Paul Ryan Is In Quite the Pickle

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Apparently the House leadership is going to introduce an amendment to its health care bill tonight. According to Politico, here are its major provisions:

  • Adds $75 billion to reduce premiums for old people. But in an awesome display of legislative farce, the amendment doesn’t actually set up the tax credits. It just tells the Senate to do it. So House Republicans have to vote for a pig in a poke.
  • Repeals Obamacare taxes a year earlier.
  • Increases Medicaid reimbursements for the elderly and disabled.
  • Deletes a provision that allows people to transfer unused tax credits into a Health Savings Account. Apparently some activists were afraid this might indirectly allow tax credits to be used for abortions.
  • Allows states to establish work requirements for Medicaid.
  • Allows states to take Medicaid as a block grant, presumably so they have more flexibility to use Medicaid money any way they want and more authority to tighten requirements for the poor.

In summary, we have:

  • Two provisions that help the old.
  • Two provisions that screw the poor.
  • Three provisions that increase the deficit.
  • And one provision that somehow caught the attention of anti-abortion paranoids.

If that isn’t a Republican amendment, I don’t know what is. Sadly, it also spends more money, which is enough for many members of the tea-party wing to oppose it. So we’re back to Paul Ryan’s usual conundrum: Half of Republicans are worried about his bill being disastrously stingy, and want to spend more money to guarantee higher benefits. The other half are worried that the bill continues to spend any money at all, and want to cut its already meager benefits further in order to reduce spending even more.

How do you reconcile this? By telling everyone, “This is your one chance to repeal Obamacare.” I guess that might do it, though it’s hard to say for sure. The vote is coming on Thursday, and plenty of people think Ryan doesn’t have the numbers to pass it. We’ll see.

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