Must-Read: David Anderson: Governing Is Hard

Must-Read: The right moment for Republicans interested in health policy to intervene in the politics was back in 2010, when the “repeal and replace” meme was first decided on. They should have said: “Hell, no!–You really do not want to say that.”

My suspicion is that they thought the battle was not worth fighting because the dog would never catch the car. The least they could do is apologize to the rest of us now…

David Anderson: Governing Is Hard: “The Republican Party has an ACA problem.  The ACA is deficit reducing…

…raised taxes on upper income families…. But the Republican Party is ideologically committed to lower taxes on high income families. The Republican Party has a policy problem. It needs to offer something that is close enough to coverage to minimize blowback of sympathetic figures crying on camera that the Republican health policy bill will kill them. So that means some type of coverage.  And that means spending some money…. So here is what the Republican Party’s wonks are proposing:

Republicans are considering capping the U.S.’s tax break on job-provided health insurance, a major change to the tax system that could be used to finance their efforts to repeal and replace Obamacare.

This is a big pool of money… a quarter trillion dollars a year… a regressive tax benefit where the benefits mostly accrue to upper income individuals…. Most liberal wonks (myself included) will agree that building a system from scratch, ESI tax exclusion would never be part of an ideal package. BUT HERE IS THE PROBLEM.  It pisses off voters who receive coverage through work. And we already sort of tried this route before:

A similar idea was proposed by Senator Ron Wyden, a Democrat, during debate over the Affordable Care Act, and went nowhere. Obamacare already includes a levy on high-cost health insurance plans, known as the Cadillac tax, that begins in 2020. Republicans didn’t say where they would set the cap….

If the Republicans need to raise serious money from this exclusion being rolled back ($50 to $100 billion a year is serious), it means the tax hits most employer sponsored health plans to some degree.  If they don’t raise serious money because they fear blowback, it is a high income earner only tax and it still leaves their plan with a massive hole.

The easiest solution for Republicans looking for money…. Just borrow it…. But I can’t see how this proposal would get 150 votes in the House or 40 in the Senate.

Whenever before Republicans have found themselves in a serious box, the out has been: Just “dynamic score” it so you can claim you aren’t borrowing it, and then–“LOOK! IT’S HALLEY’S COMET!!”