There are lots of things brewing in the House's version of Trumpcare, which has now passed out of both the Energy and Commerce and Ways and Means committees, that are going to be a big problem for the Senate. Like the newly emerged plan from the extremists, designed to attract Freedom Caucus maniacs, to screw over people on Medicaid and the states they live in now instead of in two years. That's not going to go over well. There will be a lot of those kinds of things, probably, that crop up in amendments. But there's one big thing that even Paul Ryan has kind of acknowledged. They are using the process called budget reconciliation to pass the bill. They're doing that because it only takes 51 votes in the Senate—it's not subject to a filibuster.
There's what could be a fatal flaw in the bill because of that, one you'd think Paul Ryan would have been enough of a wonk to recognize as such when he drafted the thing. When a bill is considered under budget reconciliation, the Senate rules say, all the changes have to have direct impact on the federal budget. One big one doesn't, as Sen. Chris Murphy points out.
xThat's the 30 percent surcharge the bill allows on the first year of premiums for people who are signing up after their insurance lapsed. That's what Republicans are using in place of the individual mandate in Obamacare that makes people who haven't signed up for insurance pay what's basically a tax. That's federal revenue—it's related to government spending. The Trumpcare surcharge is not—it's paid to private companies, and under the Senate rules, is subject to a 60-vote threshold.
Remember, the linchpin of #Trumpcare - the penalty on people who lose coverage - needs 60 votes. Bill falls apart without that provision.
— Chris Murphy (@ChrisMurphyCT) March 9, 2017