For one brief shining moment, the left and the right have come together in a chorus of Kumbaya. All it took was a singularly pernicious piece of legislation that simultaneously offended all of their principles. You’ve got to hand it to Republican congressional leaders: they came up with a health care bill that almost anyone can hate. Who could have imagined such a collection of odd couples – Planned Parenthood and the Koch brothers, MoveOn.org and the Tea Party, Sens. Bernie Sanders and Ted Cruz – all locking arms in battle?
Yet, even with depleted and exhausted troops, these determined generals – Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan – keep trying to climb that seemingly unscalable mountain in order to pound a stake through the heart of Obamacare. It’s a seven-year-old elusive dream that has not aged well. This bizarre mission is draped in a misplaced notion of integrity, of promises to keep. “We’re keeping our word,” Ryan told ABC news. “That’s very important.” Our promise, McConnell has repeatedly insisted, is to “repeal Obamacare root and branch.” The repeal mantra worked for Republicans back in the day. But political slogans need to change with the times. Even George Wallace knew that his 1963 “segregation now, segregation tomorrow, segregation forever” line wouldn’t play in the 1980s. Too much had changed. The health care swing was less dramatic but just as real.
The frenzy to pass this legislation is all about a promise that is no longer operative. It served conservative political interests a few years back, when the new health insurance system was confusing, unsettling and, thanks to Republican demagoguery, unpopular. However, people have gotten used to it, including the estimated 17-20 million who now have insurance for the first time. Suddenly, polls show that a majority of Americans like Obamacare. Meanwhile, NPR/Marist polling on the Republican health bill this week gave it a 17% approval rating. In that same survey, 63% of the respondents favored either leaving Obamacare unchanged or strengthening it.
From a pure standpoint of self-interest, the GOP’s health care strategy makes no sense. Politicians have two constituencies: voters and campaign contributors. So far, every health care permutation Republicans have come up with alienates both groups. If anything resembling their current bills pass, between 22 and 23 million Americans will lose insurance. Lower income families and the elderly will see premiums rise by 280%. Taking benefits away from people – or overcharging for them – is not an effective way to win votes. Republican governors get that, which is why many of them oppose their party’s mindless drive to repeal and replace. It’s a promise that has lost its predicate.
And now come the financial heavies, the real power behind the anti-Obamacare movement, all angrily insisting that the Republican bills aren’t a repeal at all. The repeal promise, of course, was not born out of a desire to create a better health care system. It was all about appeasing the Koch brothers and other titans of the corporate right. Americans for Prosperity, the Koch network’s political arm, and a number of similar groups, poured hundreds of millions of dollars into the campaign coffers of candidates committed to a total dismantling of Obamacare. They are all thoroughly disgusted with the House and Senate bills that upend insurance for millions and slash Medicaid spending. It’s not enough for them, not nearly enough. AFP leader Tim Phillips called the Republican legislation “a slight nip and tuck”, according to the Associated Press. He said it was “Obamacare-lite” and that AFP is poised to go after Republicans who support it. In other words, the only way McConnell and Ryan can satisfy their financial benefactors is to cut much deeper, leaving millions more without insurance, and passing their subsidies on to the rich in the form of tax cuts.
The Washington Post reported today that McConnell was gingerly rearranging pieces of his Senate bill in an attempt to address objections launched from every possible direction. Reportedly, this would involve scaling back tax cuts for the rich in favor of helping lower income people get insurance. That might appease some moderates but will further frustrate the right. To compensate, says The Post, he may strike some Obamacare coverage mandates from the bill. Meanwhile, the nonpartisan Congressional Budget Office reported that the bill’s reduction in Medicaid coverage would be significantly higher than originally calculated. Bottom line: the bill is not headed toward a Palm Sunday reception.
McConnell and Ryan are not in this promise trap by themselves. President Trump spent his campaign promising to slay Obamacare on day one. Of course, the president could cram everything he knows about health care and the legislative process into a single tweet, and have 140 characters left over. He says he wants a Senate bill that is not as “mean” as the House version. Yet, Trump threw a Rose Garden celebration for passage of that “mean” House bill, calling it “very, very, incredibly well-crafted . . .a great plan.” Unlike the president, McConnell and Ryan know what they are doing. They just made a huge stumble.
There is a certain nobility attached to fulfilling a promise, but nobility can quickly turn into dung when the underlying conditions behind the promise change. This is one more example of Republicans ignoring science at their peril. Remember the uncertainty principle from physics class? You can determine a particle’s position or its momentum, but you can’t accurately measure both at the same time. That’s because positions and momentum change. The Republican leadership built their repeal strategy on 2010 measurements. Once people who never had health insurance got it, the public’s position on the particle called Obamacare started to change. It’s been moving ever since, but the Senate majority leader and House speaker are just now taking stock of its momentum.