Democrats can have a field day pointing to Republicans’ proposed cuts to health care for the poor and tax breaks to the richest Americans. They can remind voters that millions who earned coverage when Democrats were in charge now will lose it. In search of a “message,” they can come back to the tried and true: Republicans are for the rich, we’re for the working and middle class.
Majority Leader Sen. Mitch McConnell (R-Ky.) knows exactly the kind of criticism that’s coming and has designed the process to minimize the amount of time his members will be subjected to devastating critiques from Democrats and the patient and provider groups. So far, AARP, hospitals, children’s health advocates and ADAPT, a national disability rights organization have blasted the bill.
If McConnell cannot win swiftly, he may figure it’s better to lose quickly. After keeping the bill bottled up, failing to build support and refusing to disarm critics, he released a bill that four members of his caucus immediately denounced as unsupportable. Moderates held their tongues, claiming to need time to read the bill. However, would cautious lawmakers like Sen. Susan Collins (R-Maine) — who offered a plan to let states keep Obamacare if they preferred — and her colleagues from states where uninsured rates have plunged (e.g., Shelley Moore Capito of West Virginia and Dean Heller of Nevada) really embrace a bill that permanently cuts back on Medicaid, makes opioid treatment harder to get and offers stingier individually purchased plans? (Five-Thirty Eight explains that “insurance companies would have to pay a smaller portion of an enrollee’s costs each year than they currently do. That probably means that the insurance plans eligible for subsidies would have higher co-pays and higher deductibles.”)
For the bill to pass, McConnell would need to corral the conservative defectors and push his moderates to vote for a very unpopular bill that will quite obviously hurt their constituents. McConnell, however, is no House Speaker Paul D. Ryan (R-Wis.), who is entranced with his own white papers and utterly oblivious to how the Republicans come across to nonideological Americans (hint: poorly). McConnell jealously guards his majority and knows that while the chances of ceding control to the Democrats are slim, a widely panned health-care bill might well sweep out obviously endangered members (e.g., Heller) but also members on the ballot in 2018 who were previously not considered to be at risk (e.g., Bob Corker of Tennessee and Jeff Flake of Arizona). Many GOP governors, including those on the ballot in 2018, would either have to oppose the bill or risk losing to Democrats who will be able to point to actual victims of the legislation.
A crafty vote-counter and political strategist like McConnell would look at the landscape, see his troops as hopelessly divided and figure a way to get out of town and onto other issues that are much more popular with both conservatives and moderates in his party. That escape hatch might include reference to reconciliation rules that might block elements essential to one or more Republicans. He’d give it a more-than-perfunctory effort and then tell President Trump the votes aren’t there — or the Senate rules make it impossible to get the votes. Unlike the House, he won’t be stampeded into bringing the bill back for months’ more wrangling. The Senate would move on to the budget, debt ceiling and taxes.
That theory at least accounts for the process McConnell cooked up and the timing of the bill’s rollout. (He also must by now have a pretty good idea how bad the Congressional Budget Office score will be.) Better to let the hard-liners (It wasn’t repeal of Obamacare!) and the moderates (I stopped them from taking away Medicaid and defunding Planned Parenthood!) vote no than to divide his caucus and set many of them up for defeat. It’s not that McConnell wouldn’t like to repeal Obamacare, but he is — we think — cagey enough to know what is possible and what is not.
As for Democrats, they have the chance to deliver a huge win for their base and win back some voters who bought Trump’s populist rhetoric. Their “victory” in 2017 can come in Congress — if they play this right and don’t get distracted — rather than in a handful of special elections. All they need to do is not get bogged down with bickering about Pelosi and instead zealously defend the health-care coverage they brought to millions. They could do that, couldn’t they?