Good morning ... How's your Trumpcare hangover? Everyone I've talked to this weekend is still in disbelief that a seven-year repeal effort just fell apart. But we haven't seen the end of calls for Congress to do something, like take a vote, any vote. Meantime, watch how the Trump administration and Congress actually handle Obamacare from here.
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Trumpcare may be dead, but that doesn't mean Obamacare is safe. The next thing to watch is whether the law actually does fall apart, not because of the design flaws, but because the Trump administration has no incentive to prevent a collapse.
When President Trump tweets that "Obamacare will explode," and House Speaker Paul Ryan says it can't be fixed, they're not sending signals that they're looking for success. The reality is that insurers will need incentives to stay in the market and not impose another round of rate hikes. Instead, we could get a meltdown followed by an endless round of finger-pointing: Trump and Ryan would blame the Democrats for a poorly designed law, and Democrats would blame them for rooting for failure.
Why the incentives have changed: The Trump administration had wanted to keep insurers in the market to guarantee a smooth transition to a new system, but that incentive "will wane" now that there isn't going to be a new system, because "they're going to be viewed as improving the law that they hate," said Chris Condeluci, a former Senate Republican aide and a member of the Axios board of experts.
Peace talks? But White House chief of staff Reince Priebus did suggest on Fox News Sunday that Trump doesn't really want a collapse: "He wants to make sure that people don't get left behind. He wants to make sure that there's competition in the marketplace so that rates are lower and people can choose their doctor."
Republican leaders are already coming under pressure not to let Obamacare repeal drop. Americans for Prosperity, one of the most powerful outside conservative groups, says the House should allow a vote on a straight repeal bill — even if it fails. Why? Because even a failed vote is better than just walking away from the repeal effort that Republicans have been promising for seven years.
"Let every member be on the record where it really matters. Then you're keeping your promise that you made to the American people for four consecutive elections," AFP president Tim Phillips told me this weekend. The voters who called for Obamacare repeal, he said, won't have any patience with arguments over what can and can't be done through budget reconciliation: "That's exactly what people hate about Washington, D.C. They expect you to do what you said you would do."
Why it matters: AFP was one of the Koch brothers groups that opposed the GOP replacement bill, and set up a seven-figure fund to support House members who voted against it. But that doesn't mean it wanted the repeal effort to end — it just wanted to go back to the original idea of a clean repeal. "We respect Speaker Ryan," Phillips said. "This is just one issue where we disagree, not on the final goal, but on the execution."
Priebus said Sunday that the Trump administration might reach out to moderate Democrats on health care — a self-described "warning shot" to the conservative Republicans that wouldn't work with them. But they'll find that those Democrats want narrower fixes than Republicans want. And they may not like the Democrats' conditions — because they'd have to drop all repeal talk.
Sen. Mark Warner, one of the purple-state Democrats most likely to get the call, might be willing to work with Republicans on some of the fixes he has already proposed, spokeswoman Rachel Cohen tells me — but only if Republicans promise not to undermine the law. The main fixes he'd support:
Reality check: There's so much bad blood between Republicans and Democrats on Obamacare that it's hard to see them talking seriously any time soon. Plus, even moderate Democrats would have to be convinced why it's in their interests to bail Trump out. But if you want to know which Democrats would be most likely to talk under the right conditions, it's worth rereading this letter from January. It's by Sen. Tim Kaine, Warner's Virginia colleague (and the guy who could have been vice president).
You mean there are other issues besides Obamacare? Here are the next things to watch:
Bob Kocher, a partner at Venrock and a member of the Axios board of experts, gave us this smart piece about what Trump could do to stabilize Obamacare if he really wants to avoid a collapse. He should get Congress to pay for the cost-sharing subsidies, Kocher writes, and tell the IRS to enforce the individual mandate so insurers don't have to worry about not getting enough healthy customers. He also suggests making it easier for private web brokers to help sign people up.
Other views from our board of experts:
What we're watching this week: House Energy and Commerce health subcommittee hearing on the FDA's medical device user fee program, Tuesday; House Appropriations Committee hearing on the HHS budget, featuring testimony from Price, Wednesday.
Thanks, and let me know what other non-Obamacare news we should be covering: firstname.lastname@example.org.