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“Now What Do We Do?” Trumpcare?

Of course, “Now what do we do,” is the famous line from Robert Redford’s character in The Candidate, stunned by his victory and confused about what to do next.

But it doesn’t really apply here.

A few thoughts as all of this sinks in:

  • Some will tell you the Republicans are unprepared for repeal and replace. Wrong. There is a plan. Don’t let anyone tell you there is not. The plan was written by Paul Ryan as part of his “Better Way” document released in June of this year. It is not in legislative form, but it is as detailed as the plan Bill Clinton or Barack Obama had the morning after they were elected. I fully expect Speaker Ryan to take the point on putting the legislative details on the table, which will generally follow this outline.
  • As I pointed out in my blog post earlier this morning, Obamacare will effectively be repealed. No ifs, ands, or buts about it. The Trump voters voted for him expecting that he and the Republicans would do it and there is no turning back. This will be the first if not one of the first agenda items. Speaker Ryan, at his press conference this morning, reaffirmed that.
  • The repeal part will be the easiest part––not a literal repeal but a defunding of the money used for the exchange subsidies, the Medicaid expansion, and that run the exchanges.
  • The much harder part will be the replacement. Republicans will say to Democrats, “Help us create the new insurance system or be responsible for the consequences.” Some are saying the Democrats won’t cooperate. Here is why they will. In 2018, there are 23 Democratic and two Independent Senators (who caucus with the Dems) that will be up for reelection––a great many in states that Donald Trump won last night! There is a clear mandate here to replace Obamacare. If these Democrats fight it and that arguably results in millions of people thrown off their coverage they will do so at their peril.

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