the national interest

Trumpcare Is Having a Very Bad Day

Mitch McConnell is facing a bleak prognosis. Photo: Tom Williams/CQ-Roll Call,Inc.

Last week, just as the Senate appeared to be racing toward the stealth repeal of Obamacare, it came to a screeching halt. Mitch McConnell has tried to use the July Fourth recess to regroup and find a way to assemble the 50 votes he needs to roll back the Affordable Care Act. But today appears to be another turning point: His plan suddenly looks like it’s on the verge of death. It is not one single development that indicates the sharply worsening outlook for Trumpcare, but several.

The most damaging development is a new statement by Mike Lee, one of the arch-conservative holdouts. Lee has been angling to make McConnell include provisions in the bill to weaken Obamacare’s protections for people with preexisting conditions. Lee’s ideas are a complete nonstarter for many, perhaps most, members of the Republican Senate. Today his spokesman told Axios reporter Caitlin Owens, “The entire bill is unacceptable without the Consumer Freedom Option.”

Lee’s position makes it almost impossible for McConnell to find his 50 votes. Blue-state senators Susan Collins and Dean Heller already appear irretrievably opposed to anything resembling McConnell’s plan. If Lee demands that the bill let insurers charge higher prices for coverage of treatments needed by sicker people, then he drives away at least one more vote on the party’s opposite wing: Lisa Murkowski or Shelley Moore Capito, among others, have expressed reservations about yanking coverage away from people who have obtained it through Obamacare.

That is not the only indication of trouble for McConnell. Kansas senator Jerry Moran, the only Republican senator who has held a town hall meeting during the recess, is nobody’s idea of a swing-state vote. But Moran faced a packed audience, and advocated a bipartisan approach in health care: Health care would be “almost impossible to try to solve when you’re trying to do it with 51 votes,” he told the audience, instead proposing this chamber “figure out where there are 60 votes to pass something.”

Bipartisanship might sound like a mom-and-apple-pie concept that a nervous Republican could throw around to mollify angry constituents without committing himself to anything specific. But in this case, 60 votes has a clear meaning. McConnell’s plan has been to use a 50-vote procedure to avoid the need for Democratic support. Indeed, he has threatened his caucus with the prospect that he will resort to bipartisan negotiations if the 50-vote strategy fails.

And today McConnell himself made the same point again. Only this time, he didn’t phrase it quite like a threat. “If my side is unable to agree on an adequate replacement,” he announced, “then some kind of action with regard to private-health-insurance markets must occur.”

This is, of course, a comical admission that the entire premise of the Republican onslaught has always been a lie. Republicans have insisted for seven years the law was totally beyond repair, and that the entire thing must be repealed, including its Medicaid expansion. The truth is that the marketplaces have largely stabilized, and they face long-standing challenges providing competition in rural areas, but nothing like the death spiral Republicans have claimed. Even Trump’s own health-care experts have admitted the Obamacare exchanges are healthy.

If Republicans want to give up their long-standing boycott of any tinkering with the bill and instead pass some simple patches, they might anger some conservatives, but they will also steer clear of inflicting humanitarian disaster on their own constituents, who might not appreciate it.

Trumpcare isn’t dead until it’s dead. But the Senate Republicans look like a group of politicians who have decided they don’t care enough about health-care policy to absorb the political blowback that passing a law snatching insurance from millions of Americans would instigate.

Trumpcare Is Having a Very Bad Day