Here’s the parallel universe Washington has become these days: The new Republican health care bill is even worse than the old ones, because they had to placate the hard-right members. Naturally, this worse bill seems to have a much better chance of passing.
House Republicans may hold a vote Wednesday. One presumes that after that late March fiasco, they now have the sense to schedule a vote if and only if they’re certain they have the votes for passage. They’ll be counting noses right up to Wednesday afternoon.
Passage of this bill into law would be a disaster for the country. Up to 20 million people could lose their health care coverage. People with serious illnesses could be screwed out of coverage again or charged far more than others under a provision that would allow states to bypass Obamacare requirements about covering those with preexisting conditions. The whopping cuts to Medicaid in the bill, wrote Jonathan Cohn Monday, would probably constitute the biggest single cut to a public benefit in the country’s history, bringing “widespread hardship to the millions of people who depend on it for everything from opioid treatment to cancer care.”
Fortunately, whatever the House does, the Senate seems, to most people watching this, like a heavier lift. Passage is certainly possible there—remember, Republicans wouldn’t need any Democratic votes to pass it under reconciliation, which also would mean the Democrats couldn’t filibuster it. Then the question would be whether three GOP senators would be willing to vote against Mitch McConnell—and of course their president. A second question would be whether McConnell really wants the GOP to be known as the party that threw 20 million people off their health insurance.
For the sake of those people, and all the others who’ll suffer under the Scrooge-Marley health care act, I can’t in decent conscience say that I hope the Republicans pass their bill. But right now, on my right shoulder, I’m feeling a little tap-tap-tap—it’s the little devil Tomasky, and he’s whispering in my ear: “C’mon, let ’em do it! They pass that bill and they’ll be handing the Democrats a huge pile of ammo for 2018! Write it!”
He’s right. If Trump and the Republicans actually do manage to repeal Obamacare, I think it would then be a near-certainty that they’d lose control of the House of Representatives. Why? Because a large number of the vulnerable House Republicans are in one of two circumstances, or sometimes both. One, they’re in states that took the Medicaid expansion, which means they’re representing many flesh-and-blood humans who will lose their coverage. Or two, they’re in districts that aren’t deep red, or are even a pale shade of blue, where approval for Obamacare is presumably pretty high.
For example, the Cook Political Report rates 13 seats held by Republican incumbents as being either toss-ups or “leaning” Republican, which means the incumbents are definitely vulnerable. Of the 13, eight are in states that took the Medicaid money. Of the remaining five, the Cook “partisan voting index,” which measures how Republican or Democratic a district is, either leans in the Democrats’ direction or is barely Republican in four. The only one of the 13 that on paper looks like it ought to be a fairly safe GOP seat is the Georgia seat that Democrat Jon Ossoff is seeking now (the election is June 20). But as we know, Ossoff appears to be the slight favorite.
Cook rates another 24 Republican-held seats as being possibly competitive. Of those 24 districts, 19 are in states that took the Medicaid dough. Most of those 19 would presumably vote against their own party on this one, but even so, they really don’t want to have to defend what their party will have done here, and as their Democratic opponents will inevitably be pointing out, “Congressman X may have voted against Ryancare, but he did vote to make Paul Ryan speaker, and Ryan made Ryancare happen.”
If they pass this bill, they are dead men (and women).
I think McConnell knows it. I imagine Ryan knows it, too, but he has that Freedom Caucus to assuage, so he has to press on. Does Trump know it? On Face the Nation Sunday, he was all over the place on the question of preexisting conditions and other matters. Of course, he insisted that people with such conditions were covered “beautifully.” When host John Dickerson informed him that the Republicans had passed an amendment to the opposite effect last week, Trump just waved it away. You’d think at this point that he’d actually care a little bit about substance, given that his success or failure now rides on the results he gets.
So here’s what we have: a Republican president who has lied repeatedly to the American people for nearly two years now about how he’d bring them health care coverage that was much cheaper and far better than Obamacare. And a Republican Congress that has lied repeatedly to the Americans for the last several years that they can pass a bill that’s vastly superior to Obamacare cuz, y’know, freedom. Trump’s lies were of ignorance; the GOP’s of ideological belief.
But even though they were different, they revealed the same truth: You can’t just magically make this better. It’s hard and complicated, and Obamacare can be improved, certainly, but only by people working in good faith to do so. The American people, finally, seem to have figured all this out.
I hope the House votes tomorrow, so they’re all on record. Then we’ll see where the fight goes from there.