10 lessons from the GOP’s failed effort to kill Obamacare
Republicans are facing one final decision on their doomed effort to repeal the Affordable Care Act: Should they bother to hold yet another vote in the Senate that they know they will lose, or should they acknowledge that it’s over, at least for this year?
“Everybody knows that’s going to fail,” Sen. Orrin Hatch said of the Cassidy-Graham bill, now that three Republican senators — Rand Paul, John McCain and Susan Collins — have officially stated their opposition, with perhaps more to follow. But Republicans will decide today whether to hold a vote. “I think there is some advantage to showing you’re trying and doing the best you can,” said Majority Whip John Cornyn (R-Tex.).
While repeal will never be truly dead until Democrats take back either a house of Congress or the presidency, this latest GOP failure gives us a chance to take stock of what we’ve learned. The lessons are many:
1. Republicans don’t care about policy. For seven years, they railed against the ACA and promised that when they had the chance, they’d repeal it and offer something better. Yet for all that time, they never bothered to sit down and work out what their replacement might look like. Then when they got control of the entire government, they still couldn’t make a serious attempt to tackle the policy challenge. The bills they came up with were hastily thrown together, full of contradictions and catastrophic consequences, and sponsored by people whose public comments made clear that they barely understood the first thing about what they were proposing.
In President Trump’s immortal words, “Nobody knew that health care could be so complicated.” The truth was that everyone who had ever taken the issue seriously knew it — but that didn’t include more than a handful of Republicans.
2. The overwhelming majority of Republicans are more than happy to vote for bills with catastrophic consequences. All of the GOP health-care bills that were offered promised upheaval — tens of millions losing their insurance, skyrocketing premiums, death spirals in the individual markets. Yet there were never more than a few Republicans willing to say no. The rest were ready to set off a tidal wave of human suffering if it meant that they could give the finger to Barack Obama.
3. Fewer people having health coverage isn’t a bug of Republican plans; it’s a feature. Every one of the GOP plans would have resulted in millions upon millions of Americans losing their health coverage, and that was the whole point. As they’ve proved again and again, Republicans would rather see someone go without coverage than get their coverage with help from the government, whether directly through a program such as Medicaid or indirectly through subsidies.
4. Yet Americans actually like government health coverage. This realization came as a shock to Republicans, who thought they could gut Medicaid and replace it with the promise of “freedom,” and no one would mind. But they discovered to their chagrin that Medicaid is extremely popular. Republicans believed their own rhetoric, which holds that when the government does something it’s always inefficient, incompetent and cruel. But it turns out that most Americans don’t share that dogmatic belief. If government insurance is a good deal, they’re happy to get it.
5. Many of the ACA’s protections are no longer negotiable. This was a fear that many in the GOP had about the ACA from the beginning, that once you gave people benefits it would be very hard to take them away. And so it has come to pass. That’s why most Republicans tried to argue that their bills protected those with preexisting conditions, even when they didn’t: They knew that the public will not tolerate the removal of those protections. Likewise, they had to keep the ACA’s mandate that young people can stay on their parents’ insurance. Even the requirement to cover essential health benefits looks very hard to take away.