Surgery, not Band-Aids

Caught between a rock and a hard right place, Senate Majority Leader Mitch McConnell yanked his grossly unpopular health-reform bill Tuesday, thwarting plans to get the legislation passed by the July 4 recess. All those who know the bill to be a steaming pile of medical waste should hold their sighs of relief — because Republicans haven’t given up on winning over the moderates among them who balk at the bill’s stark cruelty.

Look for a revised version of the bill to emerge soon, larded with goodies to court the likes of Maine’s Susan Collins, Alaska’s Lisa Murkowski and Nevada’s Dean Heller.

Special provisions aimed at individual states will only make a bad bill worse. McConnell & Co. have to wake up and smell the bitter coffee: Americans hate this bill because it was hatched in secret and would result in 22 million fewer Americans being covered by health insurance.

Because it cuts $772 billion out of Medicaid over a decade, shifting cost burdens to states.

Because it replaces more generous Obamacare subsidies with far stingier tax credits, especially for older people, who tend to be sickest.

And, coup de grâce, because it lavishes tax cuts on the wealthiest Americans. Those in the top 1% would get an average tax cut of more than $45,000 a year in 2026. Those in the top 0.1%, nearly $250,000, according to the Tax Policy Center.

Unless the Senate fixes those fundamentals — which means breaking from the toxic formula cooked up by the House — the bill deserves to fail, and fail miserably.

As the outlines of the Senate’s attempt to overhaul health care and reshape one-sixth of the American economy has come out of the shadows and into focus, popular support has plummeted. It now stands at 12%, according to a new USA Today/Suffolk survey. Demand a second opinion? A Quinnipiac poll puts the bill’s favorability at 16%.

But Senate Republicans don’t need to win over the public; they just need three or four more politicians, to get to the magic number of 50, so that Vice President Mike Pence can rush in and cast the deciding vote, sending the passed legislation back to the House to be okayed in the arcane process known as reconciliation.

Which is where the rotten pork is likely to come in. Just two months ago, it looked like the House’s Obamacare repeal was D.O.A. And so, Speaker Paul Ryan got to work cutting deals to get a vote.

One hit New York City right in the teeth: As presented by upstate Reps. Chris Collins and John Faso, the so-called “Buffalo buyout” would transfer $2.3 billion in Medicaid expenses from county budgets into the laps of state taxpayers, while leaving residents of the five boroughs picking up the full tab for our own Medicaid costs.

With that deal and others in hand, Ryan brought his bill to the floor and passed it by a narrow 217-213 margin.

McConnell has been running his Republican conference a long time. He’s had years of experience twisting arms to get his way.

Look for the wily Kentuckian to barely tweak the structure of his overhaul, doing cosmetic surgery at most, while throwing enough cash at Alaska, Maine, Nevada and elsewhere to win friends.

Murkowski, Collins, Heller and others must stand on principle. They must say “thanks but no thanks” — or, why not, something more Trumpishly direct.