Entitlement Reform

Op-Ed in The Hill: ObamaCare repeal must include Medicaid reform

Rachael Slobodien - June 05th, 2017

Today, Club for Growth President David McIntosh and Heritage Action CEO Michael Needham, coauthored an op-ed in The Hill.  In the piece, the two explain the need to include Medicaid reform in efforts to repeal Obamacare.

Read the op-ed in its entirety here and an excerpt below.


ObamaCare Repeal Must Include Medicaid Reform

The Hill

By: David McIntosh and Michael Needham
June 5, 2017

At this point it is clear that Republicans have no intention to repeal ObamaCare “root and branch” as so many promised on the campaign trail. Many congressional Republicans have begrudgingly accepted that a significant number of their colleagues were only pretending. Since coming to that conclusion, those conservatives are plotting a path forward in the repeal and replace debate that respects taxpayers and drives down the skyrocketing cost of health insurance. That dynamic was on full display in the House as the conservative Freedom Caucus and a handful of moderates worked in good faith to address the crippling costs of ObamaCare’s regulatory architecture.

A similar opportunity exists in the Senate to improve both the regulatory reforms and various other provisions, but there are serious policy risks in the upper chamber as well. One of the most notable is that some moderate Republican Senators are trying to delay the phase out of ObamaCare’s generous Medicaid expansion subsidy and increase the program’s growth rate. Having already conceded on full repeal of ObamaCare, conservatives should resist attempts to essentially lock the failed law’s over-subsidization of the Medicaid expansion in place.

The notion that the House-passed American Health Care Act (AHCA) does not provide a soft enough landing for Medicaid expansion states to transition into a new financing system is inaccurate. If the AHCA were to become law, ObamaCare’s expansion of Medicaid to cover able-bodied, childless adults will remain. . .

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How Conservatives Improved the American Health Care Act

Doug Sachtleben - May 04th, 2017

House Speaker Paul Ryan introduced the American Health Care Act (AHCA) on March 6, 2017. It was touted as a bill to “end the Obamacare nightmare and give Americans access to truly affordable, quality health coverage.”


Unfortunately, the AHCA fell far short of those lofty ideals.


House Republicans had passed a stronger Obamacare repeal in January 2016, with 239 Republicans voting “Yes,” and only three liberal Republicans voting “No.” At that time, in 2016, Speaker Ryan said, “We have shown now that there is a clear path to repealing Obamacare without 60 votes in the Senate. So, next year if we’re sending this bill to a Republican president, it will get signed into law. Obamacare will be gone.”


That was the pledge Republicans, led by President Trump, campaigned on in 2016. As the promised fulfillment to that pledge, the AHCA was fundamentally flawed, especially in its failure to address the key drivers of rising insurance premium costs.


The Club for Growth immediately engaged on the issue. The attached timeline lays out some of the meetings, calls, and action steps we took to urge conservatives in Congress and the Trump Administration to quickly address the many problems with the AHCA.


House Republican leaders remained reluctant to make significant changes to the AHCA, and it was pulled from the House floor by leadership on March 24, 2017. The Club for Growth responded with a memo that said, in part, “The conservatives and moderates who opposed the plan should start by meeting together to see what common ground they have.”


Our proposal became the plan that conservatives and moderates followed, and now we are closer than ever to seeing the House vote on a bill that has been dramatically improved.


Because conservatives, including members of the House Freedom Caucus, remained at the negotiating table with the Trump Administration and House leadership, they were successful in bringing much-needed improvements to the AHCA. A summary of those improvements follows.




Moderate Republicans Are Stopping Obamacare Repeal… Again

Doug Sachtleben - April 05th, 2017

“This is big-government liberalism at work among House Republicans and Speaker Ryan is letting them run his conference.”

Washington, DC – Club for Growth president David McIntosh released the following statement after Republican moderates in the House torpedoed a deal to repeal Obamacare:

“The left wing among House Republicans doesn’t want to compromise or keep their pledge to voters to repeal Obamacare,” said Club for Growth president David McIntosh. “They’ve rejected deals that would give Americans more choices for cheaper health insurance, and now they won’t even allow states the chance to scale back Obamacare’s costliest regulations. Conservatives, including the Club for Growth, were willing to accept the latest deal that would let states seek regulation waivers, but moderates want Obamacare largely left intact. This is big-government liberalism at work among House Republicans and Speaker Ryan is letting them run his conference. The Speaker needs to stand up to the moderates who are putting the GOP’s 2018 future in jeopardy by undermining President Trump’s Obamacare repeal promise.”

Op-Ed in Townhall: GOP to Pay Steep Price if Fail to Deliver on Health Care

Doug Sachtleben - March 31st, 2017

GOP to Pay Steep Price if Fail to Deliver on Health Care

David McIntosh |Posted: Mar 31, 2017

Read article on Townhall.com >>>

Democrats will not repeal Obamacare, and a lot of moderate Republicans would just as soon leave it in place. Both positions are an affront to the American people – who desperately want health care reform that gives them the ability to choose affordable insurance.

That’s why the American people overwhelmingly rejected last week’s House bill. They saw it as Washington keeping the status quo.

It would not have increased competition and it would have kept the cost of health insurance premiums rising; a combination that would have spelled disaster for Republicans in 2018.

Fortunately, House Speaker Paul Ryan is now listening and is ready to work with conservatives, who have been fighting for the priorities of the American people from the start. The members of the House Freedom Caucus understand that any Obamacare repeal must deliver on President Trump’s promises to bring back competition, leading to the kind of choices that will drive down costs.

To do that, the Speaker needs a repeal effort that plugs in three elements:

  •         Selling health insurance across state lines. It’s a free-market reform that will make a big difference.
  •         The rollback of more of the costly Obamacare regulations that are responsible for driving up the price of health insurance. Cutting those regulations will even reduce federal spending on the tax credits that are now part of the House bill.
  •         Handling pre-existing conditions with state high-risk pools. Speaker Ryan has called them “a smart way of guaranteeing coverage for people with preexisting conditions.”

In January 2016, after Republicans overwhelmingly passed an Obamacare repeal that was vetoed by President Obama, Speaker Ryan said, “Next year, if we’re sending this bill to a Republican president, it will get signed into law. Obamacare will be gone.” The American people believed that pledge and elected Donald Trump. Next year is here, and they want to see all Republicans keep their word to make sure Obamacare is gone, and to put in its place reforms that offer affordable coverage.

If Republicans don’t make reforms like these, or if moderate Republicans remain intransigent about even sitting down to negotiate a better bill, they will pay a steep price in 2018. Health care costs will continue climbing and voters will be angry that Obamacare is living on in a new Republican form, especially after four elections worth of promises to kill it.

Memo on Way Forward with Obamacare Repeal

Doug Sachtleben - March 25th, 2017




Interested Parties
From: Club for Growth
Date: March 25, 2017
Re: Memo on Way Forward with Obamacare Repeal

After weeks of holding their ground, conservatives saved Republicans from voting for their own version of Obamacare. Their bill wasn’t real repeal.  As the CBO noted, Speaker Ryan’s health care bill would have driven up premiums, and left more people unable to afford health insurance. It was a bad bill, and it was a heroic effort that stopped it.

But conservatives didn’t end up alone in their opposition. As the vote neared, some principled moderates stood with the conservatives, united by the idea that this plan simply did not make things better.

That conservatives AND moderates joined together to put a stop to such a bad bill demonstrated the failure of the House leadership who refused to use regular order, seek input, or listen to concerns.  They instead tried to jam a bill that didn’t deliver on the promises they made, and they tried to make it a “take it or leave it” offer.

Thankfully, conservatives “left it.”

Where does that leave us now?  How do people of principle on each end of the caucus, and on the other side of the aisle even, put together a package that keeps the promises to repeal Obamacare, but also delivers a product that will lower costs and increase access to care?

The conservatives and moderates who opposed the plan should start by meeting together to see what common ground they have.

Obamacare repeal and true healthcare reform can be saved.  The message from the House leaders and even the White House that it is now put aside is simply bluster, much like their negotiations this past week.  Rather than walk away in defeat, we should get to work.

The key is to put as much as possible into one single step, rather than the 3 pronged approach the leaders and White House had been advocating for.

  1. Take the Ryan bill and add the rest of the deregulation that the Freedom Caucus was asking for.  Repeal most if not all of the oppressive Obamacare regulations and add national competition.  Add in the free market, cost saving reforms that the President campaigned on and most if not all Republicans agree on.  Buying across state lines. Easy access to join group plans.  Essentially take all three of President Trump’s stages and put them into the House bill.  Only by adding these measures can the bill begin to roll back the costly premiums and co-pays that have been the hallmark of Obamacare. More Americans will have insurance because more will be able to afford insurance.
  2. Use regular order in the House rules to take the new complete package to the floor after seeking amendments and input.  Allow everyone to offer them from both sides of the aisle, in an open, transparent process.
  3. Ignore the naysayers on Senate rules.  First, reliable sources including Senators tell us that there is FAR more that can be done in reconciliation than we have previously been led to believe.  At the very least we should test it.  If too much falls away, then the House will get another shot at it anyway.  But we should not preemptively surrender nor should we negotiate with ourselves.  Pass what we are FOR in the House.
  4. Allow the same open process in the Senate, with regular order, amendments and ideas from both sides of the aisle.
  5. Undoubtedly a bill done this way will not be everything we want, and may include some aspects we don’t.  That’s legislating. But it will be far better than what was just brought up. It will repeal more. It will free up markets more.  It will cover more people at a lower cost.  And those should be our goals.  So, let’s join with those who believe in those goals, wherever they are on the ideological spectrum, and let’s get to work on real repeal and replace.