OBAMACARE
Republicans muffed their chance Friday to fulfill a seven-year campaign promise to dismantle the 2010 Affordable Care Act and substitute a market-oriented solution.
By Thursday night, the Republican dreams to scrap Obamacare had been reduced to a Hail Mary pass in which Senate GOP leaders hoped to push through some kind of bill — seemingly anything at all — to force a conference committee of the House and Senate, where presumably a comprehensive bill would be forged.
But in what can be described as an Alice In Wonderland conclusion in Friday’s early morning hours, Senate Republicans wound up trying to pass a bill that most of them did not want to become law. When GOP Sens. John McCain of Arizona, Susan Collins of Maine and Lisa Murkowski of Alaska killed the bill by voting no — McCain doing so in dramatic fashion — the dreary drama came to an end.
“The party created a trap for itself and got its leg caught in a trap, and no one was going to let them out of it,” said Tony Fratto, who served as deputy press secretary to former President George W. Bush.
A Republican lobbyist who spoke on condition of anonymity said the “Republican Party is very unified on what they don’t want, but not unified on what they do want in passing legislation.”
As Senate Republicans on Friday fled the rubble they had created in Washington, Obamacare remains fully intact.
Millions of middle-class Americans still can buy federally subsidized individual insurance policies in the state marketplaces created by Obamacare. Families of four earning as much as $33,948 a year will remain eligible for Medicaid, the joint federal and state program that provides health coverage for the poor.
Ohio Gov. John Kasich, a Republican, relied on hundreds of millions of federal Medicaid dollars made available through Obamacare to expand health coverage to more than 700,000 lowincome Ohioans.
Not only did the congressional Republicans swing and miss in their effort to end Medicaid expansion, but their failure also might encourage the 19 states that have refused to take part in Medicaid expansion to reverse themselves.
“If it is the law of the land, and it is not going to be repealed, then other states will opt to get into it,” Fratto predicted.
There is no shortage of people to blame for the GOP fiasco. Like most Republican candidates for Congress during the past seven years, President Donald Trump demanded that Obamacare be scrapped.
But Trump’s dysfunctional White House, often distracted by the angry tweet of the day from the leader of the free world, never provided the steady leadership needed to nudge Republicans to pass a workable alternative, analysts said. Without sustained presidential leadership, it is hard for a Congress to pass any major legislation.
Capitol Hill Republicans, while united in their opposition to Obamacare, never rallied around a consensus to replace it. Some wanted to use the health-care bill to scrap all the new taxes used to finance the new law. Other Republicans saw the bill as a chance to overhaul the entitlement program of Medicaid because its rapid spending growth is squeezing other federal priorities.
And some, such as Sen. Rob Portman, R-Ohio, tried to devise ways to extend the Medicaid expansion for as long as possible because it is popular in Ohio.
Yet every time House and Senate Republicans produced a new plan, the nonpartisan Congressional Budget Office would inconveniently calculate that it would result in millions fewer middle- and low-income people having health coverage.
Even worse for Republicans, the problems of the 2010 law remain. The marketplaces, known as exchanges, have failed to attract enough younger and healthier people to check the rise in premiums. Several insurance companies have dropped out of the
exchanges, leaving large patches of Ohio and the country without coverage.
In addition, the same budget-office economists who delivered a series of body blows to every Republican plan have pointedly reminded Democrats that Medicaid spending will soar out of control in the next decade, forcing lawmakers to either accept massive annual deficits or infuriate Americans by passing huge tax increases that could hit everyone.
The Senate vote — which began shortly before 1:30 a.m. Friday — capped a dramatic week that included a news conference late Thursday in which McCain and two fellow Republican senators essentially pleaded that their Senate leadership’s healthcare package not become law.
Calling the Senate proposal “a fraud” and “a disaster,” Sen. Lindsey Graham of South Carolina said he was prepared to vote for it only if House Speaker Paul Ryan promised that his chamber would not then pass it and send it on to the White House. The Senate bill, Graham said, “was never sold to be the final product” — only as a means to get something passed so that House and Senate negotiators in a conference committee could work out the final details. He and McCain were joined by Ron Johnson of Wisconsin.
Ryan agreed to a conference committee hours later, and a phone call among Ryan, Johnson and Graham around 9:45 p.m. Thursday sealed the deal: Graham and Johnson would vote for the Senate plan after all, if only to move the repeal of the bill forward.
However, McCain, who was diagnosed this month with brain cancer and is recovering from surgery, resisted.
“I’ve stated time and time
again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict party-line basis without a single Republican vote,” McCain said in a statement after the vote. What now? “I know some may want to throw in the towel and do nothing, but I don’t believe that is the responsible course of action,” Portman said in a statement. “Doing nothing would leave tens of thousands of Ohioans stranded without health insurance and everyone with higher costs.”
Although some progressives are calling for a Canadianstyle system in which the federal government covers all health costs, political reality makes that unlikely.
“Somewhere down the line, something has to be done because of the failure of the exchanges,” said the Republican lobbyist. “But it’s not clear what that is and how it can pass the Senate.”
Both Kasich and Democratic Sen. Sherrod Brown of Ohio are calling for a bipartisan effort — as are McCain, Collins and Murkowski.
Kasich, who praised “my old friend” McCain for showing courage, said in a statement: “Now is the time to start working together to not just stabilize our healthcare market but take on so many of the big challenges facing our great nation.”
Brown proposed this: “Let’s kick the drug-company and insurance-industry lobbyists out, listen to the people we serve and come together to lower prices and make health care work better for everyone.”