WASHINGTON – This is a week to keep focused on the most urgent question in domestic policy and politics: Will Republicans snatch health insurance from millions of Americans and slash the vital Medicaid program by nearly $1 trillion, all to enable massive tax cuts for the wealthy and powerful?
Plenty of other news is vying for attention. President Donald Trump spent Monday morning venting on Twitter about how President Obama did “NOTHING about Russia” and its election meddling – despite Trump’s frequent claims that the whole Russia controversy is “fake news” and a Democratic Party “hoax.” The Supreme Court has agreed to rule on Trump’s travel ban, which lower courts have deemed unconstitutional; and to decide whether business owners who claim religious objections to same-sex marriage can refuse to provide goods or services for gay couples’ weddings.
There’s much to say about all of those topics, and there will be occasions to say it. But meanwhile Senate Majority Leader Mitch McConnell is trying to ram through legislation that would return us to the days when hardworking families had to choose between seeing a doctor and paying the rent – legislation that will surely cost lives.
The House has already passed the American Health Care Act, which Trump described as “mean” and lacking “heart.” The Senate bill is no more compassionate. If Trump really meant what he says, he’d insist that Congress abandon its effort to repeal and replace Obamacare and instead work across party lines to fix it. Or perhaps he might convene a panel of experts to design a truly universal system of health coverage from the ground up. I expect these things to happen shortly after pigs begin to fly.
One thing we have learned about Trump is that he will always choose politics over policy. He and the GOP ran on a categorical promise to obliterate Obama’s Affordable Care Act, and the president is desperate for a big legislative victory.
Accordingly, he doesn’t much seem to care what’s in the Senate bill – or even if it actually repeals the ACA. Conservative doubters such as Sens. Rand Paul (Ky.), Mike Lee (Utah), Ted Cruz (Texas) and Ron Johnson (Wis.) say it doesn’t. Moderate GOP senators are complaining privately that the bill goes too far. It is not at all certain that McConnell, who is pushing hard for a vote this week, will be able to get the needed 50 (out of 52) Republican senators to vote yes.
But it’s also not clear that he will fail. That is why concerned citizens must make it known that the politics of this atrocious legislation are every bit as hazardous for the Republican Party as the underlying policies would be for the health of the nation.
Trump tries to claim that Democrats “own” the Affordable Care Act, which is about to “crash & burn,” and that perhaps Republicans ought to let this disaster happen and reap the resulting political benefit. His loyal base may buy this line of argument, but the historical record disagrees.
The fact is that the party that tries to make substantial changes in health care policy owns the issue and gets blamed for everything that goes wrong. Veterans of the Johnson, Nixon, Clinton, and Obama administrations bear the resulting scars – and they all tried to (BEG ITAL)expand(END ITAL) access to affordable health care, not shrink it. According to the Congressional Budget Office, the House bill would snatch insurance coverage away from 14 million people within a year, 23 million within a decade; the CBO estimated Monday that the Senate bill would mean 22 million more people would be uninsured. Does anyone think this will go over well?
Health care, as a political issue, is both universal and intensely personal. Voters whose households are not directly affected by whatever Congress and Trump end up doing will hear of friends, relatives and neighbors who lose their insurance despite having critical health care needs. One sick child’s heartbreaking story has more impact than a dozen Heritage Foundation white papers.
Republicans worry about having spent seven years promising to “repeal and replace” the ACA and then failing to follow through. But if they do take the leap, Democrats competing in the 2018 midterms will be able to turn that slogan around with a clarion call to “repeal and replace” the American Health Care Act, or whatever the final legislation ends up being called.
Republicans have no great political options here, so maybe they should just do what is right: Stop sabotaging Obamacare and start working with Democrats to make it better.
Eugene Robinson’s email address is email@example.com.