Democrats sounded nearly giddy on Wednesday when the House Freedom Caucus agreed to changes in the America Health Care Act that made it potentially even less generous to millions of Americans. Why were they so pleased? Either Republicans will vote for the latest dog’s breakfast or once again prove their incapacity for governing.
The House Freedom Caucus said the amendment negotiated by its chairman, Rep. Mark Meadows (R-N.C.), along with moderate Rep. Tom MacArthur (R-N.J.), would drive down health-care costs by allowing states to opt out of certain rules under Obamacare.“While the revised version still does not fully repeal Obamacare, we are prepared to support it to keep our promise to the American people to lower health-care costs,” the Freedom Caucus said Wednesday in an unattributed statement.The decision came as three conservative advocacy groups — the Club for Growth, FreedomWorks and Heritage Action for America — also declared support for the plan, adding to its momentum.
The opt-out would apply to “the requirement that health plans cover essential medical benefits and the ban on charging customers higher premiums if they have preexisting conditions.” These were two essential features for the few moderates who supported the bill last time. Now it seems likely that more moderates will defect. (“Republican leadership can afford to lose only about 20 votes if most of the Freedom Caucus backs the measure. As of Wednesday afternoon, roughly 30 Republicans who are not members of the Freedom Caucus were either opposed or undecided.”) Moreover, the House changes drop any pretense that they want to pass a bill that could comply with Senate reconciliation rules.
This seemed to be more an exercise to shift blame for the AHCA failure from right-wing groups to moderates, who now have even more reason to reject the bill. Moreover, these moderate Republicans include the members most vulnerable in 2018, either because they won in districts Hillary Clinton carried or are in districts that President Trump carried by a slim margin. (“Among them were Reps. Charlie Dent (Pa.), Jeff Denham (Calif.), Leonard Lance (N.J.), Ileana Ros-Lehtinen (Fla.) and Barbara Comstock (Va.), who have said they will not support the revised bill. Rep. Mike Coffman (Colo.), who supported the original bill, said he is now undecided. Rep. Carlos Curbelo (Fla.) said he wants a ‘thorough analysis’ of the new measure before he decides.”) It surely seems that because Freedom Caucus members in safe seats want to avoid blame for a humiliating GOP belly-flop, they would willingly put vulnerable members on the chopping block. It is a dangerous game, as a gain of 24 seats (23, if Georgia’s 6th Congressional District goes Democratic) will give the majority to Democrats.
The timing could not have been worse for Republicans. President Trump’s approval ratings are historically awful. A large majority of the public wants the House to move on to other issues and opposes wholesale repeal of Obamacare. The latest CBS News poll, for example, finds: “Fifty-three percent of Americans want Mr. Trump and Congress to move on to other issues rather than try to pass another health care bill. While just 12 percent of Americans think the Affordable Care Act is working perfectly, most (61%) say it needs changes rather than complete repeal. Most Americans do not think Obamacare needs to be completely replaced.” Remember that the last time the AHCA came close to getting a floor vote, only 17 percent of voters liked the bill.
When, if ever, the new AHCA will get a floor vote is anyone’s guess. There is no scoring, and there has been no committee consideration of the changes. The president desperately wants to have accomplished something on health care at his 100-day mark, even though he insists it’s a “ridiculous standard.” Of course, it’s not much of an accomplishment to pass something in the House that’s dead on arrival in the Senate, but Trump craves victory, no matter how hollow.
Will Trump’s ego and the Freedom Caucus’s desire to ingratiate itself with him (and show that its members really did vote for repeal) force the House to take a vote? In essence, the choice for Republicans now is to do nothing or pass something that might cost them the majority. Now you can understand the Democrats’ schadenfreude.