2018 and repealing Afrocare

    After losing sleep and bouncing off walls for two days I am ready to fight back against Trump---to think about 2018 and beyond. Fighting back means getting the brain to avoid its propensity for "story" and focusing on facts and action plans. Trump can achieve big parts of his non-economy agenda through executive action and getting his nominee(s} confirmed in the Senate. Conservative judges will appease a large part of the religious right but not to suffer reverses in 2018 and beyond he has to deliver both additional red meat to his base plus economic success to everyone else. Obviously he can deliver red meat easily. But if he overdoes, and especially if he doesn't deliver on the economic front, 2018 might not be a cake walk for him and Republicans. 

    "Afro"care, or if you must, "Obama"care---the same notion---is inextricably tied to both Trump's red meat and economic deliverance goals, but in different ways. Eliminating and/or revising and renaming "Obamacare", accompanied by a lap dance of red meat and racial overtones, accomplishes the first goal---but how it's done is not easy without risking adverse economic benefits, and a degree of social backlash---which I assume still holds some relevancy with the moderate Republicans who held their noses and voted for him. 

    Apparently Trump agrees with a Ryan healthcare overhaul plan which in no big surprise eliminates the  "guaranteed issue" (can't preclude on the basis of pre-existing conditions} and the mandate. Trump has the business sense to see that eliminating these features will make insuring 20 million people even more difficult than it is now. It's a potential mess for him. If the new healthcare plan is bungled, who could escape the tag of "Trumpcare"?

    Eliminating the health care of 20 million people would have an enormous adverse economic effect due to the profit and employment importance of the healthcare sector. Ryan's plan was never supposed to work. Trump is the one who has the hot potato and it is for that reason I think, that he reportedly has introduced the idea of allowing insurers to market willy nilly in any state, thereby creating competition and reducing plan costs. For a whole host of reasons explained well by others, the efficacy and reduction of plan costs via interstate marketing is a non-starter.

    Thus, it is one thing to get rid of "Afrocare" and another thing to get something to replace it and neither make a mess nor depress the economy. I don't think Trump can get away with eliminating the Affordable Health Care plan or replacing and gutting it without causing a social backlash and a negative impact on the economy. If Trump can't deliver the red meat on Afrocare, he is feckless and incompetent and will lose an edge with his base. If he messes up health care he is a bungler, living up to his history of questionable business ventures. If he eliminates the structure altogether, plan costs will go up and the economy will take a ding---both bad scenarios for 2018 and beyond.

    So let's take heart, try to save the health care of millions and hammer the Trump Administration in the lead up to 2018, starting now.


    Couple of good articles today on Bloomberg, especially the health care one by Megan McArdle.

    There is no federal bar to interstate sales right now.  It's just another one of those expeditions into fact free discourse that is begun every time he opens his mouth. 


    The regulation is virtually all state, although one could envision  federal preemption legislation mandating interstate marketability, but no one wants to sell that way because you can't manage a provider network remotely.

    Hey, Jolly. Essential to the argument and, as always, concise. Thanks.

    I'm more pessimistic than you, Oxy. Republicans have voted to repeal "Afrocare" sixty-something times, but they have not once voted for anything to replace it. Why not? Paul Ryan and friends certainly understand the need to offer an alternative, but the Freedom Caucus disagrees. Ryan doesn't have the votes to pass another plan, and Democrats certainly won't help him out. The only thing Republicans can agree on is that Obamacare has to go, so that's what's going to happen. They may try to come up with an alternative, but they won't be able to pass it. Will that "make a mess?" You betcha, as our future Secretary of the Interior would say. A big goddamn mess. But that's how they roll.

    PS I've no idea how Trump will try to handle this, but he commands neither the loyalty, nor the charm, nor the mandate to make the Republicans do anything they don't want to do.

    Thanks for commenting. I dread the thought of people losing everything.

    Do you agree that repealing would result in an economic drag? And new infrastructure spending, which might otherwise offset the impact, is going to be limited by the same freedom caucus.  So it's a problem for Trump.

    The direction of health care stocks will be a telling sign.

    And what is the moral obligation of democrats to salvage something, given they may be enabling Trump's presidency

    Good blog good points. 

    Found this interesting and scary analysis at a progressive blog, on the Trump 'southification of the north'.

    As I noted yesterday, rural whites in places like Pennsylvania voted for Trump in close to the same numbers that you typically see whites in states like Mississippi vote for the Republicans. Where Romney might have gotten 70% of their votes, Trump frequently got around 80%.

    Back in 2013, I said it would be “criminal” for the Republican Party to deliberately racialize our politics in the North to the point that they resembled what we see in the South. I said that to accomplish this, the GOP would have to use “a strategy that will, by necessity, be more overtly racist than anything we’ve seen since segregation was outlawed.”

    I didn’t say the strategy couldn’t or wouldn’t work.

    It did work.

    Thanks NCD. An excellent reference.

    So, the takeaway is that the election proves that whites in the North are, in the final sense, and perhaps for the first time, voting as an ethnic group---whereas in the South they have been doing so forever. This doesn't give me a lot of hope for the future, given increasing voter restrictions.

    While I agree with the article, not sure it can be proven statistically---yet.

    I have been thinking whether I want to continue living in Red Texas, given I ike my neighbors but hate what they have all just voted for.  lAs far as I can see, Vermont is looking a lot more attractive than it did last week. Irony is that they are a white state.


    Lived in NJ and NYC (and VA AK AZ CA) not New England, NEnglanders seem much better educated than the Penn/Ohio/Kentuc/Tenn region. They got Bernie and Eliz Warren and voted out Ayotte or whatever her name was.

    I just heard the Republican gov of AZ is pleading with Trump and his nujob right wing handlers to fix Obamacare not repeal it, and do so with Democrats. Seems 400,000 arizonans depend on it. The healthcare system could collapse here.

    This, I think, is the conundrum the R's have, particularly Ryan, R house, and Trump.

    If House doesn't repeal, 2018 will see tea party R's with even more rabid challengers than they themselves are.

    If they do repeal, states lose on the economic front---as, well, states do need a healthy workforce.

    No, Tea Party is dead. Under Trump it's simply what he says. Chairman Trump *is* the Party. Build a wall, don't build a wall - it's up to him. No one will be tallying election promises. He's the exceptional leader for an exceptional country. Anything goes.

    As long as we're on Cole Porter, let me say that I get a kick out of you.

    Michael Moore, who apparently is the only predictor with any feel of the pulse, says Trump will be impeached before his term is over. You may say that he's the top.  But that's the problem, he's going to give the Congress a hundred good reasons to kick his ass out. I myself had been predicting such an outcome but forgot to mention it until now.


    Michael, remember how Obama rolled up all the splinter groups under him after election day? Expect the same and worse under Trump. He may not command loyalty or charm, but they all (almost) came crawling back to him before election day. And America, at least the right, loves what they perceive as a winner, so his "charm" will be considerably improved.

    Update: or with the infighting beginning, maybe it won't be as clean, maybe it will.

    A gem I didn't realize earlier about Jared Kushner, Trump's son-in-law:

    The other pointed out that Kushner’s father was prosecuted and convicted for tax evasion, illegal campaign donations and witness tampering by Christie during his time as a U.S. attorney.

    “Jared doesn’t like Christie,” the person said. “He’s always held that against Christie.”

    Should have watched more "Sopranos" - I'm out of my depth now. But the apple don't fall far from the apple tree, it seems.

    BTW, CNN hiring Lewandowski as an analyst was cynical media malpractice at its worst. Him going on and on election night as a partisan shill was simply disgusting. Now he'll at least be in the corrupt administration where he belongs.

    So, this is the first test.  How Republican is our new president?  Does he let Paul Ryan have his way with all the policy stuff?  If so, forget just goodbye ACA, the government will truly get out of our Medicare. Along these lines, does Trump want two terms or an enduring Republican majority?  If not, then he has no political third rails.

    That's what Ryan is proposing according to an article I read just a couple of hours ago. He just said he wants the repeal of obamacare to include the privatization of medicare.

    I've been trying to distill this relationship between Trump and Ryan and the inescapable conclusion is that it's adversarial, the key word being "careerism". There is no way these young Republican Turks----Cruz, Ryan, Rublio, etc. are going to put up with Trump for more than four years. I'm not sure how it affects the Turks' decision-- making vis a vis everything That Trump will want. But it's a rift which Democrats might exploit. 

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