Wednesday, August 9, 2017

Shared Legislative Power: Inspiring, Refreshing, Encouraging, Promising

I just returned from a few days visiting an old friend of mine of some 42 years. We yak. We yak a lot about politics and the great issues of our time. We’ve been yakking for 40 some years. It’s fair to say that this year, considering all that’s going on with Donald Trump and Congressional gridlock, we yakked ourselves into depression -- literally coming away from our visit feeling hollow and somewhat hopeless about the future.

Somewhere during the yakking I mentioned to my friend about a post I had done about Michigan's experience with shared legislative power way back in 1993-94 when the Michigan House was deadlocked 55 Republicans & 55 Democrats. I told him how uplifting it was and how it demonstrates there is a better way.

When I returned home I re-read the post and found it was inspiring, refreshing, encouraging and promising. I needed that after all of the depressing yakking.

I decided the post needed to be emphasized and to focus just on the summary of Legislator comments and hope it may provide solace to others who may be suffering depression, frustration and general pessimism about what lies ahead.

Here is an excerpt from the post I did back in March 2017, entitled: Shared Committee Power And The Ambience of Bipartisanship. Hope it helps.

Here are brief excerpts of the thoughts of 26 Michigan legislators who express, far better than I ever could, what I am now calling the ambience of bipartisanship.

John Gernaat (R-Cadillac) – “Shared power will go down in history as an example of how people on both sides can work together to get things done.”

Ilona Varga (D-Detroit) – “Both sides had to compromise. I feel the people got the best two years of representation in the over eight years I have been there.”

Tom Middleton (R-Ortonville) – “The House had a much more open line of communication in solving partisan problems [referring to the fact that the Senate during this time remained under Republican partisan control].

Michael J. Griffin (D-Jackson) – “…people of goodwill and determination can put public policy ahead of partisan consideration. . . Students of government, civics, political science, et cetera, can learn a great deal from this experience.”

Glenn Oxender (R-Sturgis) – “It gave a variety of leadership and made bipartisan support necessary for the passage of each bill. I rate it as a success because of the significant amount of legislation that was passed.”

David Points (D-Highland Park) – “The Eighty-seventh Legislature was an example of an unbiased bipartisan balance.”

Timothy L. Walberg (R-Tipton) – “A pleasant by-product of this situation was the development of friendships with the members of the other party who were once only acquaintances.”

Clyde Le Tarte (R-Horton) – “I found that in the main, we tended to focus on policy issues instead of political advantage because political positions could not be sustained through the process.”

Jan C. Dolan (R-Farmington Hills) – “Even when a vote comes down along party lines, there appears to be a willingness to hear out all viewpoints. Michigan has been well served by this cooperative spirit.”

Richard A. Young (D-Dearborn Heights) – “I believe that you can learn from the fact that you can accomplish the people’s work and you don’t have to do it in a hostile manner.”

James Mick Middaugh (R-Paw Paw) – “People seemed to genuinely want to work together. You had to, or you did not get anything accomplished.”

James Agee (D-Muskegon) – “I think it made us respect those on the other side of the aisle and know that we had to compromise with them.”

Carl F. Gnodtke (R-Sawyer) – “I have often thought it worked well enough that there should be a constitutional amendment requiring equal numbers from both parties be elected to serve in the House.”

Joseph Palamara (D-Wyandotte) – “I found the shared power arrangement to be an unqualified success… To me, the essence of representative government was embodied in the shared power agreement.”

Harold J. Voorhees (R-WyomingMI) – “Truly shared, the power agreement that was adopted by the House of Representatives in 1993 is and was a genuine masterpiece – a model for future legislatures throughout the land.”

Candace Curtis (D-Swartz Creek) – “The experience was one of compromise between not only the two parties but also between controlling interest groups.”

Don Gilmer (R-Augusta) – “As a body we at least had a greater amount of respect for one another because of power sharing, and a lot of that still carries on.”

Lynn Jondahl (D-Okemos) – “Working under the shared power agreement was successful in that we quickly adapted to the new rules/procedures and were able to proceed quite smoothly.”

Susan Grimes Munsel (R-Howell) – “One, you had to have the best policy, or two, you had to have a lot of factions with you on an issue, and that kind of focus forces you into the central area which is where the best policy making is anyway.”

Clark Harder (D-Owosso) – “While political pundits swore in advance it would never work, they were obviously proven wrong.”

Tom Alley (D-West Branch) – “Power sharing was probably the greatest experience any legislator could go through in a career of elected office.”

Frank Fitzgerald (R-Grand Ledge) – “I think that what you learn from shared power is that it is possible in a tie situation to make a legislative body operate.”

Pat Gagliardi (D-Drummond Island) – “The best part of shared power, for me as well as many others, was the fact that relationships from both sides of the aisle improved on a personal as well as on the professional level. . . Having been in the majority and the minority, the people of the state of Michigan would be best served if each party was equally represented.”

Paul Baade (D-Roosevelt Park) – “An opportunity to develop a spirit of cooperation and negotiation to move on many issues.”

Kirk A. Profit (D-Ypsilanti) – “I am personally very grateful to have had the wonderful opportunity to represent the eighty-five thousand people in the Ypsilanti area at such an incredible time in Michigan history when new standards for legislative production were set and new foundations of faith in government were laid.”

William Bryant (R-Grosse Pointe Farms) – “Shared power works because it encourages each party to act like a responsible majority.” [Note: Rep. Bryant presented a proposal to the co-Speakers to perpetuate the agreement into the future as an historic opportunity to move “politics not just in Michigan but nationally past sheer partisanship. . .” He concluded by saying, “Seize the moment. Have the vision. Change what it means to be a member of a legislative body. Make history.”]

Can you imagine 26 diverse U.S. Congressional members commenting on the state of the current Congress with the sincerity, excitement and insightfulness of the comments above? Isn’t this what the vast majority of Americans want from their government and their legislators? [Congressional approval rating is currently 10% (8/3/17)]

Congress must accept the fact that the electorate is divided 50-50 and stop trying to propose one-sided solutions to complex problems. True bipartisanship is just a decision away. Mitch McConnell, Paul Ryan, Chuck Schumer & Nancy Pelosi could make it happen now and end the madness if they wanted to.

It is possible. There is a better way. #BetterGovmt

Other posts on shared committee power and true bipartisanship:

Shared Committee Power And The Ambience of Bipartisanship

Tuesday, July 18, 2017

Wake Up Democrats; Another Chance At Self-Identification

If you've been following the news the last couple of days you learned that Donald Trump's approval rating are already low and ticking downward and the Republican-led Senate has now officially failed to pass a replacement bill to get rid of that nasty Obamacare stuff.

Everyone's talking about how the Trump administration is a disaster and the GOP is failing or dying as a result of their inability to get anything done, despite the fact that they control Congress and the Presidency.

But wait, there is also news that a new Washington Post-ABC News poll, indicates that 52 percent of respondents, when asked what Democrats stand for, indicated that they are "just against Trump."

So, while the GOP under the leadership of Donald Trump, Mitch McConnell and Paul Ryan are literally failing miserably on many fronts, the Democrats have failed miserably once again to show and tell the American public what they stand for. 

We've seen this movie before. See my 3/27/17, post, “Democrats Could Lead The Bipartisan Revolution.” That was when the GOP was trying to "repeal and replace" in the House. I've been advocating for months that Democrats need to step it up and take the lead and demonstrate what they stand for. 

I said Democrats need to develop the "Affordable Care Improvement Act", designed to do what needs to be done to make the Affordable Care Act work better and introduce it in the House and Senate with 100% of the Democrats in both chambers supporting it. Simultaneously, they need to launch a massive public education and media campaign comparing the Republican and Democratic alternatives with the focus on leading rather than simply opposing.

In politics you don't often get a second chance, but now that the GOP effort has once again failed in the Senate and the Democratic Party is suffering a self-identification crisis, the timing couldn't be better. If Democrats continue to be self-absorbed with Trump/GOP bashing, without defining a better way, they too will be a failed Party. That scenario could lead to defeat in 2018 and 2020, despite the incredible incompetency of the GOP leadership.

Not only can Democrats lead with a better alternative to health care, they can lead with a proposal to demonstrate a better process to be used in the development of major legislation.

On July 17, 2017, U.S. Senator John McCain (R-AZ), who is recovering from a procedure to remove a blood clot from above his left eye, released a statement on the best path forward on health care. McCain said,
“One of the major problems with Obamacare was that it was written on a strict party-line basis and driven through Congress without a single Republican vote. As this law continues to crumble in Arizona and states across the country, we must not repeat the original mistakes that led to Obamacare’s failure. The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation's governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.”

While this is certainly a magnanimous cry from the wilderness of insanity on health care that we have been witness to lately, it still lacks definition of a clear process that will lead ultimately to a bipartisan solution that will reap rewards for the American people and not the special interests.

“Regular order” is the terminology for the normal way that Congress develops legislation – i.e. subcommittee with hearings and expert testimony; committees with hearings and expert testimony; floor proceedings, amendments and votes on passage. While this is far better than the secretive, backroom formulation with no public hearing or expert testimony that was instigated and maneuvered by Senate Majority Leader Mitch McConnell, it is also the same process that has led to Congressional approval ratings of 20% and lower.

I have already spilled a lot of ink describing why this “regular order” process isn’t working any more in today’s highly polarized, tribal environment with an almost 50-50 divided electorate. It doesn’t matter which party is in control, the process is rigged so that the “majority” Party controls the agenda, the public hearings, testimony, input; and most importantly, the votes. Furthermore the lobbyists need only to focus their influence and money on a few select legislative members in leadership positions to control the outcome and in many cases actually write the legislation.

Despite some semblance of “order”, the process with all of its gridlock tricks along the way continues to produce one-sided solutions to major complex problems – the kind that the President never realized were so hard. See my 1/18/17 post: “Congress Could Be Functional; If It Wanted To.


In many previous posts I’ve tried to emphasize the importance of Congressional committees and subcommittees within the structure of our government; their relation to gridlock and dysfunction; and the idea of sharing political party power to vastly improve the functioning of the legislative and oversight roles of this critical branch of government. Previous postings include:

·        Shared Committee Power And The Ambience of Bipartisanship

As I have tried to explain in previous postings, true bipartisanship, beginning with shared power in the committee and subcommittees system of the House and Senate, could completely alter the legislative process dynamics, reduce the incentive for gridlock games and political posturing, maximize and focus staff resources and blunt the affect of excessive lobbying and financial influence.

A shared power committee structure would force bipartisanship at the beginning of the process. Imagine, at the subcommittee level where Members with specific knowledge of the subject matter from both sides of aisle each present their proposals for addressing the issue. They would most likely be markedly different. They would have to argue and debate, have hearings with experts and testimony equally from both sides, utilize unbiased staff resources to investigate and develop suggestions and finally craft a compromise. The process would be somewhat like the Conference Committee process where competing differences between House and Senate bills are resolved; however, it would be much more thorough, comprehensive and nonpartisan.

So, Democratic leadership, I challenge you. You’ve got a second chance. Identify yourself. Let’s see what your health care bill looks like. And how about taking it a step farther and proposing a revised process that will lead to a true bipartisan solution. Show us you can be smart leaders with real solutions, not just Trump/GOP bashers. Give us a reason to vote for you.


Thursday, July 13, 2017

Donald The Muddler & The Ones That Know Better

Those who voted for Donald Trump as the "change" candidate didn't really get what they bargained for, but they don't seem to mind. What they really got was a "muddler".

noun1. a person who creates muddles, especially because of a disorganized method of thinking or working.

So what are muddles?
noun1. an untidy and disorganized state or collection. synonyms: mess, confusion, jumble, tangle, mishmash, chaos, disorder, disarray, disorganization, imbroglio, hodgepodge

Yep! That pretty much sums it up. And, I guess, in a bizarre sense, it is a form of change. And, in fact it's pretty consistent with the expressed national goal of one of the President's right hand men -- Steve Bannon.

"I'm a Leninist. Lenin wanted to destroy the state, and that's my goal, too. I want to bring everything crashing down and destroy all of today's establishment."

If you take a look at the first six months of the Trump Presidency, I guess we're pretty much on track.

So do the people who voted for Donald Trump feel like they got swindled? Hell no! They're loving it. It's a movement; and it's solid. 

With all that's gone down in the last six months -- constant lying, fake news, Russian collusion/coordination; women, minority and media bashing; bigotry, bullying, betrayal of allies, nepotism, financial deception, disrespect for norms and embracement of indecency -- the Muddler's support has hardly waivered. It appears to be solid at about 40%.

So what does this say about the good old U.S.A.? It's not so much about the Muddler himself? It's not about healthcare, tax reform, infrastructure, environment or other important policy issues. The Muddler promised to fix all those things and make them "beautiful" and "amazing", but he's not going to do it.

It's about the 40%. That's not "small potatoes" as my Grandma would have said. That's a huge chunk of the American population that is willing to support, praise or just tolerate the behavior of the Muddler. I think we should be concerned.

I would break the 40% down into basically two major groups: (1) the group that truly supports what the Muddler stands for (that's scary); and, (2) the group that is tolerating him because, despite his abhorrent behavior, he will allow them to advance their ideological political agenda. This group includes most GOP Congressional members, leaders, surrogates, strategists and D.C. insiders; all willing to sacrifice fundamental, human and democratic principles for party passion and ideology. 

It's the second group that bothers me the most. Maybe the country can endure 15 to 20 percent of the population that actually supports what the Muddler stands for; but, it's the ones that know better who continue to fall in line that is really troubling.

I'm convinced that there are many, diehard Republicans that are appalled by the Muddler's disingenuous (I'm being nice) statements, Tweets, treatment of our allies and puzzling relationship with Russia; but they are willing to continue their support for this intolerable, immoral, and embarrassing conduct of an American President.

What will it take to make them snub this insult to our Presidency and country? Or will they ever? The Muddler's shenanigans and malfeasance would have already brought down any President known to modern man. The mischief, indiscretion and misdeeds of the likes of Richard Nixon and Bill Clinton seem like child's play in the wake of the Muddler. Yet, the ones that know better continue their toleration.

Our future is the hands of the GOP members that know better. Because they're in control of the House and Senate, they are the ones who must lead. So long as they remain silent and let the travesties of leadership continue they are empowering the worst among us from both sides of the political spectrum. 

Unfortunately, it's not looking good. As I have pointed out previously, the tolerance of the American public for this continued malfeasance and incompetence is not sacrosanct -- it will reach a point of eruption. The creaking sounds of a breaking democracy can already be heard. 

If the GOP leadership, the ones that know better, continue to force a one-sided, reckless, heartless health care bill through the process simply to fulfill a 7-year, half-baked, mantra ("repeal & replace") the democratic underpinnings may fracture.

Meanwhile, the delusional Muddler, who resides in an alternative fantasy land, amuses himself by Tweeting:

Donald J. TrumpVerified account @realDonaldTrump The W.H. is functioning perfectly, focused on HealthCare, Tax Cuts/Reform & many other things. I have very little time for watching T.V.


Thursday, June 29, 2017

Rattling the Underpinnings of Democracy: What Have We Become?

How can it be that our governmental processes have degenerated to the point where it is considered okay by a large portion of the public and political leadership to deny funding for needed health care services to children, old people, poor people and the sickest among us, and at the same time give huge tax rewards to the richest among us? With nearly a trillion dollars involved, this is not an incidental action; but, a massive transfer of necessary human survival services for unnecessary individual enrichment.

Tax breaks for the rich and "trickle down" economics have been a part of the political landscape for years, but the direct taking of money for lifesaving services to provide windfalls to the wealthiest has reached a new level of cold-heartedness.

Let's pause and take stock. It's 2017. The Presidency is a national and international embarrassment led by a man who is supported by about a third of the public. His actions scoff traditional norms of decency, undermine the basic foundation of American government, and threaten national security. He has established a new normal where facts can no longer be distinguished from lies. Hard to believe, but the good old U.S.A. is being led by a man so in love with himself, that he prints a fake Time magazine cover "trump"eting his phony accomplishments and resides in a constant state of alternate reality. 

Congress is non-functional because of intense political polarization that has reached a point of frantic implausibility. The two major political parties have morphed into factionalized tribes, trading patriotism for partisanship, to the point that they can no longer define or articulate what they stand for and being led by the extreme elements of their ranks.

We can't blame the current state of affairs solely on our bungling President. There are two prominent and skilled GOP leaders -- Mitch McConnell & Paul Ryan -- who could stop this madness in a New York minute if they chose to elevate reverence for country over their dogmatic passion for Party supremacy.

The breakdown of the major political parties and their growing dysfunction has led to their inability to provide the required "check" on the executive branch. Congressional paralysis in recent years provided the underpinnings for the movement that led to the election of Donald Trump and its persistence now allows the continuation of this national and international insult to the American brand.

The more extreme ends of each party remain active and continue to fan the rhetorical fires that further divide the electorate. The mainstream media continues to report the constant drumbeat of lies, dumbfounding tweets and statements, and unimaginable political faux pas. The alternative media distorts reality and rationalizes the GOP and White House shenanigans and demonizes the mainstream media.

At the same time, much of the public have allowed their eyes to glaze over and begun to tune out the constant frenzy of insanity. Many are in search of distractions to avoid the insults to their intelligence. Many have run out of adjectives to describe what is happening. Many avoid discussions with family and friends because the circumstances are so sensitive and confrontational.

The vehement debate over health care is indicative of what is to come as the country faces other major policy directives and issues. The political leadership of both parties is pushing the framework of democracy dangerously close to its breaking point. The tolerance of the American public for this continued malfeasance and incompetence is not sacrosanct -- it will reach a point of eruption.

Within the next few days the GOP leadership and Presidency have a choice: to either stop the current intolerable proceedings and start anew with a bipartisan approach; or, they can continue to ram through a one-sided solution constructed with no public hearing or scrutiny that is doomed to failure and will push the public to the brink. The choice is theirs.

From my perspective, the desired process would be to develop legislation via the shared committee power process which I have continually advocated in this blog. See more on shared committee power and links to further information:

Saturday, June 3, 2017

My Heart Died A Little Bit Today

Editor’s Note: I wrote this poem back in December 2016. It still seems timely six months later.
My heart died a little bit today
I watched the news and felt it skip a beat
Seeing the death and destruction on the streets
I remembered back when things seemed right
And tried to figure out when I first noticed the slide
Where was I when my country cried?

My heart died a little bit today
It didn’t seem that long ago
But I’m getting confused and not sure I know
There were other times, I’m now remembering
I was lost in my mind and not able to cope
But this seems different – like there is no hope.

My heart died a little bit today
How could this have happened while we just lived our life.
We’ve lost our way and can’t see the strife
Yet it’s all around and hard to miss
But we’re all going on doing the stuff we must
While our leaders have stumbled and lost our trust.

My heart died a little bit today
It’s like we’re drifting in a sea of hate and divide
While serious things keep slipping aside
Simple decisions are hard to make without a fight
Working together seems not an option any more
People are thinking and talking about a civil war.

My heart died a little bit today
We can now see our globe from afar
And know that all our life depends on a little star
We’ve lost respect for land and water
The air we breathe -- the animals and seed
Have lost their value and been replaced with greed.

My heart died a little bit today
It’s becoming hard to find the truth
And I fear what will become of the world’s youth
It is now okay to ignore the facts and make things up
Education and learning may fail to meet the test
As officials and leaders claim they know best.

My heart died a little bit today
We see the oceans rise, the ice melt and the sun beat down
Yet some in power simply reply with a silly frown
They claim it’s a hoax, an international trick and a university scam
Their goals are uncertain but they confuse the masses and increase the gasses
Now with victory at hand they smile with glee and hoist their glasses

My heart died a little bit today
I try to imagine what the rest of the world perceives.
What happened to the global leader of the free world they believed?
Disrupting partnerships, breaking agreements and doing deals
Some countries and individuals may see opportunity and financial gain
But many I suspect may think we’ve gone insane

My heart died a little bit today
We have a new style that seems to be catching on
Civility, statesmanship, politeness and respect are all but gone
Bullying, bigotry, name calling, lying without guilt are now accepted
There’s no excuse; it seems senseless and cruel
But with leadership’s endorsement it is becoming the rule.

My heart died a little bit today
By hook or crook they’re now in control and arrogant in style
Previous enemies shed hate and disgust as they fall into single file
The rest of us wait with our fate in the balance as suspicion abounds
They insist they will act with our best interest in mind
But the actions we witness seem counter to promises and more mastermind.

My heart died a little bit today
I now feel a little hollow, sad and confused – extremely perplexed
Not knowing quite how to react or what to say – seriously vexed
It’s unfamiliar, strange, odd, weird, baffling and inexplicable
My faith and trust is now buried deep in the past
As I hope the Founders’ wisdom and written structures will last.

My heart died a little bit today. . .

Friday, April 7, 2017

Bipartisan, Democratic-Led Health Care Reform

Billy Wynne[1], writing for the Health Affairs Blog has done a wonderful job of outlining some of the essential ingredients necessary to address the national health care insurance issue. The posting on April 4, 2017, entitled, “What Now?: A Four Step Plan For Bipartisan Health Reform” is precisely what I have been saying is needed for Democrats to use in the development of an “Affordable Care Improvement Act” that could provide a sensible alternative to the GOP cobbled up, disastrous proposal known as the American Health Care Act (AHCA)[2]. See my March 27, 2017, post, “Democrats Could Lead The Bipartisan Revolution.”

I have been advocating for Democrats to take the lead now that the GOP efforts have failed and the President has declared:

“I think the losers are Nancy Pelosi and Chuck Schumer, because now they own Obamacare.  They own it -- 100 percent own it.”  And this is not a Republican healthcare, this is not anything but a Democrat healthcare. . .”

Following the GOP debacle[3], I said Democrats need to develop the "Affordable Care Improvement Act", designed to do what needs to be done to make the Affordable Care Act work better and introduce it in the House and Senate with 100% of the Democrats in both chambers supporting it. Simultaneously, they need to launch a massive public education and media campaign comparing the Republican and Democratic alternatives.

It is no wonder that the GOP is still divided on Healthcare? The House Freedom Caucus' 30+ votes will continue to block any effort that Speaker Ryan proposes. The GOP is getting so desperate to just pass something that they have now discounted rationale health care reform. The HFC's basic strategy is to reduce insurance costs for their constituents; an admirable goal, and they have found a guaranteed way to do it. Their "Plan" is don't cover anything including preexisting conditions. That should definitely reduce costs.

For example, items to be excluded under various GOP proposals in addition to preexisting conditions would include: outpatient care; emergency services; in-hospital care; pregnancy, maternity and newborn care; mental health and substance abuse disorder services; prescription drugs; rehabilitative services and habilitative services (including treatment for kids with autism or cerebral palsy); lab tests; preventive services (like vaccines, cancer screenings like mammograms and colonoscopies and, coverage of birth control); and pediatric services.

One can only imagine that eliminating coverage for these essential health care services would definitely reduce costs. Speaker Ryan said, "Instead of imposing arrogant and paternalistic mandates [like coverage for the above listed items], it [GOP plan] would increase choice and competition, creating a vibrant market where every American will have access to quality, affordable coverage."

Democrats need to step it up, lead the way, and not just be the party of “No” opposing all of the iterations of the GOP’s American Health Care Act. Instead of trying to get a few Democrats to sign on to a fatally flawed GOP proposal, why don’t Democrats turn the tables, propose a plan that makes sense and get 25-30 moderate, “Main Street” or “Tuesday Group” Republicans to sign on.

Billy Wynne has now provided the substance of what is needed in a Democratic alternative. Below is an extremely brief overview, but I highly encourage reading Mr. Wynne’s complete proposal. Some of this is fairly technical, but I am including it to illustrate the extent of Affordable Care Act (ACA) [Patient Protection and Affordable Care Act (PPACA) 2010 HR3590, or Affordable Care Act (ACA) for short] improvement ideas that exist which could be advanced.

Step 1 – Enhance The Individual Market: Wynne lays out a number of critical “mechanical options” to enhance markets and maintain the basic elements of the existing Affordable Care Act including continued funding the cost-sharing subsidies currently available to individuals in the exchange markets; actively marketing and supporting enrollment in available coverage options; and more substantial changes that would improve competition and reduce costs. Some options suggested have strong conservative support.

One major suggestion is that in lieu of the initial GOP approach of delivering tax credits of equal value to individuals at different income levels, the existing subsidy structure could be expanded to all households so that none are required to pay more than 9.5 percent of their income for coverage, which de facto phases out the subsidy at high income levels. While ensuring affordability for the middle class, this will also entice a broader array of consumers to get into the market.

Other significant suggestions include establishing default enrollment, perhaps into the lowest cost plan available with an opportunity to opt out; and ending the now four-year extension of plans that do not comply with the consumer protections enacted in the ACA.

Step 2 – Rationalize The Employer Market: The majority of Americans with health insurance acquire it via their employer -- two key changes could be enacted to improve that market’s condition. First, the so-called “family glitch,” which denies subsidies to family members if one of them has access to relatively affordable individual coverage from their employer, should be fixed to allow those family members to acquire subsidized coverage elsewhere. Second, access to the small business tax credits in the ACA could be expanded to assist more workers in this market.

Allow small business employees to be merged into the individual market completely over time and provide large employers greater opportunity to provide their employees a fixed allotment with which they can purchase insurance in a private exchange. Finally, addressing the “elephant in the room” “. . .by capping or eliminating the “around four trillion dollars over ten years” of tax exclusion for employer sponsored insurance.

Step 3 – Embrace Medicaid & Step 4 – Don’t Forget The Big Picture: Wynne says “It’s time to drop the ideological divide over Medicaid, a program that covers 74 million Americans who truly have nowhere else to turn.” He also reminds that health insurance coverage is really just a method for helping consumers address the underlying issue: their health -- we need focus on patients and the providers who take care of them.

Yes, there are problems with House leadership putting such an alternative bill up for a vote, but that's why an aggressive education & media campaign is needed. Wynne concludes:

“The bottom line is that there are a host of policies that lawmakers and regulators can embrace to start drastically improving the condition of our health care system. This will not be easy, nor will it happen quickly. Policymakers of all political stripes can come together now, though, to begin the arduous process of identifying evidence-based solutions and building the necessary consensus to enact them. It’s a winning strategy for politics and for the public.”

While I agree, I don’t think the current GOP leadership or Republican base has the desire or will to lead this effort. They are too wedded to the 7-year mantra of “Repeal & Replace Obamacare.” That’s why Democrats must take the lead.


[1] Billy Wynne, J.D., is the Managing Partner of TRP Health Policy. A division of the Washington government relations firm Thorn Run Partners, TRP Health Policy combines industry-leading, actionable analysis and insight with sophisticated, informed advocacy to help healthcare organizations solve challenges and capitalize on opportunities in the Federal policy space.
                TRP Health Policy is also home to Policy Hub, an online portal and daily digest delivering in-depth intelligence on every important regulatory and legislative development impacting healthcare.
                Previously, Billy served as Health Policy Counsel to the U.S. Senate Finance Committee. He received his B.A. from Dartmouth College and his law degree from the University of Virginia.

[2]CBO report on H.R. 1628, the American Health Care Act, incorporating manager’s amendments 4, 5, 24, and 25, March 23, 2017.

[3]List and summary of opposition to GOP AHCA from nurses, doctors, hospitals, teachers, churches, and others, from Representative Jim Cooper (D-TN)

Articles & Resources of Interest

May 25, 2017“Obviously we’re all united in opposition to Trumpcare. That’s easy. People know what we’re against, but we want to promote more what we are for.” A quote from Rep. John Conyers (D-Mich.), who has been introducing single-payer legislation (“Medicare for all.”) since 2003. House Democrats See Medicare for All as Answer to ‘Trumpcare’. H.R.676 now has 111 Democratic co-sponsors. There are 193 Democrats in the House.

"Mending Obamacare: Where Do Dems Go from Here?", The Democratic Strategist, Mar 28, 2017,  By J.P. Green

"Will GOP leadership work with Democrats? These Republicans hope so." The Christian Science Monitor, Apr 3, 2017. By Francine Kiefer.

"No ‘Death Spiral’: Insurers May Soon Profit From Obamacare Plans, Analysis Finds" The New York Times. Apr 7, 2017. By Reed Abelson.

HealthSherpa | Fast, Easy Obamacare Policy Information. Enter your zip code & find plans and prices.

Health Care Reform News Updates

Funding H.R. 676: The Expanded and Improved Medicare for All Act – How we can afford a national single-payer health plan in 2014,” by Gerald Friedman, Ph.D., Department of Economics, University of Massachusetts, Amherst.

Physicians for a National Health Program - PNHP is a non-profit research and education organization of 20,000 physicians, medical students and health professionals who support single-payer national health insurance.

Medicare for all bill reaches a record-breaking 104 [and counting] co-sponsors in Congress
Posted on Wednesday, April 26, 2017

H.R.676 - Expanded & Improved Medicare For All ActSponsor:Rep. Conyers, John, Jr. [D-MI-13] (Introduced 01/24/2017), Cosponsor statistics: 108 current

Monday, March 27, 2017

Democrats Could Lead The Bipartisan Revolution

Sometimes an impossible situation presents options and opportunity that weren’t visible when your attention was diverted by bizarre happenings that seemed to defy reality. That is the case with the current Congressional health care debacle that unfolded Friday afternoon (March 24, 2017) with Russian spy stories and the fate of the U.S. Supreme Court playing in the background.

The House Republican caucus was frantically getting an education in the new D.C. math game called Freedom Caucus Integration. Woops, after 7 years and 50+ practice votes and with “repeal and replace Obamacare” reverberating in their brains the new math was not adding up -- they had to withdraw their bill.

Here’s how Freedom Caucus Integration math works: (218 votes needed to pass legislation) does not equal (193 Democrat no votes) plus (approx. 30 Freedom Caucus no votes).

Founded on January 26, 2015, the House Freedom Caucus (HFC) says it “gives a voice to countless Americans who feel that Washington does not represent them. We support open, accountable and limited government, the Constitution and the rule of law, and policies that promote the liberty, safety and prosperity of all Americans.”

The nine founding members and the first board of directors included: Scott Garrett (NJ), Jim Jordan (OH), John Fleming (LA), Matt Salmon (AZ), Justin Amash (MI), Raúl Labrador (ID), Mick Mulvaney (SC) [now Trump’s OMB Director], Ron DeSantis (FL) and Mark Meadows (NC). The group of nine founding members in their organizational meeting in Hershey, PA set as a criterion for new members that they had to be willing to vote against then House Speaker John Boehner on legislation that the group opposed. The HFC has now grown to approximately 30 members in districts indicated below.

Congressional District map for Freedom Caucus membership of the 114th Congress. Former members in light color.

Based on the new math, and emboldened by their ability to stop the passage of the American Health Care Act, the HFC is now the major player in Republican politics. They have virtually hijacked the Republican Party. If Democrats continue to hold tight in opposition to one-sided, partisan Republican legislation, nothing will pass the House without the approval of the HFC.

Thus, we’re not just talking about a health care bill, but the complete array of upcoming legislative initiatives that demand attention and political leadership – e.g. the budget; tax reform; immigration; infrastructure; raising the debt ceiling, etc. etc.

After hyping the importance of the need to repeal and replace Obamacare for the last four election cycles and relentlessly by Donald Trump during the Presidential campaign, the Republican response to Friday’s crushing defeat was simply we’re going to drop it and move on to something else.

While controlling the House, Senate and Presidency, the Republican answer to a health care system that according to House Speaker Paul Ryan (R-WI) is on a “death spiral” and according to President Trump is sure to “implode” and “explode” very soon, is to simply let it spin out of control. President Trump’s response

“So Obamacare is exploding. . . But we're very, very close.  And again, I think what will happen is Obamacare, unfortunately, will explode. . . It's going to have a very bad year.  Last year you had over a 100 percent increases in various places. . . So what would be really good, with no Democrat support, is if the Democrats, when it explodes -- which it will soon -- if they got together with us and got a real healthcare bill. I would be totally up to do it.  And I think that's going to happen.  I think the losers are Nancy Pelosi and Chuck Schumer, because now they own Obamacare.  They own it -- 100 percent own it.”  
"And this is not a Republican healthcare, this is not anything but a Democrat healthcare.  And they have Obamacare for a little while longer, until it ceases to exist, which it will at some point in the near future.  And just remember this is not our bill, this is their bill. . . So now we're going to go for tax reform, which I've always liked. . .”

The Republican response is give up; blame it on the Democrats and move on to something else. Who cares about the millions of people and businesses who are being affected day to day by a broken health care system that is about to explode? It’s not the Republican’s fault.

So now is the time for the Democrats to stand up for what they believe in and take control of the health care debate. After all, the President said, “They own it -- 100 percent own it.” Now is the time for Democrats to lead the way to a bipartisan revolution. How?

Here’s how. The Democrats know there are problems with Obamacare. Some are market based and some have been inflicted by Republican manipulations and actions in D.C. and the states, designed to make the system fail.

Democrats need to develop (if they haven’t already) the Affordable Care Improvement Act, designed to do what needs to be done to make the Affordable Care Act work better and introduce it in the House and Senate with all the Democrats in both chambers supporting it. Simultaneously, they need to launch a massive public education campaign comparing the Republican and Democratic alternatives.

Now, let’s look at the new math again. (218 votes needed to pass legislation) equals (193 Democrat yes votes) plus (25 yes votes from moderate Republicans). Now where could Democrats find 25 moderate Republican votes?

How about the Main Street Republicans, a group of 70-80 that, “. . .share the belief that governing matters. They’re not coming to Washington to shut government down but to make it work more effectively. They’re conservatives, not obstructionists. They want to address the causes of voter discontent by finding solutions rather than trying to prove how uncompromising they are.” [Real Clear Politics, January 31, 2017].

Or, how about tapping Ohio Republican Governor John Kasich who said on the Sunday talk shows (3/26/17) "You cannot have major changes in major programs affecting things like health care without including Democrats from the very beginning." As reported in the Columbus Dispatch, Kasich calls on "reasonable" Republicans and Democrats to unite and craft a bipartisan fix for Obamacare that preserves expanded Medicaid coverage for the drug-addicted and mentally ill. Kasich said that parts of Obamacare are in "very serious trouble," but reforms can be enacted without throwing out coverage for the additional 700,000 Ohioans who gained health coverage under his acceptance of the Medicaid expansion.

So, it’s highly unlikely that Democrats are going to sign on to a Republican led initiative to repeal Obamacare. The Republican’s efforts to “repeal and replace” have failed and the GOP has given up and said it’s moving on to other issues.

It’s time for Democrats to lead the way; start the bipartisan revolution. Remember, the President says “you own it 100%.” If Republican’s won’t work with you and the health care system explodes, at least you will have tried to act responsibly and in the public interest. After all, there’s only so much you can do when Republican’s own the D.C. political system 100%.


Note: the 218 votes needed to pass legislation is based on a full House with 435 members. There are currently 5 vacant seats so the current math changes slightly to 216 votes. But going forward we must assume a full House.

P.S. I also realize that the HFC or Republican leadership could attempt to block a Democratic led solution from coming to the House Floor. But, that's where the public eduction campaign comes in.