The defections of Sens. Jerry Moran and Mike Lee late Monday night confirmed what smart congressional watchers had long suspected: The attempt to repeal and replace the Affordable Care Act is dead. For now. And maybe forever.
In the wake of the collapse of the legislation, the Trump White House insisted it would fight on. The President sent this tweet just after 10 p.m. ET: “Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!”
Talk to any Republican privately and they will tell you that there are simply no good options to turn this legislative lemon into lemonade. Below are seven hard realities Republicans need to face in the aftermath of this epic collapse.
1. There is no other, better bill
In the days leading up to Monday night’s implosion, there was chatter that if it became clear that the current version of the bill wouldn’t pass, Senate Majority Leader Mitch McConnell would go back to the drawing board and the result would be a “better” bill.
The legislation McConnell initially put forward was his best effort to cobble together the disparate coalitions within his party behind a single bill. He wasn’t holding the “better” bill back. There is no better bill. If there was, Republicans would have come up with it sometime over the last eight years.
2. “Repeal then replace” isn’t likely to go anywhere
Part of the pivot by the White House – and McConnell – to the idea of “repeal then replace” is because they need to say something following such a consequential defeat at the hands of their own party.
But, there’s very little chance that such a plan will work. After all, the reason that congressional leaders did “repeal and replace” was because their initial idea of “repeal then replace” wasn’t going anywhere. As CNN congressional reporter Phil Mattingly tweeted Monday night: “Your weekly reminder that repeal only, then replace, was the original Hill GOP plan. It was deemed un-passable. Hence repeal/replace.”
And, if you thought the Congressional Budget Office report on the proposed Senate bill was bad, take a gander at the numbers on the idea of repeal then replace.
3. McConnell wants this to go away
Arizona Sen. John McCain’s proposal, released after the Moran/Lee announcement, to start the health care process all over again is the exact opposite of what McConnell and House Speaker Paul Ryan want.
McConnell’s push for a straight repeal vote is a way to get the health care issue off the table as soon as possible. He knows it’s not likely to pass. And he believes that if/when it fails, he will be able to say to the conservatives in his conference: “I did everything I could to get rid of this law. It didn’t work. It’s time to move on.”
McConnell and Ryan know that every minute they are debating how their effort to make good on the promise of repealing and replacing Obamacare failed, they are losing. Expect a repeal vote followed by a quick move to tax reform.
4. House Republicans who voted for health care are WAY out on a limb
The danger of going first in a game of legislative chicken like health care became is that the other chamber does exactly what the Senate just did: Walk away.
That’s the reality House Republicans in marginal districts who voted for the bill are waking up to this morning. And there are plenty of them; only 20 of the 238 House GOPers opposed the health care legislation in May.
Now they not only have a very tough vote on a very unpopular proposal but they are nearly certain to have nothing tangible to show for it either.
5. Obama leaving office was the worst thing that happened for repeal/replace advocates
The New York Times’ Nick Confessore asked the right question on Twitter Monday night: “Not being flip here: how much did Obama leaving office strengthen Obamacare politically? (Not procedurally)”
During Barack Obama’s time in office, approval for the health care law – particularly among Republicans and independents – tracked extremely closely with approval for the President himself. It was a proxy vote; Republicans who hated Obama hated Obamacare. Simple.
Republicans deeply miscalculated by assuming that even when Obama left office, the law he left behind would remain just as unpopular as it was when he was president. It didn’t. The further Obama receded into peoples’ collective rear-view mirror, the more popular the law that bore his name became. In the July Kaiser Family Foundation tracking poll, 50% approved of the bill while 44% disapproved.
6. Delaying the vote was a total killer
Give McConnell this: He knew that the only chance the health care legislation had of passing was a very quick vote prior to the July 4 recess. More time is never the friend of this sort of legislation – it’s too complex with too many hard choices to possibly benefit from a really close examination.
Once McConnell was forced to push the vote until after the July 4 recess, it was doomed. Opposition only hardened as Senators returned to their home states to get an earful from constituents who might not love Obamacare but were very nervous about an unclear alternative.
7. Trump never had any real idea about the policy
On Monday afternoon at an event touting “Made in America” week, President Donald Trump said this about the health care legislation: “We’re getting it together and it’s going to happen. Right, Mike (Pence)? I think.”
The truth is he had no idea – of the vote count or the policy debate. The idea that Trump was going to get on the phone with, say, a noted policy maven like Ohio’s Rob Portman and offer a convincing case for why Portman needed to be for the bill was laughable. Trump didn’t know or seem to care about the particulars. He just wanted to sign something and declare victory.
Trump’s lack of knowledge was brutally exposed when, even as he was dining with seven senators last night, Moran and Lee stabbed the bill in the heart.