod and Florence like their current plan.

“I’d prefer to stay with our current plan because it meets our needs,” Rod says.

Unfortunately, their current coverage fails to meet new requirements imposed under Obamacare by federal bureaucrats. At the end of this year, that plan will no longer be available to Rod and Florence. They’ll have to find another, Obamacare-sanctioned plan that may restrict their access to certain treatments or force them to buy coverages they neither want nor need.

Second, many Americans will lose access to physicians they trust. The Wall Street Journal recently highlighted the case of John Nowak, who faces a dilemma when he chooses an insurance plan on Obamacare’s Exchanges this fall. He “will be able to pick a [revised, Obamacare-compliant] plan from his current insurer—or go for one that includes his primary-care doctor.”

To save costs, many plans on Obamacare’s Exchanges are limiting physician networks. So if John chooses to keep his current insurance carrier, he may not be able to keep his current doctor. At minimum, he will pay a lot more to see that physician out-of-network.

Third, Obamacare places bureaucrats between doctors and patients. The law imposes new penalties on doctors who do “not satisfactorily submit data” that meet Washington bureaucrats’ standards.

It also creates a panel of unelected, unaccountable bureaucrats empowered to make rulings that reduce Medicare spending.

Little wonder that nearly three in five physicians responding to a recent Deloitte survey think the practice of medicine is in jeopardy.

Fourth, Obamacare dumps millions of patients onto Medicaid—a health program so bad that not even Medicaid patients call it “real insurance.” An analyst for the liberal Consumers Union once admitted that a Medicaid card is but a “hunting license”—“a chance to go try and find a doctor” that actually accepts Medicaid patients.

Moreover, several studies have shown that people enrolled in Medicaid often have worse medical outcomes than those with no health insurance at all.

Expanding a broken Medicaid program is just giving millions of Americans a cruel and empty promise—an insurance card with limited access to real health care.

Fifth, Obamacare’s reductions in Medicare spending could undermine the health system for millions of seniors.

According to the non-partisan Medicare actuary, the law’s arbitrary spending reductions could cause 15% of hospitals to become unprofitable by 2019, and as many as 40% of hospitals to become unprofitable in the long term. These hospitals could face the choice between shutting out seniors or shutting their doors for good.

Either outcome is unacceptable.

Obamacare is not just bad for Americans’ physical health—it’s bad for America’s fiscal health as well. If Congress does not act, on January 1, 2014, Washington will tap a gusher of new federal spending on Obamacare.

Over the next decade, the cost of the law’s new entitlements will soar more than fivefold, from $48 billion in 2014 to $250 billion in 2023.

That will create a lot of pain in taxpayers’ wallets.

For all these reasons and more, Congress must act, and act now, to stop Obamacare before it takes root.

This fall, Congress will have an opportunity to use its “power of the purse” to block Obamacare from going forward.

I recently traveled across the country on a town hall tour sponsored by our sister organization, Heritage Action for America.

I met many Americans concerned about the impact of Obamacare on their health care, who want the law stopped immediately.

There are things we can and should do to improve America’s health care system and reduce costs, but first we must stop Obamacare before it starts.

The law is a dangerous prescription for America, and its side effects will damage our collective health.

This post was originally published at Fox News.

Obamacare: What Conservatives Should Do Next

Given last week’s devastating announcement that the Administration cannot implement Obamacare’s employer mandate next year without costing jobs, many conservatives have pondered the best course of action for Congress to take in response. The strategic options are many, but the choice should be clear: Congress should refuse to spend a single dime implementing this law.

For instance, some have called for repealing or delaying the individual mandate-because struggling families should get the same break big businesses received when the Administration delayed the employer mandate last week. Others have called for delaying the law for a year, or for defunding IRS efforts to implement Obamacare.

Repealing only some portions of the statute-for instance, the individual mandate, or IRS enforcement-will allow other portions more fully to take root. And without language fully defunding the law, delaying portions of Obamacare will only give the Administration more time to try and “fix” the technical glitches hampering creation of Exchanges. That’s why the best “delay”-and the only effective one-is a full defunding of the statute, one that forces all federal bureaucrats to put down their pens and stop crushing the American economy with Obamacare mandates and regulations.

Only a full, complete, and total defunding of Obamacare accomplishes all of these goals. Conservatives should keep their eyes on the prize and focus on the ultimate objective: Ensuring Congress does not spend a single dime on Obamacare.

This post was originally published by Heritage Action.