Don't Buy Into The Idea That Trumpcare Is Too Horrible To Pass-- That's Not Criteria Republicans Use

George Stephanopoulos had two very different Senate Republican opponents of TrumpCare on his show Sunday, Susan Collins (R-ME), who finds the bill cruel and even draconian, and Rand Paul (R-KY), who doesn’t find it nearly draconian or cruel enough. He started with Rand Paul, pointing out to him that his position is at odds even with Señor Trumpanzee, who said the bill that bears his name should “have more heart.” Paul scoffed and ran off in directions unrelated to the debate outside of the one in his own head.

Well, you know, the fundamental flaw of Obamacare was that it added regulations to insurance, mandates, which made insurance more expensive, but then it also told individuals, you know what, if you don't want to buy now, you can wait and buy it after you're sick. That still remains, 10 of 12 regulations that add cost to insurance remain under the Republican bill. And we still say you can still by insurance after you're sick.

If you add those two together, you still get the death spiral. The Republican plan acknowledges that we're going to still have this death spiral, which is sicker and sicker people in the individual market and the healthy people don't buy insurance, they acknowledge this by putting over $100 billion of insurance bailout money to try to say, oh we're going to tamp down prices. We're going to fix the problem, we're going to acknowledge the will continue forever and we're just going to pile taxpayer money into it. That is just not a conservative notion to add a new federal program to bailout insurance programs… I'm not voting for something that looks just like Obamacare and still doesn't fix the fundamental flaw of Obamacare.

It was a weird discussion. Stephanopoulos kept babbling about the politics on the bill-- how many no votes are there? What will it take for McConnell to get your vote? That kind of stuff-- while Paul just wanted to make a tired libertarian case about abolishing all regulations. So George said au revoir and moved on to Susan Collins. He started by asking her if there is “any way this week for Senator McConnell and President Trump to come up with a bill that both you and Senator Paul can support?”

Collins: It's certainly going to be very difficult. For my part, I'm very concerned about the cost of insurance for older people with serious chronic illnesses, and the impact of the Medicaid cuts on our state governments, the most vulnerable people in our society, and health care providers such as our rural hospitals and nursing homes, most of whom are very dependent on the Medicaid program.

So threading that needle is going to be extremely difficult.

Stephanopoulos: You just heard Kellyanne Conway say though that those are not Medicaid cuts. What is your response to that?

Collins: Well, I respectfully disagree with her analysis. But this is why we need the Congressional Budget Office assessment of the impact of the Senate bill on costs and coverage, including its analysis of Medicaid. And that will be coming out tomorrow.

But based on what I've seen, given the inflation rate that would be applied in the outer years to the Medicaid program, the Senate bill is going to have more impact on the Medicaid program than even the House bill.

Stephanopoulos: So that means-- if that's true, and if that is confirmed by the Congressional Budget Office, you're a no?

Collins: I want to wait to see the CBO analysis. But I have very serious concerns about the bill.

Stephanopoulos: You also have concerns about Planned Parenthood. This bill would deny funding of Planned Parenthood for a year. I know you're planning on introducing an amendment with Senator Murkowski that would restore the funding for Planned Parenthood.

If that amendment fails, will you oppose final passage?

Collins: Well, first, let me say that it makes absolutely no sense to eliminate federal funding for Planned Parenthood. There already are longstanding restrictions on the use of federal funds for abortion. So that's not what this debate is about. And Planned Parenthood is an important provider of health care services, including family planning and cancer screenings for millions of Americans, particularly women.

And they should be allowed to choose the health provider that they want. That's one of the issues that I care deeply about. But there are many others as well.

Stephanopoulos: Even though you think you'll prevail on the amendment, but if you don't, I understand that you have other concerns with the bill as well. Is Planned Parenthood funding a bottom line for you? If this bill denies funding to Planned Parenthood, are you against it?

Collins: It is one of many factors and a very important one that I will consider in casting my vote. But I'm also very concerned about the Medicaid cuts, what it means to our most vulnerable citizens. And I'm very concerned about the cost of insurance premiums and deductibles, particularly for that very vulnerable group between the age of 50 and 64.

They are particularly at risk, based on my initial analysis. So I'm going to look at the whole bill before making a decision.

Stephanopoulos: Are there a critical mass? We know that Senator Paul and three other conservatives want more repeal from their perspective. How many more senators do you believe share your views on Medicaid?

Collins: Well, there are several of us who have been meeting under the leadership of Senator Rob Portman to look at the Medicaid provisions. And there are about seven to eight people in that group. I can't speak for them. But suffice it to say that they are certainly concerned. And that is why the CBO analysis quantifying the cuts and the impact is going to be so important.

You can't take over $800 billion out of the Medicaid program and not expect that it's going to have an impact on a rural nursing home that relies on Medicaid for 70 percent of the costs of its patients. So this is an access issue as well as one having to do with cost.

Stephanopoulos: Does the bill pass this week?

Collins: It's hard for me to see the bill passing this week. But that's up to the majority leader. We could well be in all night a couple of nights working through what will be an open amendment process. And I think that-- that at least is good. The process could have been a lot better. I would've liked to have seen the Democrats step up to the table and negotiate with us now, not wait till the bill is passed or defeated.

So now the CBO score she was waiting for is out-- higher premiums for less insurance-- not to mention 22 million kicked off healthcare-- include 15nnext year. How's that, Senator Collins? Ultimately, I don’t see any Republican tanking the bill. Cruz, for example, already said that if he’s the deciding vote, he’ll hold his nose and vote YES, as always, a real man of principle. I think McConnell will give Dean Heller (R-NV) a pass if his NO vote doesn’t kill the bill, because of the local politics. But I can’t see Rob Portman, Collins or the 2 Alaskans finding the courage to actually vote NO, no matter how much worse they make the bill to please the far right fringe. Odd that none of them fear their constituents enough-- other than Heller-- to back away from a bill that only about 20% of the country supports. Maybe they have some surprises during the long break that starts next week. And while her staff is going over the CBO analysis, she might want to look at this analysis too, since it pertains to her own constituents in rural northern Maine.

...And The UPDATE:

Even Lindsey Graham is predicting that the CBO score will make it much harder for McConnell to get to 50 votes. And just a few hours ago, Susan Collins said that not only is she a NO, she'll vote against even allowing the vote to take place! She tweeted that the Republicans should work with the Democrats to improve Obamacare instead-- the first Republican senator to come to that very logical conclusion. Meanwhile House Freedom Caucus sociopath is railing that the Senate bill will be blocked by the Freedom Caucus because it isn't conservative enough. This guy is insane! (Help repeal him and replace him with Matt Coffay, the very vocal Medicare-For-All supporter running in western North Carolina for the seat Meadows holds.)