Health care bill on life support
Everybody has a question about the Senate health care debacle. Here’s mine: How’d Mitch McConnell get a reputation for being a master legislator?
Look at his record on Obamacare. First, he took a bad House “repeal and replace” bill and made it worse. Unable to round up even 50 votes for that bill, he brought forth a second “repeal and replace” bill which was worse than the first. He couldn’t get 50 votes for that one, either.
So then he announced he’d drop efforts to repeal and replace Obamacare for a “repeal only” bill — which he was quickly forced to abandon because, again, he couldn’t find 50 Republican votes. And he did this without holding one public hearing or debate on a proposal that impacts one-fifth of the American economy.
Celebrate Mitch McConnell as a legislative genius? Republicans should sue him for malpractice.
Veteran Congress watchers say they’ve never seen a more badly bungled legislative process. It all started when Republicans, reeking with hubris after Donald Trump’s surprising win, ignored three fundamental political lessons: on priorities; on entitlements; and on substance.
On priorities. In many ways, the GOP disaster on health care is deja vu. Didn’t they learn anything from mistakes made by Democrats? In 1993, Bill Clinton made health care his first priority. So did Barack Obama in 2009, both with the same results. Democrats got their clocks cleaned in the mid-term elections of 1994 and 2010, as Republicans are now setting themselves up to do in 2018. Lesson lost: Health care’s complicated. Don’t do it first, and don’t try to ram it through in a hurry.
On entitlements. As political poison as they may once have been, Social Security, Medicare, and Medicaid are now political gold. Too many millions of Americans depend on them, almost 70 million on Medicaid alone. It’s only been in force for seven years, but Obamacare’s now in that same category, with a total 22 million people signed up. Lesson lost: Once an entitlement’s in place, it’s impossible to get rid of. Don’t even try.
On substance. The dumbest mistake of all. For more than seven years, while in the minority, Republicans promised: “Repeal Obamacare!” But they never took time to figure out what to replace it with. So, once in the majority, they were caught empty-handed. Lesson lost: There’s a big difference between campaigning and governing. All you need’s a campaign slogan for one; the other requires a real plan and real leadership.
As bad as their proposals to replace Obamacare were, however, McConnell’s plan — sometimes endorsed by Donald Trump, sometimes not — to “repeal only” with the promise of replacing Obamacare with “something” else in two years is far worse. Senate Republicans passed that bill in 2015, when they didn’t have to worry about political consequences because they knew President Obama would veto it.
At the time, the Congressional Budget Office estimated that repeal only would double the number of uninsured Americans and cause 32 million Americans to lose their health insurance — far more than the 22 million CBO says would lose insurance under the latest Senate bill. Asking Republicans to vote for that same bill today, which Donald Trump would gladly sign, is asking them to commit political suicide.
Is there any way out of this mess? Indeed, there is, and it lies very close — just across the aisle. Trump and McConnell try to blame their failure on Democrats. They’re nothing but “obstructionists,” Trump fumes. But the truth is, Democrats had nothing to do with the collapse of the Senate bill. Determined to act with Republican votes alone, McConnell shut Democrats completely out of the process. Now’s the time to reach across the aisle and bring them in.
If Trump and McConnell are really serious about health care, they should forget about repeal, sit down with Democrats, figure out what’s wrong with Obamacare, and come up with a bipartisan plan to fix it. Add a public plan option, for example. Crack down on prices of prescription drugs. Put caps on premiums. In a phrase: Mend it, don’t end it.
Under that plan, everybody comes out a winner. Congress ends partisan gridlock. McConnell gets 85 votes. Donald Trump invites Democrats and Republicans to the White House and crows about what a great leader he is. And millions of Americans keep the health insurance they now enjoy for the first time in their lives.
Impossible dream? No, it’s all possible — if only Republicans would agree to work with Democrats on health care.