White House Is Working With Congress To Amend Healthcare Bill

Tyler Durden's picture

After yesterday's disappointing CBO scoring of the republican Obamacare repeal bill, which prompted loud protests from both the White House on Tuesday said it is working with House leadership on changes to the Obamacare repeal bill in the form of a “manager’s amendment,” which could alter the bill before it hits the House floor.

According to Reuters, when asked at today's regular briefing if the White House was in discussions with House leadership over "shaping a major or significant managers' amendment," spokesman Sean Spicer said: "Yes... We are obviously in talks with House leadership," he said of the discussions.

"As we have noted multiple times from the podium, when people have ideas that are constructive or supportive, or ones we’ve heard about from different members we’ve engaged with … we’ve always stated a willingness," Spicer said noting that “part of the reason we’re engaging with these individuals is to hear their ideas.”

"All of that is part of a comprehensive strategy to engage with members who support us, who have ideas, who want to be on board, who wanted to be constructive in the process."

Spicer added that the White House is "in talks with House leadership about the content," noting that President Trump will speak with both House Speaker Paul Ryan (R-Wis.) and Majority Leader Kevin McCarthy (R-Calif.) later Tuesday afternoon to talk "about some of these ideas and a path forward." According to The Hill, a manager’s amendment is typically used after the traditional committee process to make changes to a bill to gain more support before a floor vote.

Speculation that one would be used increased as GOP members aired their opposition to the bill as it is. More conservative members of the House Freedom Caucus don't believe the legislation goes far enough to repeal ObamaCare.  Spicer pitched the amendment as a way to help forge a greater consensus on the legislation. But asked whether its existence is an admission the bill can't pass as is, Sean demurred, arguing that it's about forging a consensus. 

"That's not entirely true. I think it's an admission of what we stated at the beginning of this entire process, which was the president was going to engage with members to hear their ideas," Spicer said adding that "this has never been a ‘take it or leave it.’ … We want to get the strongest bill through the House with as many ideas and opinions and facts that will help strengthen this as possible."

Some Republicans also fear that moving to meet some concerns of the more conservative members could cost support from more moderate lawmakers in both the House and the Senate.  Ryan spokesman Doug Andres said it was "too early to discuss" any manager's amendment.

Meanwhile, earlier on Tuesday, the architect of Trumpcare, House Speaker Paul Ryan, said he doesn't plan to make major changes to Republicans’ plan to replace Obamacare, even as the White House effectively contracited him. House leadership is “working on getting that consensus” with Republicans in both chambers, Ryan said on Fox News Monday evening. Ryan said he expected the score to show fewer people covered under a plan that doesn’t include a mandate to buy insurance, and he highlighted the deficit reduction and lower premiums in the long term.

“Actually I think if you read this entire report, I’m pretty encouraged by it, it actually exceeded my expectations,” Ryan told Fox’s Bret Baier Monday.

Representative Mark Meadows of North Carolina, chairman of the House Freedom Caucus and an opponent of Ryan’s plan, said, "I think we’re making real good progress with the White House and leadership, and I’m optimistic that we’ll see some good results in less than a week." Ryan and House Majority Leader Kevin McCarthy are speaking with President Donald Trump by telephone Tuesday afternoon to discuss the next steps.

For now, however, what shape the bill will take next is anyone's guess: Senator Roy Blunt said Tuesday that he thinks the House will alter the bill before it gets sent to Senate. "And the plan will be open to change here," the Missouri Republican said as he headed into a lunch with Health and Human Services Secretary Tom Price

 

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cossack55's picture

This bill makes me sick

chunga's picture

The only thing missing is Jonathon Gruber. Hut, Hut, Hike!

Croesus's picture

Gruber is another one who needs to be lined-up against a wall..."It's working the way it was supposed to work"...is just a proof of the idea that EVERYTHING with these people, is all about how it looks on paper, with no thought at all given to 'theory in practice', or consequences of any kind.

If you've ever worked for anyone else, I'm sure you've dealt with management types who are just like that...they're basically incapable of thinking like a chess player.

Jim Sampson's picture
White House Is Working With Healthcare CEOs To Amend Healthcare Bill
OpTwoMistic's picture

Put Mike Pence in charge of the health care effort.  It is not like he has a job.

Croesus's picture

I'd like to see Pence out of there. I voted for Trump, but I don't trust Pence. There's something about him that rubs me wrong.

FriendlyAquaponics's picture

Properly grown and prepared food is medicine, and healthcare costs PLUMMET when it used in such a manner.

Industrial food = disease.

GROW MORE FOOD, and eat it looking as it looks when it comes from the plant.

Giant Meteor's picture

Americans Healthcare Affordability Act of 2017 or AHAA for short

AHAA -

ha ha tee hee, ah ha ha ha ,,ho, ho ho ..

peeing on self, ahaa , ho ho ho, tee  hee

Fuck, pass the depends, ho ho ho ho, ha ahaa 

Holy Shit ..

jmack's picture

It is a simple, one sentence bill. "Obamacare is hereby repealed".

 

   Then you start working on what you want to implement to replace it.  It takes away all the bullshit arguements comparing ryancare to obamacare, cuz there aint no obamacare anymore.

 

    Obamacare was not passed legally, it should have never existed, and it is design to have barbs that will hurt if you pluck it out.  does that mean you dont pluck it out?  you just let it sit there, getting infected, spreading gangrene to the whole body?  No, get rid of it, and start over. Like you promised.

CJgipper's picture

No.

 

More.

 

Subsidies.

 

 

Actual taxpayers (i.e., people who don't get money back) are tapped out.  Time to pay your own way.

Clinteastwood's picture

Outlaw health insurance altogether. Such a new law would mandate an increase in your salary if your employer currently provides this. The price of health care would drop instantaneously to affordable levels. Hospitals, drug companies, and high-priced providers would only get paid what the patient could or would (wink wink) afford. Just like in every other free market.

Every time the government gets into health care they mess it up even worse. Every time.

lil dirtball's picture

Please stop threatening the down-voters. They need this system because otherwise, they're helpless.

Stan522's picture

The plan is just a tweaking of what and how insurance companies can and should do. It does NOTHING in reducing the cost of health care. It is exclusively focused on the insurance side of things and again, it is still an entitlement.

 

My suggestion is to focus more on making health care more affordable, reducing restrictions put out by government on where insurance can do business and to eliminate as much regulation as possible. The other and most important item has to be the consumer and what they are allowed to do and see.

 

When you want to buy a house, a car, a TV, a computer, or any other consumer product, you have the ability to shop for it. You can check out the price, determine its value then proceed with the best choice. This helps drive down the price. We also get to determine value by all of the online reviews that are in real time. We consumers are better served because of this.

 

With health care, the cost is masked under the cover of insurance. Health care insurance is merely a complicated shell game with consumers left with little power, or understanding of total cost. When the consumer cannot see the price, the free market does not work. In addition, there really are no real incentives for the health care providers, or the insurance companies to become affordable, or economical. They simply pass on the costs to the consumer through higher deductibles, co-pays and premiums and procedures. We have seen this year after year with higher EVERYTHING. When 0-care was passed it increased exponentially.

 

Here is the idea.... Under the HITECH law passed by the democrats, there were stipulations that were created to force health care providers to go digital. Part of that led to the creation of a coding system used by insurance and health care providers called ICD-10. This meant every procedure known to man had to have a code. All health care providers and insurance companies use the exact same code for the exact same procedures. This code was used to bill insurance and once insurance had this they would pass on the cost of what's not covered onto the consumer.

 

How about you force health care providers to publish their costs that already exists within the ICD-10 coding system, so that the consumer can see it? This also has to be set up with insurance companies becoming less restrictive on where you can go for coverage. By disclosing their prices up front, we consumers can make better choices. We then can check both the reviews and the pricing and make a better choice for us. This will force health care providers to find a way to be more price conscious and be less wasteful. There are already plenty of existing review programs online that help consumers pick the right doctor, or hospital.

lil dirtball's picture

You wanna know why this shit goes on day after day? Because idiots like you still think it's real and indulge TPTB by 'voting' and then talking about their machinations and tuning into the TV so Bill Fuckface can tell you how it's gonna be while the 'sponsors' put money in his pocket.

Go on thinking this shit is real, you wonky fuckin' moron. Learn the vernacular and .gov acronyms. Talk about it some more with your congresscritter. Tune in to the 'news' so you are informed. Remember, if you believe, you have the power to change the system.

Lol @ YOU, retard.

Stan522's picture

Hey quitter.... you should just end it all because you have no hope. Rid us all of your carbon footprint.... Lib

crossroaddemon's picture

People like you are the reason there's no hope. Until more people cotton onto the fact that we can't vote our way out of this hole we can't even have a conversation about our options. 

Stan522's picture

People like me are why this country has hope.... People like you are why there are so many suicides....

VWAndy's picture

 Wake up buddy. Open your eyes look around. We are getting played. This whole government thing? It is not anything like what we was teached in skools. They aint got no magic. Just lies. And murder. Thats always the plan B.

lil dirtball's picture

> Lib

WTF is this, n00b? Did your fingers cramp before you could get the whole thing out or is this some new obscure acronym? OR - are you implying that I'm a dreaded 'Liberal' (as opposed to 'Conservative'? Oh, my!). You TV watchers love your labels, no?

LOL. You should call me a 'snowflake' just for good measure. That would sure tell me!

LOL @ YOU!

Stan522's picture

Did I get under your skin Lib....?

TheLastTrump's picture

Typical arrogant ass..."you tv watchers"....ego ego ego fuck off loser.

 

 

Looks like you did it too. Hypocrite much? >>> "You TV watchers love your labels, no?"

Giant Meteor's picture

Well I admit his style is a bit abrasive but truth is, I've always been fond of Little Dirtball. No, the world would be a much sadder place without him. Shout out, heh Little Dirtball, how are you today?

See how different that is ? All ya have to do, is sometimes reach out to people. Try to put yourself in their shoes. Maybe he was just having a bad day.

I'm sure this is all one big misunderstanding is all.

edit; Stan, lighten up dude, this is some of my best work ..

crossroaddemon's picture

I see you're getting insanely downvoted but I don't know why. If it isn't obvious by now that our participation in power is exactly zero...

lil dirtball's picture

Lol ... see more wonky cut & paste below.

lil dirtball's picture

Oh - and so does the down-voting anonymous coward think that that wall-o-wasted-text was written on the fly?

It's a comment section, kiddies, not a blog.

Giant Meteor's picture

Now now, there there little dirtball. You've probably just been misunderstood all these years.

Why anyone can plainly see, Stan is just trying to make friends with you!

edit; Ooops, or maybe not ..

TheLastTrump's picture

oh geez....THAT'S A FUCKING LIE

 

I've never had more political 2 way participation then in the last 2 years. Hands down. Tens of millions of Americans agree with me. Go fuck yourself.

TheLastTrump's picture

One word proves you wrong and exactly who the  "wonky fuckin' moron" is:

 

That word is TRUMP.

 

Aptly named lil dirtball

lil dirtball's picture

Your level of retard is unique and stunning - all at the same time.

It comes natural, doesn't it. I wish I were jealous.

Jim in MN's picture

All good thoughts.  My friends and I have revised our short proposal for competitive reform in health care.  I truly believe that without creating large incentives for provider cost controls (think supply chain logistics and bidding at all internal cost points), there isn't much to be gained.

A Competitive ‘Big Bang’ for U.S. Health Care Reform

The Bottom Line

The U.S. health care industry needs a transformational ‘big bang’ transition to competition.  President Trump should demand industry cooperation for the creation of a $100 billion fund, paid for up front by the industry.  This fund would be used to pay the profits for those elements of the industry that demonstrate significant efficiency gains over the following three years, by greatly increasing supplier choice and bidding at all key cost points.  The fund would also be used for immediate premium relief for all American households.  Catastrophic care and pharmaceutical negotiations would be handled in separate arrangements, leaving a huge new competitive health care sector for nearly all services.

The Problem

Health care is directly in the new Administration’s sights.  There is immense appetite for change.  Replacing the Affordable Care Act is proving an elusive quest for the establishment Republicans.  On the Democratic side, a mix of timid incremental fixes rests uneasily with an urge to socialize the entire health care sector.  If the next reforms fail, systemic collapse or a national single-payer scheme become by far the most likely outcomes.  Indeed, we may see both.

The Big Idea

Facing this extreme strategic risk, it is clear that the President has an opportunity to bring in the executives of the Nation’s health care insurers, major care providers, and pharmaceutical firms.  He can make, and expect to win, very tough demands and come to very big deals with these executives. 

Making a large proportion of this industry into a highly competitive free market has a huge potential to benefit the American public.  Cost savings, efficiency gains, better services, and more choices are all possible.  This can be done as it has been in financial services, energy markets, and other examples across numerous countries.  The ‘big bang’ of a planned leap from fully regulated to largely market-driven industry is really no longer just an option for health care in the U.S.  It is, simply, necessary.

Another insight based on experience in other industries is crucial for U.S. health care, due to the size, complexity, and highly varied nature of industry service delivery.  In cases where the exact nature of cost points and potential efficiency gains are opaque or otherwise hidden from policymakers, the use of very large incentives can force industry to find the efficiencies without excessive regulatory oversight. 

The Proposal

Now is the time for a fresh proposal—one based on the fundamentally American and bipartisan tenets of liberty, free markets, and the quest for innovation.  A proposal that blows by the status quo and the short-sighted strategies of the industry powers that be.  A proposal, most importantly, that can be implemented quickly, offer premium relief to Americans, and create a permanent shift in an industry that makes up 20 percent of the U.S. economy.

What the President should demand is the creation of a $100 billion fund, paid for up front by the industry.  One name for this could be the Joint Operations-Premium Yield (JOPY) fund.  This fund would be used to pay the profits for those elements of the industry that demonstrate significant efficiency gains over the following three years.  In other words, profitability would become conditional on meeting performance targets, rather than gaming the system.  But on the upside, the level of profits need not be limited or regulated beyond meeting the targets for increased competition.  Success would be both lucrative and unlimited, within the competitive market.

For the first time, corporate boardrooms would be seeking lean and efficient cost structures rather than padding and gold plating (to inflate or hide excess profits).  Insurance companies, hospitals, medical partnerships, and patients would all share a common goal, to meet needs at the lowest cost.   In practice, the key notion is to embed bidding and arbitrage throughout the system.  At least five competitive sources should be sought, or if necessary created, for as many cost points as possible. Foreign providers and procedures should be allowed to compete in open marketplaces.  Rewards, bonuses and other incentives should be developed at many levels to spur innovation and efficiency.

 In this manner, one three-year ‘big bang’ would be the genesis of a culture of competition and, one can hope, excellence in service delivery. 

Supporting Experience

Decades of work across dozens of countries and diverse economic sectors has shown that the key to well-functioning markets is to establish as much competitive bidding and price arbitrage as possible into the system.  One, two or even three potential suppliers of goods and services are nearly always insufficient.  Five to seven competing suppliers has been shown to be a very strong indicator that bidding and arbitrage will push prices down (competitive pricing), rather than up (oligopolistic pricing).  The raw truth is, there is no such thing as neutral price arbitrage.  It can only work for the consumer, and economic efficiency, or against them.  This is why identification of key cost points, and putting a high priority on developing depth in the supply pool, is of the utmost importance in any market-based reform plan.  Ensuring that bidding and arbitrage function as pervasively and successfully as possible is paramount.  And yet, it is not as simple as simply imagining that these competitive structures can operate literally everywhere.  All industries and national settings are unique (and in the U.S., some state and regions are large enough to have their own unique conditions).  Paraphrasing Einstein, “make every industry as competitive as possible—but no more.” 

Issues and Responses

Identifying true market failure and unique limits to competition is also needed.  Market-based reforms fail when they are pushed too far or ignore fundamental, empirical facts about the industry.  For the U.S. health care system there are two major areas that should not be forced into a minimally regulated free market.  Catastrophic care can be seen as the long end of the risk tail for health care costs.  It is unrealistic to expect a patient with immediate or chronic need for the most expensive medical services to obtain bids, and for suppliers to maintain such costly technologies while risking losing bids.  Catastrophic care should be provided by a consortium of specialized insurance and provider entities, which could be public or private.  In many ways this catastrophic care system could remain much like today’s arrangement, but with performance-based reimbursement and profitability reforms.  

Similarly, pharmaceutical negotiations could aim for more competitive outcomes in the long term, but in the current crisis simple and dramatic price reductions should be demanded.  The past five to ten years of consolidation and profiteering in medical drugs will have to tide these firms over; the American public simply has to see major and immediate relief in this area.

DrDre's picture

The idea has a lot of merit. Unfortunately, the reason why healthcare is such a disaster is that nobody really wants to fix it. The republicans only pretend to be 'pro' market, except in the part that requires their corporate sponsors to lower prices and play real competition.

DrDre's picture

Now here is a concrete idea that makes sense. If you want to give free market choices to consumers, then you have to force providers to be transparent and honest with their pricing practices. This part the republicans seem to coneniently forget.

Frithir's picture

Pricing for procedures is only relevant to those without insurance. Before the ACA,insurance was only for those in the Group market, or, in the Individual market those who had no documented pre-existing conditions. A cancer survivor was SOL when it came to getting insurance in the indiviual market.
In 2008 when millions lost their jobs, I had Cobra. 6 months and $4200. out of pocket later, I was diagnosed w/ stage 4 adenocystic carcinoma. 2 months and $12k more, I became cancer free.
10 years have passed & I'm still cancer free. Without the pre-existing conditions clause, I would be uninsurable. So fuck all you ass-backward brain-damaged psychopaths.
OH! And for those of you who scream "Repeal!" YOU are the REaL Gim'me dats! You can't take my life.

TheLastTrump's picture

This ObamaRyanCare or O.R.C. bill is another in a long line of betrayals by Republican leadership.

 

DRUDGE was absolutely fucking A right.

 

ORC.

DocBerg's picture

Here in Northern Illinois, Northwestern University Medicine has gobbled up most of the hospitals and clinics.  So, they have a lot of market power.  Healthcare costs would be a lot lower if monopolies were broken up.  So, along with posted prices, anti-trust enforcement would do wonders in a lot of places. 

WinstonSmith1984's picture

After 7 years of trying to defeat Obamacare, how can the Republicans still not know how they are going to replace it?

Stan522's picture

The problem resides in the fact that after nearly 7 years, it has entrenched itself into being an intitlement... Try ripping that out of the hands of the Gimmie-Dat's....

VWAndy's picture

 Hand them their own bartab. They will catch on real quick as soon as they see the bill.

TheLastTrump's picture

Paul Ryan is Obama's premier legacy achievement. It's the gift that keeps on giving.

 

Boehner went away and the deals were struck and Obama got his best bud on the Hill.

Giant Meteor's picture

Well after 8 years of Gee Dubya, I figure they never saw themselves "winning" a national election again, in their lifetimes. And the other team? Why those smug bastards believed that shit too! See thats the trouble, everyone going around drinking their own koolaid all the time, never thinkin, gee we might actually have to work for a living one day.

On the other hand, lifetime perks, money for nothin, top shelf health care (for life) why the fuck would they worry!? They can fuck shit up 7 days per week, 365 days per year and STILL wind up coming out of the septic system smelling like roses ..

 

TheLastTrump's picture

sad sack sonsabitches, that's why

 

raping our wallets while they themselves got a different medical plan

 

let them eat cake

IridiumRebel's picture

It's called Ryancare.

TheLastTrump's picture

It's called caving in to pressure from out-of-state-plate "protestors" at Repub town hall meetings.

 

Soros got his filthy lucres worth out of this one.

 

And some genuine middle aged people that take out far more then they put in don't want the pre existing conditions clause to go away, OR the subsidies.

 

 

rejected's picture

"After yesterday's disappointing CBO scoring of the republican Obamacare repeal bill,"

This morphing from a Democrat POS to a Repub POS is now considered a 'repeal' bill!

Is the entirety of our language undergoing redefinition?

Mr. Trump / Con-gress/ ZH,,, Here is what the voters wanted in case there is any confusion.

Eliminate the damn thing.

Do not change it

Do not amend it.

Do not pass another POS

Eliminate = Discard, Burn, Destroy, etc.

Hopefully this clears things up.

VWAndy's picture

 If congress is involved its going to suck. Just enforce the laws equally and the whole thing changes for the better. No need to bring in a bunch of thieves to sort it out? Instead of trashing the whole economy how about just trashing one of the most feral of all the blood sucking segments. They some sick puppies and begged for it.

SubjectivObject's picture

On a related note; the repugnicans think you should be genetically tested, for the record.

http://www.csmonitor.com/USA/2017/0312/Why-a-House-bill-wants-workers-ge...

MuffDiver69's picture

All medical care is going to genetic testing. The more generations you have on record the better. Life's not some fucking sci-fi movie .Take a few minutes and look it up...I'm not going to bother and educate people.