Where to go from here?

It’s easy to be united in opposing something. It’s hard to be united in standing for something. This is a dilemma many Republicans face in Congress. Health care reform in the House of Representatives was initially stalled. While most Republicans backed the bill, conservatives in the House Freedom Caucus and moderates in the Tuesday Group were opposed to it for different reasons. Paul Ryan and the GOP leadership made changes that finally passed the bill, but disunity was predictably going to be a problem in the Senate.

The Senate made its own proposal called the Better Care Reconciliation Act. It included proposals like health tax credits based on income level, reducing Medicaid spending growth, gives state more autonomy, repealing Obamacare taxes, and creating a $2 billion fund for states to fight opioids. This bill was opposed by both conservatives and moderates. It was back to the drawing board for Republican leadership.
 
Mitch McConnell and his team released a new version of the bill to try to appease both sides. Some of the adjustments were keeping some Obamacare taxes, a $45 billion opioid fund, giving people the opportunity to use health tax credits for catastrophic plans, and allowing people to use their Health Savings Accounts for premiums. Another significant change was an amendment provided by Ted Cruz. It allowed insurers to sell plans didn’t comply with Obamacare’s mandates so long as they sold one that did.

Even with all these changes, the passage of health care reform remains uncertain. The changes weren’t enough to get all Republican senators to support the law. The GOP has a narrow majority and that means it’s impossible to any health care reform bill approved without almost every Republican on board.

Whatever the conclusion of this long debate is, the Republicans in Congress can take a few lessons away from it. Creating a health care bill in secret has many drawbacks and it has played a role in slowing the process. It is also important to make sure that the concerns of every caucus and faction are heard. It’s great to see leaders build a closer relationship with House Freedom Caucus chairman Mark Meadows. This can help with legislation in the future.

Once the health care drama is over, Republicans have to move on to another major issue: tax reform. The success or failure of health care reform could directly impact what happens with taxes, but when that debate comes around all sides of the party better take part and stay informed on the bill in order to ensure maximum support.

- John M. Graber, Jr.

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