THE MORNING PLUM:
McConnell will be employing at least two tactics. First, he will use several hundred billion dollars that CBO says the bill would save to try to buy off moderate opponents with side deals, such as increased funding for Medicaid or opioid treatment.
Second, McConnell will press the argument that if this bill does not pass, Republicans will have no choice but to negotiate over the future of the Affordable Care Act with Democrats. Multiple reports have said that McConnell has privately warned Republicans that failure would mean they must enter into talks with Democrats on ways to shore up the individual markets, which would effectively mean that a chance to pass a partisan repeal bill is gone.
But, in making this latter argument — which will likely gain more scrutiny in the days ahead — McConnell is effectively destroying one of President Trump’s most cherished false narratives. And this could have all kinds of implications for where this whole debate could head next.
Trump has spent months making several intertwined claims. He has relentlessly asserted that Obamacare is collapsing on its own. He has offered a variation on this by threatening to cut off the cost-sharing reductions to insurers that subsidize out-of-pocket costs for lower-income people, which would drive insurers out of the markets; Trump has said this threat will force Democrats to the table to “deal” with him. And Trump has also blasted Democrats for refusing to participate in his designs (even though there are no circumstances under which Democrats would join in an effort that would leave 22 million more uninsured). Trump tweeted his fury at Democrats for not helping him destroy the ACA just yesterday.
All of these claims are absurd in their own way, but they add up to a big bundle of unified nonsense. Yet McConnell is now laying waste to this entire story-line. McConnell’s argument to fellow Republicans — that failure means talks with Democrats over the ACA’s future — concedes a number of points. It concedes that, despite Trump’s claim of a desire for talks with Democrats, Republicans cannot work with Democrats, as long as Republicans remain wedded to their own priorities — that there is simply no bipartisan consensus possible, as long as Republicans are hellbent on cutting health spending on poor people by hundreds of billions of dollars to finance an enormous tax cut for the rich. After all, McConnell is arguing that passing a bill that does this, on a purely partisan basis, is the only way to avert any need to dilute the GOP’s devotion to those priorities.
McConnell’s argument to Republicans also concedes that the ACA exchanges do not have to continue struggling; lawmakers can act to prevent this. And it concedes that Republicans will not want that to happen and will feel pressure to do something about it (presumably because, as a recent Kaiser poll suggested, they risk taking the blame for it). McConnell is basically conceding that Republicans can’t just let the ACA implode, as Trump seems to believe.
This could have real consequences for the coming debate, should the GOP bill fail. The Trump administration is likely to continue trying to sabotage the exchanges if this happens, by employing, among others, tactics such as continually refusing to clarify whether it will renew cost-sharing reductions and generally sowing uncertainty over the ACA’s future. This is already having a real impact on the health of the exchanges. And so, we could soon see a battle over who is to blame for the ACA’s continued problems, and a jockeying for political advantage if bipartisan talks do start. In that context, Democrats can spotlight McConnell’s admissions in a helpful way.
As Brian Beutler writes, there actually is space for bipartisan agreement over various reforms to the ACA that are more modest than the massive overhaul Republicans are pursuing. One pleasant surprise this debate has produced is that a number of moderate Republican senators are deeply reluctant to support a huge rollback of assistance for the poor and lower-middle-class — one that would leave millions far more vulnerable to health-care and economic catastrophe — to facilitate an enormous tax cut for the wealthy. If that holds — and there is no certainty that it will, of course — then there may be an incentive for some Republicans to enter into more constructive talks over the future of the health-care system, ones that could result in some concessions to Republicans that are not as destructive to the ACA as the deeply regressive priorities that they remain ideologically devoted to with such zeal. If those priorities are put on ice for the time being, such talks are at least possible. McConnell has now helpfully conceded this himself.
* ANOTHER POLL FINDS TRUMP’S APPROVAL IN THE TOILET: A new PBS/NPR/Marist poll finds Trump’s approval rating at 37-51. And here’s another striking finding:
Who do you think is a more effective leader?President Donald Trump: 34Former president Barack Obama: 58
Looks like a large majority of Americans are already tired of all the winning.
* ANOTHER POLL FINDS GOP HEALTH BILL’S NUMBERS IN THE TOILET: A new Politico-Morning Consult poll finds that only 38 percent of Americans approve of the GOP health bill, while 45 percent disapprove. And:
The intensity gap is on the side of the bill’s opponents: Thirty-one percent of voters overall “strongly” disapprove of the bill, roughly double the 16 percent who “strongly” approve.
Meanwhile, even one-fourth of Republicans disapprove of the bill. By the way, the new Marist poll mentioned above has the health bill at 17-55.
* DEMS HOLD LARGE GENERIC BALLOT EDGE: Another key nugget from the new Marist poll: Democrats lead Republicans in the generic House ballot match-up by 48-38. That’s a bit wider than the average of polls, which puts Dems up by nearly 7 points. Also keep in mind that Dems will need to prevail by a large margin to have any chance at winning the House.
* REPUBLICANS KEEP TRYING TO GAME THE CBO: Politico reports that this happened at a meeting between GOP senators and the head of the CBO:
CBO Director Keith Hall was also present for the meeting, and GOP senators quickly laid into the man who’s been haunting them with projections of 22 million fewer insured and short-term premium increases, according to people in attendance. It seemed to be a genuine effort by Republicans to discredit the nonpartisan referee so that the GOP’s final health care bill isn’t derailed by the CBO. “CBO could stand for ‘Confusing But Obtuse,’” said Sen. Steve Daines (R-Mont.) afterward.
Keep in mind that the CBO may have to score another version of the Senate bill. In this context, this seems like rank ref-gaming.
* COLLINS: IT WILL BE ‘DIFFICULT’ TO CHANGE MY VOTE: This quote from Sen. Susan Collins, the Maine Republican who has come out against the Senate health bill, is worth keeping in mind:
“It’s difficult for me to see how any tinkering is going to satisfy my fundamental and deep concerns about the impact of the bill.”
We’ll see where Collins draws the line between “tinkering” and addressing her “deep concerns,” but if the bill’s broad strokes remain, it’s hard to see her backing it without rendering this a lie.
* GOP SENATOR SURPRISED AT TRUMP’S LACK OF KNOWLEDGE: The New York Times reports an intriguing nugget on the meeting yesterday between GOP senators and Trump about the future of the health bill:
A senator who supports the bill left the meeting at the White House with a sense that the president did not have a grasp of some basic elements of the Senate plan — and seemed especially confused when a moderate Republican complained that opponents of the bill would cast it as a massive tax break for the wealthy, according to an aide who received a detailed readout of the exchange.
Once again, Trump has zero clue what is in the bill he’s championing, even though it would impact one-sixth of the U.S. economy and could harm tens of millions of people.
* BUT TRUMP INSISTS HE KNOWS HEALTH CARE WELL: Good morning, Mr. President:
The next person who is fortunate enough to interview Trump might consider asking him to explain in detail what’s in the health-care bill.