With the announcement from Sen. Shelley Moore Capito (R-W.Va.) that she would not vote for repeal (at least as defined by the 2015 reconciliation bill that would leave 32 million more Americans uninsured) with no replacement, the whole dreary episode of Republican hypocrisy on Obamacare can come to an end. Capito’s statement said plainly:
As I have said before, I did not come to Washington to hurt people. For months, I have expressed reservations about the direction of the bill to repeal and replace Obamacare. I have serious concerns about how we continue to provide affordable care to those who have benefited from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis. All of the Senate health care discussion drafts have failed to address these concerns adequately.
My position on this issue is driven by its impact on West Virginians. With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.
Those on the right who argue that she is being disingenuous because she voted for the 2015 act knowing it would be vetoed are themselves being disingenuous. There was nothing wrong with casting a protest vote then and now acknowledging that since the GOP has not a clue how to replace Obamacare, it would be cruel and unwise to pull the plug on the Affordable Care Act. Capito and fellow moderate Sen. Susan Collins (R-Maine) had the nerve to come out unequivocally, as their male colleagues hemmed and hawed (“serious concerns!” “very troubled!”), to put an end to a legislative charade.
It’s not the moderates who have been disingenuous here. They actually took seriously the position that a better health-care bill could be devised. They were not the ones who insisted on making this a tax cut for the super-rich by removing the funding mechanism for health-care reform or by throwing Medicaid cuts into the hopper. They wanted to solve the problem Republicans had identified originally — health-care exchanges in the individual market that did not provide affordable (enough) health care and that suffered from an acute case of adverse selection despite the individual mandate.
On the disingenuous scale, no one beats President Trump, who never had a health-care plan, never understood what was in any bill and never explained how he’d come up with a miraculous bill that would cover everyone without breaking the bank.
Next, consider the right-wingers who opposed the Better Care Reconciliation Act — and the House bill and every other variation — but were willing to vote for repeal with the promise of a replacement in two years. Where in the world do they think is the replacement bill that the GOP could arrive at in two — or 20 — years? If they simply want to go back to pre-Obamacare days, they should have said so; instead, their current position in favor of the 2015 reconciliation act is surely the worst of all options. (Regulations remain, costs soar, tens of millions lose health care.) Sorry, but Sens. Rand Paul (R-Ky.), Mike Lee (R-Utah), etc., are no heroes.
Then take a look at Sen. Majority Leader Mitch McConnell (R-Ky.), who reportedly told moderates that the Medicaid cuts were phony, threatened his own members with a repeal vote that he knew would be unpalatable and never let on that the GOP promises (more coverage, fewer out-of-pocket costs, big tax cuts) were impossible. He seemed willing to sacrifice his most vulnerable members (e.g. Sen. Dean Heller of Nevada) rather than tell the White House that the jig was up. So much for his reputation as a legislative genius.
But the award for the most disingenuous man in the GOP goes to House Speaker Paul Ryan (R-Wis.). Without the benefit of a Congressional Budget Office score, he rammed through a measure that had no chance of passing in the Senate, did not expand coverage or lower costs for the most vulnerable, falsely advertised its protections for those with preexisting conditions (the meager support for high-risk pools would cover a fraction of the cost for hard-to-insure people in states that opted out of minimum benefit requirements) and catered to his right-wing members in safe seats at the expense of moderates who will be vulnerable in 2018.
There’s plenty of blame to go around, but let’s not blame the moderates in the GOP who refused to be bullied and stood up, however belatedly, for the most vulnerable Americans.
UPDATE: A third moderate GOP woman, Sen. Lisa Murkowski (Alaska), has thrown a bucket of cold water on repeal-and-delay. “As I’ve been saying, the Senate should take a step back and engage in a bipartisan process to address the failures of the ACA and stabilize the individual markets. That will require members on both sides of the aisle to roll up their sleeves and take this to the open committee process where it belongs,” she said in a written statement. She concluded that she “cannot vote to proceed to repeal the ACA without reform that allows people the choice they want, the affordability they need and the quality of care they deserve.”