The ‘Nuclear Option’ Is Now the Only Way Forward
Below is an opinion article I originally published with Michael Hamilton, The Heartland Institute’s health care research fellow (and a good friend). The article was written immediately after congressional Republicans voted to reject the first version of the American Health Care Act. Several weeks later, the House approved a modified version of that proposal.
Why would I republish an article that’s a month old and seemingly no longer applies to the current situation? Plainly, because although some important parts of the situation have changed, many aspects have not. At the end of the day, congressional Republicans cannot pass real health care reform without using the nuclear option, and rather than focus on putting pressure on moderate Republicans to go along with that plan, Congress is settling for mediocre legislation that could end up making the current health care problems worse.
The ‘Nuclear Option’ Is Now the Only Way Forward
By Michael T. Hamilton and Justin Haskins
Star-crossed House Speaker Paul Ryan’s (R-Wisc.) ill-fated American Health Care Act (AHCA) has flamed out over Washington, D.C., a city whose “rendezvous with destiny” is, it turns out, controlled by conservatives.
The narrative that conservatives killed health care reform, blowing their only chance to repeal the Affordable Care Act (ACA), is as absurd as it is patently false. This yarn would be true had members of the House Freedom Caucus somehow stopped passage of AHCA in a suicide move, rendering both themselves and Ryan impotent.
They did the opposite, however. To the chagrin of establishment Republicans, conservative members of Congress just proved, at long last, they actually matter.
The rational conclusion from the House Freedom Caucus having just won its negotiation—and make no mistake about it, that’s what it did—is that the House Freedom Caucus will win again. Far from preventing a repeal of Obamacare or stifling what Ryan had called significant health care reform, House conservatives just wrote their ticket for enacting true free-market reforms in the future.
Neither Ryan nor Trump will again risk rolling out a massive regulatory overhaul (which AHCA was, despite its similarity to ACA) without consulting House conservatives early in the process. Every bill Ryan brings up and Trump backs must spell success, and the Caucus just proved itself a schoolmaster.
The White House will hang the AHCA albatross around Ryan’s neck instead of that of Rep. Mark Meadows (R-N.C.), one of the Freedom Caucus’s chief rabble rousers, an administrative official told the Chicago Tribune hours before the bill was pulled. Trump has already moved on to tax reform, and Congress and the spotlight will follow him there. This leaves conservatives free to develop and propose the kinds of health care reforms Republicans should have presented to begin with.
And when the House Freedom Caucus wants to bring better health care reform legislation to the floor, Ryan will have to let them, or he’ll risk getting stalled again and hold up Trump’s other agenda items.
Supposedly, most House GOP members supporting Ryan’s plan—including Ryan himself—should favor robust conservative reforms, because all along, they have excused AHCA’s similarity to Obamacare as a necessary evil to avoid a Senate filibuster. If ever Republicans were going to repeal and replace Obamacare through the reconciliation process and by keeping the Senate filibuster intact, it was with AHCA.
For the first time ever, no one can deny the “destiny” Ryan foresaw was mythical. Reality is that replacing Obamacare—which Trump and Republicans in Congress promised voters they would do—actually will require “nuking” the Senate filibuster. Reality is House conservatives will have their way, and moderate House Republicans have every reason to let them, according to their stated reasons for supporting AHCA.
That the Senate will have to go nuclear to pass such legislation is a foregone conclusion for those who thought AHCA a born failure. Predictably, some Republican senators will resist, fearful they will one day need its protections.
Preserving the filibuster for the protection of future minority Republicans is short-sighted. Next time Democrats win a majority, they will have rightly concluded the Republican Party is neutered and wrongly concluded the voice of GOP members is illegitimate. They will regard their newfound power not as the start of something new, but as their chance to finish what they started seven years ago with Obamacare: their march to a wholly statist regime (or at very least, a statist, single-payer health care system).
So close to their goal, Democrats won’t let future minority Republicans trifle with the filibuster. Democrats will use the nuclear option—just as former Senate Majority Leader Sen. Harry Reid (D-Nev.) used it to confirm Obama’s judicial appointees with a simple majority in 2013—regardless of whether Republicans “went nuclear” in 2017.
Moreover, Senate Minority Leader Sen. Chuck Schumer (D-N.Y.) has vowed to filibuster the confirmation of Judge Neil Gorsuch, Trump’s nominee to the U.S. Supreme Court. Senate Republicans are already likely to nuke the filibuster to confirm Gorsuch, so it only makes sense to use it now to enact potentially revolutionary free-market health care reform.
Failure to do so would not only break the promise made by Republicans to repeal and replace Obamacare with policies that are substantially better, it would also guarantee the Obamacare death spiral continues its inevitable descent. This could set the stage for the health care crisis Democrats have long awaited, one they need to convince an otherwise freedom-loving nation to adopt a socialistic health care model that will make every American totally dependent on a massive centralized government.
Make no mistake about it; if Democrats were in the same situation, they wouldn’t think twice about capitalizing on this historic opportunity.
Republicans have first-strike capability, and it’s use it or lose it. They should use it now to accomplish truly market-based health care and entitlement reform in time for the free market’s Invisible Hand to enrich and inspire enough voters in the next four to eight years to ensure a Republican successor to Trump—or, at the very least, to ensure the U.S. health care system doesn’t look disturbingly similar to that of France or the United Kingdom a decade into the future.
Michael Hamilton (@MikeFreeMarket) is a research fellow in health care policy at The Heartland Institute and managing editor of Health Care News. Justin Haskins (@TheNewRevere) is executive editor of The Heartland Institute.
PHOTO: Congressman Paul Ryan of Wisconsin speaking at CPAC 2011 in Washington, DC (Photo by Gage Skidmore)