The demise of an un­wanted, unloved health care bill

The Denver Post - - OPINION - By Jonathan Bern­stein

We’ve never had any­thing like the Repub­li­can health care bill, which fell just one vote short of pas­sage in the Se­nate — in the dead of night, of course, be­cause Repub­li­cans ap­pear ab­so­lutely ded­i­cated to ful­fill­ing in fact every fic­tion they told about the Af­ford­able Care Act back in 2009-10.

But that’s not what made any ver­sion of the Repub­li­can bill — in­clud­ing the pared-back “skinny re­peal” edi­tion — so spe­cial. Nor am I talk­ing about the se­cre­tive pro­ce­dures un­der which the bill was con­sid­ered, in­clud­ing all of two hours be­tween mak­ing the fi­nal Se­nate bill pub­lic and vot­ing. The process was aw­ful, and hardly any way to de­sign such an im­por­tant law. How­ever, while this is an ex­treme case, we’ve had bills con­sid­ered and even pass un­der ter­ri­ble pro­ce­dures be­fore.

No, the most as­ton­ish­ing thing about this bill, from when the first ver­sion was in­tro­duced in the House right un­til what ap­pears to have been the bit­ter end, was that hardly any­one was will­ing to ac­tu­ally say they liked it. That’s ex­tra­or­di­nary. And I sus­pect at the end of the day that’s what killed it.

Health care work­ers and or­ga­ni­za­tions didn’t like it — the doc­tors, the nurses, the hos­pi­tals, the in­sur­ance in­dus­try and more. Pa­tient or­ga­ni­za­tions hated it. Other or­ga­nized groups (AARP, for one) tar­geted it.

I’m al­ways very skep­ti­cal of pol­icy polling, but for what­ever it’s worth, vot­ers had been telling poll­sters they hated it. No one can re­call the last ma­jor bill that passed with such aw­ful polling num­bers.

The bill never ap­peared to gen­er­ate any real party en­thu­si­asm, ei­ther. If Repub­li­can ac­tivists ral­lied to it, they did so very qui­etly. Quite a few Repub­li­can health care ex­perts ei­ther op­posed var­i­ous ver­sions of the bill or sup­ported them with­out real con­vic­tion. Repub­li­can-aligned me­dia seemed more in­ter­ested in chas­ing ru­mors about Hil­lary Clin­ton than in build­ing sup­port for leg­is­la­tion. Some of this has to do with the post-pol­icy Repub­li­can Party, which just doesn’t con­sider pub­lic pol­icy as im­por­tant as sym­bolic ac­tions, but I sus­pect the tax bill, if we get one, will gen­er­ate at least some in­ter­est.

The pres­i­dent never both­ered learn­ing any­thing about the bill, and at least pub­licly did very lit­tle for it. He did men­tion it from time to time, but there was no high-pro­file speech ded­i­cated to it, no Oval Of­fice ad­dress, and I be­lieve just a sin­gle event ded­i­cated to pitch­ing it. And of course his dys­func­tional White House hardly was in a po­si­tion to lobby ef­fec­tively for it. It’s quite pos­si­ble the lack of a strong sig­nal from the White House might have been re­spon­si­ble for Repub­li­can vot­ers fail­ing to rally to the bill in the polls.

Even the peo­ple vot­ing for the bill didn’t like it. Repub­li­cans had an hour to ad­vo­cate for the bill, and Se­nate Bud­get Com­mit­tee Chair­man Mike Enzi spent that time ram­bling on a wide va­ri­ety of top­ics, al­most none of which had any­thing to do with the bill un­der con­sid­er­a­tion.

In his post­mortem speech, Ma­jor­ity Leader Mitch McCon­nell did get in some digs against Oba­macare, but his re­marks lacked ref­er­ences to what would have been the case if the bill had passed.

The story the news me­dia is telling is about the three Repub­li­cans who split with their party on what turned out to be the big vote: Su­san Collins, Lisa Murkowski and John McCain. And each of them had rea­sons for do­ing so. But the truth is that jig­ger­ing the bill this way or that way would have pro­duced a dif­fer­ent group of three, or a group of five or nine or 15. That McCon­nell even­tu­ally chose the path he did makes it look like those three de­feated the bill, but that’s mostly an il­lu­sion. Its odds have been very low since Jan­uary, with the real ques­tion be­ing who would get caught with­out a chair when the mu­sic died.

And I sus­pect the big­ger story was re­ally the House than the Se­nate. Yes, Speaker Paul Ryan man­aged to get some­thing through his cham­ber. But it ar­rived in the Se­nate with no en­thu­si­asm, no strong sup­port and way too many en­e­mies. Per­haps a bet­ter leg­is­la­tor than McCon­nell could have man­aged to save it, but his task was al­ways go­ing to be very dif­fi­cult.

At any rate, I don’t think the core prob­lem was with Ryan, or McCon­nell, or even Don­ald Trump. I think the core prob­lem was a bill no one but its op­po­nents cared about. It’s aw­fully hard to pass some­thing like that. Mac Tully, CEO and Pub­lisher; Justin Mock, Se­nior VP of Fi­nance and CFO; Bill Reynolds, Se­nior VP, Cir­cu­la­tion and Pro­duc­tion; Judi Patterson, Vice Pres­i­dent, Hu­man Re­sources; Bob Kin­ney , Vice Pres­i­dent, In­for­ma­tion Tech­nol­ogy

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