On Thursday, Senate Republicans wrote a bill over lunch that would reform one-sixth of the American economy. They made the text of their plan available to the public at 10 p.m. Minutes later, the Congressional Budget Office announced that the legislation would increase premiums by 20 percent, and swell the ranks of the uninsured by 15 million, by the end of next year. A little after midnight, 49 Republican senators voted for that bill.
Three of those 49 had publicly denounced the legislation as a “fraud” and a “disaster.” Ron Johnson, Lindsey Graham, and Bill Cassidy announced Thursday evening that they would only vote for their party’s health-care bill if House Republicans assured them that it would never become law.
House Speaker Paul Ryan refused to make that promise. Some observers wondered why Senate Republicans didn’t just stitch a “poison pill” into their legislation, so as to ensure that Ryan would never pass it. After all, the goal here was, ostensibly, merely to advance the process to a conference committee between Republicans in the House and the Senate. (The bizarre idea being that such a conference would be more likely to yield a comprehensive repeal bill capable of winning 50 Senate votes than prolonged negotiations among the senators, themselves.)
But when the bill was unveiled, it contained no provision stripping House Republicans of their salaries, or imposing a surtax on Green Bay Packers tickets. Instead, the “skinny repeal” bill — which had been touted as a “modest” measure that would merely abolish Obamacare’s individual and employer mandates, and medical device tax — was adorned with sections transparently designed to enhance the legislation’s chances of passing the House. Beyond killing the mandates so loathed by conservatives, the “skinny” bill also defunded Planned Parenthood and subtly undermined Obamacare’s regulations of the insurance market.
Meanwhile, House leaders openly indicated their eagerness to pass the bill — perhaps, even, by Monday: House Majority Leader Kevin McCarthy told his members to be “flexible” in their weekend travel plans, as “pending Senate action on health care” might require them to be in Washington.
But Graham, Johnson, and Cassidy voted for “disaster” anyway. And all but three of their Republican colleagues did, too. And so, the United States Senate came within one turn in John McCain’s mood of passing a bill that it knew would increase premiums, medical bankruptcies, and the number of Americans who die each year for want of health insurance — without offering any justification for doing so, beyond a (disingenuous) prediction that their plans would never take effect.
On Friday morning, the big story is that three Republicans voted no, and spared the individual insurance market from the threat of imminent collapse. But in the long run, the more significant development may be that 49 voted yes — and kicked out another chunk of concrete from the crumbling foundation of our (sorry excuse for a) representative democracy.
Congressional Republicans have often blamed the carnival barker–in-chief for their health-care bill’s many deaths. But, if anything, the apocalyptic farce playing out at 1600 Pennsylvania Avenue has provided the GOP leadership with an abundant supply of priceless diversions. As McConnell whipped votes for his “skinny” bill last night, cable networks discussed Steve Bannon’s alleged affinity for autofellatio. Such distractions may not have given Republican lawmakers quite enough freedom from scrutiny to repeal Obamacare. But they have prevented much of the mainstream press from recognizing that the threat to our republic has not been quarantined in the White House.
The congressional GOP has spent most of the past six months trying to cut nearly $800 billion out of a half-century-old program that 70 million Americans rely on for basic health care. They have also worked to erode protections for people with preexisting conditions; increase the average deductible on insurance plans sold over the individual market; and drastically raise premiums for a large swath of their own base, all for the sake of maximizing the amount of tax cuts they can deliver to multi-millionaires.
They have done all this while explicitly promising their own voters that they were trying to do the opposite. McConnell has denounced Obamacare for leaving 25 million Americans uninsured — while working diligently to increase that figure by another 20 million. Ryan has promised to protect people with preexisting conditions, while demanding that his caucus vote to allow states to price nonaffluent cancer patients out of the insurance market. Shelly Moore Capito vowed to protect her constituents’ Medicaid benefits, and then voted for a bill that would have ended the program as we’ve known it.
These deceptions were as self-conscious as they were incessant. Republican lawmakers knew that their policy goals lacked the support of their own voters. The House’s health-care bill was the least popular piece of major legislation in living memory — and when pollsters described the bill’s actual effects to voters, opposition swelled even higher. A recent NPR/PBS NewsHour/Marist survey found that only 10 percent of Republican voters wanted to see Obamacare changed so that it offered less generous benefits. That is precisely what every GOP health-care bill has tried to accomplish.
America’s hospitals, doctors, insurers, and advocacy groups for the elderly and the disabled were all but unanimous in their opposition to every Republican bill. But none of this led the vast majority of GOP lawmakers to abandon their plans. Instead, it merely led them to try and obscure them. They avoided hearings and town halls, kept their bills secret until days — or hours — before voting, in the explicit hope that they could make policy before the public had time to mobilize against it. When that failed, they faked their bill’s death, multiple times, to throw constituents off their scent. They tried to keep voters ignorant of the likely effects of their legislation by passing it faster than the Congressional Budget Office could score it. When that failed, they attacked the CBO as a Democratic front group. They lied and hid, and hid and lied, until, finally, their mendacious cowardice reached its tragicomic apotheosis, and three U.S. senators publicly announced that they would vote for a “disaster” bill — but disavowed all responsibility for the effects it would have if passed into law, because they officially opposed it.
Trumpcare may be dead. But the libertarian plutocrats who bankroll the Republican Party are not. The Kochs, Mercers, and their ilk are not going to stop fighting for their agenda. And so long as an overwhelming majority of Americans do not want to live in Ayn Rand’s utopia, advancing their aims will require undermining responsive government in the United States. Earlier this month, House Republicans released a “budget blueprint,” which functioned as a formal declaration of the party’s long-term fiscal goals. Those included $500 billion worth of cuts to Medicare, $1.5 trillion in cuts to Medicaid, and the utter decimation of food aid and tax credits for the working poor. Few, if any, Republicans won election by publicly touting such plans. The party’s standard-bearer won the White House by promising to protect — and expand — the welfare state. They know they aren’t going to realize their vision through the power of persuasion.
But if they can pass enough voter-suppression laws to fine-tune the electorate; sow enough fatalistic cynicism about our political system to get ordinary Americans to tune out; buy up enough local television stations to deliver conservative propaganda to 70 percent of U.S. households; supply enough campaign contributions to insulate GOP incumbents from democratic rebuke; and eliminate enough transparency from the legislative process to leave the public incapable of comprehending what their representatives do and don’t support, maybe, just maybe, they can substitute their will for the majority’s.
Last night, they came one vote short. That’s a relief. But it’s also a crisis.