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Dave Brat Thinks We’re Stupid

The failure of House Republicans to pass an Obamacare repeal and replace bill has been all over the news, and there are a lot of people casting blame and taking credit.  Ignore the spin – there’s only one group of people in Congress who deserve the blame for the American Health Care Act’s [1] failure.

Not the Democrats, who may be claiming a victory, but truthfully had nothing to do with it.  They were irrelevant and sitting on the sidelines.

Not Paul Ryan and the House leadership, who did everything they could to get this bill done, within their limited power.

Not moderate Republicans, who were always considered a second tier priority to be dealt with after House conservatives.

Not President Trump, who worked as hard as anybody to support Speaker Ryan and convince holdouts to support him and his agenda.

The blame (or credit, if you like Obamacare) lies solely with the House Freedom Caucus, of whom Congressman Dave Brat is one of the loudest and most visible members.  Obamacare is the law of the land today and stronger than it was just a week ago because of him and his colleagues.  The President knows who the blame belongs to, and said as much:

Brat and the Freedom Caucus are now in damage control mode, and that’s why Brat’s already out spinning some egregious “alternative facts” over on TBE [4].

It’s surprising how many misleading statements, half-truths and simply incorrect information one Congressman can squeeze into one single op-ed, but give Congressman Brat credit.  Almost everything in that op-ed is either wrong or misleading.  Brat has to be held accountable for these claims, and people deserve to know the entire truth, no matter how difficult (or boring) it is to explain.  This is long, even in terms of one of my articles, so bear with me.

Let’s take a look at just the most obvious of bogus claims he wrote about.

Bogus Claim #1 – “The House voted to repeal Obamacare more than 50 times – when it was clear that President Obama would veto the bill.”

This claim is absurd on its face.  First, the House never voted more than 50 times to repeal Obamacare.  That just didn’t happen.  What the House did was vote 50+ times to “repeal or amend” Obamacare, not simply to repeal it.  According to his own citation (which had a misleading headline) that was based on an article in the Washington Post [5], the vast majority of those “50+ votes” were votes to repeal or amend some aspect of Obamacare, not the entire law.  On at least 9 occasions, the Post noted, the House was able to successfully repeal portions of the law, passing bills that ended up being approved by the Senate and signed into law by President Obama.  Only a small handful of those 50+ votes were actual full repeals of Obamacare, and none of those full repeals were ever taken up by the Senate.  No full Obamacare repeal – and by full, I mean a complete repeal of every single provision of both the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (together making up all of Obamacare) – has ever been taken up by the Senate.  Not once. 

President Obama never vetoed a complete, clean repeal of the Affordable Care Act because one never reached his desk.

Bogus Claim #2 – “If we truly want to pass a bill, to make good on our promise of the past 7 1/2 years to repeal and replace the broken law, we would put the same bill forward that already passed with near unanimous GOP support.”

This is a claim that’s been repeated by a variety of people over the last few days, including Brat.  The bill they’re referring to was 2015’s H.R. 3762 [6], which was the GOP’s first and only attempt to force President Obama to veto a bill that substantially altered Obamacare.  Brat and others in the Freedom Caucus have been incorrectly claiming that this was a full repeal of Obamacare, but it wasn’t, and it didn’t include any replacement provisions.  The bill could not have been a full repeal because the bill was passed through Congress’s budget reconciliation process – the same process the AHCA was going to use to get enacted.  Brat is counting on people not understanding how budget reconciliation works – and that’s easy to do because it is an arcane, legalistic parliamentary trick that is being twisted to do things it wasn’t meant to do – in order to mislead people into thinking that a full Obamacare repeal is possible and within the House GOP’s grasp because of the false claim that they did it in 2015.

The budget reconciliation process allows Congress to expedite the passage of a bill designed to reconcile the Congressional budget with Congress’s priorities.  You can read more about it in this non-partisan brief written by the Congressional Research Service [7].  Please do not read this while driving or operating heavy machinery.  To make a long story short, in order to do budget reconciliation you have to have a Congressional Budget Resolution, which is enacted by the House and Senate and does not have to be signed by the President.  If the House passes the budget resolution, it does not need 60 votes in the Senate in order for it take effect (if the Senate passes one alone, it does [8]).  The House and Senate passed a budget resolution [9] for fiscal year 2017 (which started October 1, 2016 and lasts until September 30, 2017) in January [10] before President Trump was sworn in.

Included in that budget resolution was language designed to make it possible to repeal a significant portion of Obamacare without needing 60 votes in the Senate to defeat a filibuster.  Those instructions require the committees of jurisdiction over Obamacare in the House (Energy and Commerce and Ways and Means) and the Senate (Finance and Health, Education, Labor and Pensions) to come up with deficit reduction of not less than $1 billion for the period between fiscal years 2017-2026.  That sets up the use of budget reconciliation to repeal a large portion of Obamacare.

But here’s the catch – you cannot repeal all of Obamacare through budget reconciliation.  It’s not possible, thanks to the Byrd Rule, which is codified in federal law at 2 U.S.C § 644 [11].  The Byrd Rule was designed to ensure that only budget related matters ended up in reconciliation bills, and its terms require that any provision included in a reconciliation bill has to have some kind of impact on the federal budget.  If it doesn’t, it’s considered “extraneous” and gets cut from the bill.  Thus, reconciliation can only be used to repeal the things like the Medicaid expansion, things like the individual mandate that has taxes attached to it, all the spending provisions and the like.  You can’t use reconciliation to repeal the non-budgetary aspects of Obamacare – things like the provisions requiring health insurers cover people with pre-existing conditions, the mandatory minimum coverage rules, and the provisions that allow young adults to stay on their parent’s plans until age 26.  Those provisions don’t have a dollar sign attached to them, and thus they can’t be repealed through reconciliation.

When Brat, Ted Cruz and others claim that the 2015 “repeal” was a full repeal, they are wrong.  It was not.

Bogus Claim #3 – “Why the rush?”

Brat argues there was no need to try to rush to do in 17 days what it took President Obama a full year to do.  What Brat doesn’t want to admit was that this was the second step in a multi-step process that was going to take months to come to fruition.  Congress has until September 30th to pass a reconciliation bill before they will have to start over with a new budget resolution for Fiscal Year 2018.  The President and House leadership fully expected that Congress would use that entire time period debating and coming up with changes to whatever was passed last week, because everybody was fully aware that many of the provisions suggested by the House would not fly in the Senate.  The Senate would have worked on their own bill, passed that, and then both House and Senate would come together in the conference committee process to iron out the rest of the bill and present a final version for both Houses to pass on an up-or-down, no amendments vote.

The idea that the bill that the House was looking to pass was going to be enacted into law with no changes is patently absurd.  No bill of this magnitude would make it through the process without significant changes.  The goal was to get the reconciliation bill done first, then move to the policy bill or bills that will need to get done to complete the repeal of Obamacare through the standard process.  Be repealing the taxes and spending portions of Obamacare, the GOP would be forcing some kind of action on a replacement bill.  Without the individual mandate and the other tax provisions, the rest of Obamacare becomes unworkable.  That kind of pressure is the only kind of pressure that could get any Democrats to cross over in the Senate to help put together a replacement, and even that statement borders on insane naivete.

Why the rush?  Because there are a lot of steps that had to happen, and this was step two.  There was no reason not to do it now, but by not doing it, you eat up precious time for getting it done later and for getting the rest of the President’s agenda enacted.

Bogus Claim #4 – “The GOP leadership’s bill included premium increases of 15 to 20% until 2020. That is not progress.”

It’s also not the whole picture.  CBO’s score of the bill did indicate that premiums would go up until 2020, but then they would start going back down [12].  According to the CBO score, “[b]y 2026, average premiums for single policyholders in the nongroup market under the legislation would be roughly 10 percent lower than under current law[.]”

Bogus Claim #5 – “While some were led to believe we were getting a repeal of Obamacare, this bill left in place the worst planks of Obamacare, the parts that drive up the cost of insurance.”

This claim is bogus both because it repeats the claim that people were led to believe this was a full repeal of Obamacare – it wasn’t, and it couldn’t be – and because the idea that the bill left in place “the worst planks” is also misleading.  Yes, the parts that drive up the cost of insurance, like requiring coverage for pre-existing conditions, are still included but that’s because they can’t be repealed through reconciliation.  That provision, while the most costly, also happens to be one of the most popular provisions of the law, with a whopping 92% of the population arguing that any Republican repeal/replace bill include coverage for pre-existing conditions, according to a poll commissioned by the conservative American Action Network [13].

Brat says “[i]f you want to be able to shop for your health insurance, like you used to be able to, that was not in this bill. If you want your premiums to go down to where they used to be, that was not in this bill. If you are a young person who just wants to go out and buy a bare bones insurance plan that fits your life and needs, that was not in this bill,” all of which are true, but all of which are absurd to even mention.  People can’t shop for insurance now because they often don’t have any more than a single option for coverage, [14] and that’s because of Obamacare, not the GOP bill.  Young people are no longer required to buy any coverage because they aren’t going to be forced by the individual mandate to get coverage, but the policy changes that created the minimum coverage requirements that killed off ‘bare bones’ plans can’t be repealed via reconciliation, as was already noted.  And there is no way this bill, or any other bill, is going to force premiums down to “where they used to be,” although CBO did say their analysis was that average premiums would drop by 10% over current levels by 2026.  You can’t put the genie back in the bottle, and it’s not fair for Brat to demand that when any rational person should know it’s impossible.

Bogus Claim #6 – “Bottom line, the conservative members were left out of the drafting of the bill.”

Unless Congressman Brat is claiming that there are no conservatives on the House Budget Committee (which he sits on), the Energy and Commerce Committee and the Ways and Means Committee, the idea that no conservatives were involved in the drafting and review of this bill is patently absurd.  Brat, Mark Sanford (R-SC) and Gary Palmer (R-AL) all sit on the Budget Committee, which was the first committee to review the AHCA [15].  Brat, Sanford and Palmer joined every Democrat in voting against the bill after it was marked up.  Energy and Commerce [16] and Ways and Means [17] both held marathon sessions discussing the bill and offering amendments.  Energy and Commerce includes Virginia’s own Morgan Griffith, a Freedom Caucus member, and there are other strong conservatives on the committee who aren’t Freedom Caucus members.  Saying that no conservatives had any role in drafting this bill is wrong and its insulting to the folks who were involved in the process, which was more than just leadership.  In addition, the Speaker and the President went out of their way to try to address Freedom Caucus concerns.  They were never going to get to yes, because they won’t willingly admit that they do not want any kind of replacement that would come remotely close to doing the things Obamacare does.

They want a full repeal, with a piecemeal replacement of Health Savings Accounts and cross-state competition, which nobody has been able to make work and which isn’t going to take care of the issues some people have with getting insurance – whether it’s cost or a preexisting condition.

The op-ed never gets any better. Brat goes on to repeat a variety of these bogus claims, even going so far as to demand putting the 2015 reconciliation bill – again, NOT a complete Obamacare repeal – up for a vote this week without a replace package.  That would be foolhardy, even though it would likely pass, because Republicans only have one bite at the reconciliation apple – it can only happen once per Congressional budget resolution – and if they just did a repeal of the financial provisions of Obamacare, they would be wreaking havoc on the private insurance market and the health care industry while not having a plan ready to go that can pass Congress to replace it.  There is just no way to do a partial repeal through reconciliation first and then a replacement later.  Unless you do both at the same time, getting as much done in the first bill as you can and then setting up a second bill designed to get some kind of Democratic support, Obamacare simply can’t be repealed and replaced.

Let me repeat that – for those asking “why didn’t they just repeal the entire law,” as of right now, there is no way a straight repeal of all of Obamacare gets passed.  The votes are simply not there.  Any repeal has to be packaged with a replacement, and that replacement is going to necessarily include popular parts of Obamacare that conservatives don’t like but the general public does. The idea that we are going to take health insurance away from millions of Americans is a non-starter. It is not going to happen, and anybody who thinks it is possible (or that it should be done) is not being rational.

That’s the actual bottom line, but Congressman Brat doesn’t want you to know this.  He’d rather peddle half truths and misinformation.

There are two conclusions, and only two conclusions, that we can draw from all of this.

  1. Congressman Brat thinks we’re stupid, and we are easily mislead about how Congress works, and is thus telling us lies that sound good in an attempt to maintain his reputation with the activists who love him no matter what he does or;
  2. Congressman Brat has no idea what he’s doing, and is simply repeating things he’s heard without actually taking the time to understand the process, the history, or the policy behind the issues with the Affordable Care Act and its repeal.

Because I’m a southern gentleman and I was raised properly, I am loath to call any man a liar.  That only leaves me with option two.  But I could forgive you if you think option one is more likely.

At some point, Brat’s constituents – the ones who have silently sat back and accepted him because he’s not a Democrat – need to step up and demand more from their representative in Congress.  At the very least, they should be able to get better information from him than do from me.

Right now, they don’t.

Brat and his fellow travelers in the House Freedom Caucus just handed President Trump his biggest setback of his presidency and they are the ones responsible for Obamacare being the law of the land. Do not let them weasel out of accepting responsibility for their actions. Hold them accountable.

But it’s worse than just handing President Trump a loss in his first hundred days.  Already in Virginia we have seen Governor McAuliffe [18] and General Assembly Democrats use the failure of the House to vote on a repeal/replace package to renew their calls for Medicaid expansion.  That stance would have been even more nuts than it is if the House had voted to repeal the funding for states to use to expand Medicaid.  That language, oddly enough, was included in the House GOP repeal/replace bill, which phased out the increased subsidies for Medicaid expansion by 2020.  This was a possibility that a variety of Republicans, including me [19], raised years ago when we first started opposing Medicaid expansion in Virginia.  But since Obamacare is safe, thanks to Congressman Brat, the Virginia Medicaid expansion is back, just in time for 2017’s gubernatorial election.  The Democrats are going to use this issue to bludgeon our gubernatorial nominee and all our Delegate candidates in November.

Not only did Congressman Brat hurt President Trump, he just hurt whoever the GOP nominee for Governor is going to be in 2017.

Virginia’s Most Useless Congressman™ strikes again.