(11-11-2016 03:25 PM)Owl 69/70/75 Wrote: And I would expect a lot of support from republicans and zero from democrats. Democrats are interested in concentrating power in the federal government. Quality of health care is immaterial to them.
If I were Trump and had to get a repeal/replacement through Congress, I'd be very careful about how I'd approach the process given that the Democrats will pull out all the stops to maintain the only real 'achievement' of the Obama administration. He could try and ram it through without them, but to go at it without any Democratic support would mean the GOP would have to either do a partial repeal through the filibuster-proof budget reconciliation process, or pass a full repeal and create a replacement by throwing the filibuster out the window.
He can't do the first since it'll be seen as a cop-out with the regulatory structure essentially staying intact. If he tries going with the second, he runs into a few problems: One, he needs to get basically every Republican senator on board, and it's tough to get fifty-one senators even of the same party to agree. Two, you run the risk of compromising the final bill with such a small room for error. And three, even if you manage to create a viable replacement out of that, Trump loses a lot of political capital and creates the problem Obama had with the GOP and half the nation with Obamacare; political opponents have no problem disowning and trying to undermine a law they have no attachment to. Failure to incorporate any bipartisanship in the legislative process seldom yields sound results.
The best way to deal with stubborn Democrats is to reinstate the effect of the Grassley Amendment by eliminating the illegal Obamacare SHOP exemption for congressional employees. With the stroke of a pen, all the sudden every single one of them is subject to the ACA again after Obama unilaterally created a loophole in 2013 because the GA was so unpopular on Capitol Hill.
The best way Trump could go about that is to sign an EO that closes the loophole on a specific date, creating a mob of angry staffers who would threaten to leave by the busload after it takes effect. In doing so, he gets any lukewarm Republicans to fall in line and then forces Democrats to the table for two reasons. One, members of Congress can't afford to lose entire staff of loyal employees with connections to their district/state for campaigning and constituency services. And two, if they still refused to cooperate they'd get crushed in the forum of public opinion; no American will have sympathy for members of Congress or their well-compensated staff forced to play by the same rules as everybody else.
From there the Democratic Party will be far more willing to compromise even if the GOP has to sweat a little bit too, which is why the deadline would be set well in advance to allow for enough time to craft an effective law. It might take some marginal changes to the final health bill or some extra bridges built in blue states as part of Trump's infrastructure investment plan, but it'll work a lot better in the long run than force-feeding.