Republicans should refuse to "reward collaborators" by not helping industry groups that supported the healthcare law unless they support its full repeal, the non-profit FreedomWorks told House leaders in a confidential memo sent Monday.
"We think the Republicans would be foolish to go along with their requests for changes absent their support for repeal," said memo co-author Dean Clancy, who was the top healthcare policy official at the Office of Management and Budget under President George W. Bush. "If you repeal it all, then you repeal its warts and all. Our advice is don't make a bad bill better."
The memo suggests repeal is within reach, and advises House leaders to start offering their own proposals for healthcare reform.
"We're sending this memo because we believe your ultimate success depends as much on how you handle the 'replace' as the 'repeal' side of the strategy," reads the memo to Speaker John BoehnerJohn BoehnerLobbyists bounce back under Trump Business groups silent on Trump's Ex-Im nominee Chaffetz won't run for reelection MORE (R-Ohio) and Majority Leader Eric CantorEric CantorBrat: New ObamaCare repeal bill has 'significant' changes Overnight Energy: Flint lawmaker pushes EPA for new lead rule House staffer, Monsanto vet named to top Interior posts MORE (R-Va.). "We think it's time to start emphasizing what you're for as much as what you’re against."
The memo from Clancy and FreedomWorks leaders Dick Armey and Matt Kibbe outlines a seven-point repeal strategy that includes making repeal unavoidable by passing a balanced budget amendment, and not reducing any taxes from the healthcare law unless the affected industries endorse full repeal.
The House in January voted to repeal the healthcare law, but Republicans in the Senate failed to win a majority vote on a procedural motion to move to healthcare repeal. Every Senate Democrat in attendance voted against repeal.
Even if a repeal bill made it through Congress, it would be vetoed by President Obama.
FreedomWorks is a conservative organization affiliated with the Tea Party movement.
As quoted from the memo, Republicans should:
• Make repeal unavoidable by passing a balanced budget amendment;
• Keep working to put full repeal on the president's desk;
• Not repeal the Independent Payment Advisory Board or reduce any of the various taxes, unless the affected industries endorse full repeal; and not re-fund Medicare Advantage unless the health insurance lobby publicly endorses full repeal;
• "Improve" the law only so long as the improvements don't significantly increase its support: for example, supporting the elimination of the 1099 tax reporting requirement is acceptable because it's only peripheral to the healthcare law;
• Unravel the law by repealing or delaying its core elements;
• Defund implementation and eliminate "egregious provisions";
• Keep building the case for repeal: "Highlight the special interest deals and corrupt bargains. Scrutinize the hundreds of waivers and thousands of pages of regulations issuing from HHS. Publicize the premium cost increases and coverage losses. Keep (Medicare administrator Don) Berwick talking."
"The repeal votes were supported by only three forces: employers, the Tea Party, and the truth. The K Street healthcare lobbies were AWOL," Clancy told The Hill. "And we're telling Republicans, don't reward the folks who brought you Obamacare unless they help you repeal it."
Clancy acknowledged that a lot of the lobby groups want the same "fixes" to the bill. He said Republicans should get them all on board repeal before dealing with them.
"If the big dogs at the table join the repeal effort, then the other smaller actors will probably come along," Clancy said. "If the hospitals, the doctors, the nursing homes, the big players switch sides, it will be an earthquake in this town."
The memo also lists six "key strategies" to create a "patient-centered system":
• Focus on reducing costs and expanding freedom, not on expanding coverage;
• Make federal healthcare programs voluntary;
• Defend true insurance and expand the individual market;
• Reduce reliance on third-party payment;
• Convert federal healthcare subsidies into defined contributions; and
• Stay on offense. Every day Washington talks about health care is a good day for reformers.
Finally, the memo states the GOP should offer a concise "replace" agenda.
"Politically, it's much easier to sell repeal if people know what you would do instead," Clancy told The Hill. "During the House and Senate floor debates, defenders of Obamacare said 'you have nothing to replace it with'. And we're trying to help give the lie to that charge."
Replacement legislation should:
• Make participation in tax-subsidized health coverage more voluntary and portable;
• Ensure full funding for state high-risk pools and reinsurance programs;
• Lower prices through greater transparency and competition;
• Increase consumer choice in federal health programs by converting Medicare and Medicaid into vouchers;
• End Medicare price controls and prevent rationing;
• Give individuals greater control and security through strengthened Health Savings Accounts; and
• Encourage states to lower costs and increase competition.