If you've clicked on this article (thank you), you're probably thinking: Wait. I thought Republicans' attempts to repeal Obamacare crashed and burned a few days ago.
You would be correct. It died earlier this week. But in the past 24 hours, it kind of came back to life, mostly on President Trump's insistence.
And Thursday, thanks to yet another Congressional Budget Office analysis, we get news that further ensured its demise: Republicans can't write a bill that won't leave millions uninsured, which means Republicans can't write a bill that will get approved by 50 of 52 of their ideologically diverse members, which means Republicans have no health-care bill.
This isn't for lack of effort. Republicans have spent the past couple of months trying to come to a consensus, piecing together a couple of different versions of the same bill.
The latest CBO estimate is their third report on a Senate version of legislation, and its prediction is similar to the last two: Senate Republicans' plan would leave 22 million more people uninsured over the next decade than if Obamacare remained law, and it would raise premiums on the most vulnerable.
The second version of the bill pours millions more into health insurance subsidies and Medicaid and opioid funding. But the CBO wasn't convinced that would make any difference on the insurance rate, said Paul Ginsburg, a health policy expert and director of the USC Brookings-Schaeffer Initiative.
So leaders made the second version less tenable for conservatives, and it did nothing to assuage moderates' concerns.
Here's a reminder of what CBO found in its estimate on the first version of the bill.
From the first to the second version, there is no significant change to how many people will be covered under their plan — and, thus, no change to who votes for it. And, thus, no deal.
“So far, Republican leadership and the White House haven't found a piece of health-care legislation that can get 51 votes,” said Alex Conant, a GOP strategist whose public affairs firm represents health-care clients.
Perhaps most telling: Senate Republican leaders have already given up on trying to get this legislation passed.
While President Trump was dining with supporters of the legislation on Tuesday, two conservatives, Sens. Mike Lee (Utah) and Jerry Moran (Kan.), threw a grenade at the legislation by becoming the third and fourth GOP senators to oppose it.
In frustration, Senate Majority Leader Mitch McConnell (R-Ky.) decided to let the Senate vote on a straight repeal of Obamacare, even though policy experts said it would be disastrous to the insurance markets and, potentially, Republicans' political future. That plan died a couple hours later, felled by three female GOP lawmakers who had been left out of an all-male negotiating process: Sens. Lisa Murkowski (Alaska), Shelley Moore Capito (W.Va.) and Susan Collins (Maine). It is unclear when Sen. John McCain (R-Ariz.), who announced he has been diagnosed with brain cancer, will return, leaving McConnell with one fewer possible vote in favor of repeal.
(Also not helping senators go to the mat for this: It's historically unpopular.)
But, politics. Before McCain's announcement, Trump got everyone together for a photo op on Wednesday and vaguely told the Senate to figure something out while vaguely threatening some of the senators who have opposed this legislation. GOP senators then huddled Wednesday night and afterward vaguely said they had figured something out.
The plan is to have a vote Tuesday on the House-passed version of the bill, and there was a faint possibility that enough senators had agreed to amend it in a way that could pass by the skin of its teeth.
Failure, after all, is a powerful motivator.
And then, the CBO score was released, reminding the senators who hated the House bill (which CBO estimated would leave 23 million more uninsured over the next decade) why they hate this Senate bill.
Bottom line: Health-care experts and political analysts say if a bill that could pass the Senate as the Senate stands now, it probably would have already manifested.
“I don't think it can pass,” said Alice Rivlin with the Brookings Institution. “And they will have to at some point just say: 'Okay, we tried. And we're moving on.' ”
Republican senators could always come back to this later. In Congress, phoenixes have been known to rise from the ashes.
But that requires a
little lot of magic. And this CBO score isn't going to help create any.