Keys to affordable health care debated

When it comes to the long-awaited Republican repeal and replace of Obamacare, my stare is transfixed on two Hoosier environs, the 2nd and 6th Congressional Districts.

Up in the 2nd Congressional District, U.S. Rep. Jackie Walorski exulted in the imminent repeal of Obamacare. “We’re doing exactly what we said we would do,” Walorski told the South Bend Tribune. “It’s what people have been asking for.” And from the Indiana perspective, she is right. Obamacare has never been popular here, and President Trump’s vow to repeal and replace it with something “terrific” resonated with Hoosier voters in 2016 in emphatic fashion.

In January, Trump explained, “I want to take care of everybody. I’m not going to leave the lower 20 percent that can’t afford insurance. So I want to make sure that nobody’s dying on the streets when I’m president.” He vowed that it would be low-cost and better coverage … for everyone.

The American Health Care Act unveiled on Monday is full of promise but doesn’t have a Congressional Budget Office score. On Tuesday, Walorski said that she could not guarantee that no one would lose coverage, saying, “Folks that need coverage and access to coverage will absolutely have it.” She didn’t yet know how Republicans would pay for it. “We’re still working on the details of that,” she said before voting for the plan in the Ways & Means Committee early Thursday.

Walorski represents the most competitive congressional district in Indiana, at +6 Republican on the Cook Partisan Index. She appears to be getting a break in that the most potent Democrat challenger, South Bend Mayor Peter Buttigieg, appears to be passing on a 2018 challenge, telling the Huffington Post, “I don’t think that’s going to be me. A lot of emerging leaders take a look at opportunities to run for Congress and decide it is not for them.”

But 2018 appears to be a vastly different beast than any of the other cycles of this decade. This is the first with a Republican president, and the 2nd Congressional District over the years is much more competitive in mid-term elections under GOP presidents. Just ask former congressman John Hiler. How President Trump will be perceived, and whether he has coattails or becomes a millstone, is impossible to forecast. Just six months ago, Trump was supposed to be a burlap sack of cinder blocks for Republicans, and he turned out to provide them Red Bull wings.

In the 2nd Congressional District, there are 18,900 people who have accessed health coverage via the federal Obamacare exchange. Of the 420,000 Hoosiers on Healthy Indiana Plan 2.0, around 50,000 have coverage in the 2nd Congressional District. So what happens to upward of 60,000 to 70,000 of Walorski’s constituents is to be determined. Logic says that if you take away a benefit, those folks might be motivated to vote against those responsible.

The 6th Congressional District in southeastern Indiana has become a microcosm of the Republican stew. Vice President Mike Pence represented the 6th Congressional District for 12 years and declared of RyanCare that “This is the plan,” though conceding that it faces a “very open process on Capitol Hill.” Pence’s friend and predecessor, Club for Growth President David McIntosh, panned it, saying, “If this warmed-over substitute for government-run health care remains unchanged, the Club for Growth will key vote against it.”

On MSNBC’s “Morning Joe,” McIntosh said the legislation hasn’t been marked up and is being rammed through. “What I think they can do is open up this process, take the RyanCare version, put in about five or six changes,” McIntosh said. “Cut all the taxes immediately, block grant Medicaid, allow insurance sales across state lines, then they could get a bill that could be solidly supported by the Republican base. Our friend Paul Ryan did it like a think tank. They cooked it.”

How will poorer folks fare?

“We’ve got the best answer,” McIntosh said. “When you start competing across state lines, they will have affordable health care. The rates will go down. With the Ryan bill the rates won’t go down. They’ll have a lot better options than either under Obamacare or RyanCare.”

And Pence’s successor, U.S. Rep. Luke Messer, part of the House leadership team, told me on Monday that he believes there will be Republican consensus, saying, “There is a legitimate debate within the Republican Party and our caucus about which way is best. But I think there is consensus we’ll be on the same page.”

Messer went on to say, “My sense is that President Trump will be the tiebreaker here.” But President Trump was all over the map on Tuesday, telling the House GOP Whip Team that he was “proud to support” Speaker Ryan’s bill and wants it to pass “largely intact.” That is startling naivete.

Later on Tuesday, U.S. Sen. Rand Paul, was declaring it “Obamacare Lite” and a non-starter. To which Trump tweeted, “I feel sure that my friend @RandPaul will come along with the new and great health care program.”

Which statement do you believe? Or, when do you believe him? And will he throw you under the bus with a Saturday morning Tweet?

Stay tuned, Folks.

Brian Howey is publisher of the Howey Political Report, a weekly briefing on Indiana politics. Contact him at 317-506-0883 or online at howeypolitics.com.

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