Republicans have had nearly eight years to come up with a plan to repeal and replace the Affordable Care Act. This summer, it became evident that they didn't have one, at least not one that could pass a divided Republican Party.
And they still don't have one. Days before a potential vote on an unpopular repeal proposal by Sens. Bill Cassidy (La.) and Lindsey O. Graham (S.C.), and hours before one of the bill's only public hearings, the measure's supporters have thrown out a new version that seems directly motivated to get something passed, rather than to reform health insurance markets.
The revised bill, first reported by The Washington Post's Sean Sullivan, Paige Winfield Cunningham and Abby Phillip, would give Alaska 3 percent more funding than the Affordable Care Act gives the state and Maine 43 percent more funding.
That's not a coincidence. Two holdouts are Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine). “It's difficult to envision a scenario where I vote for this bill,” Collins told CNN's Jake Tapper on Sunday, a day after she met with Vice President Pence, who was trying to sell the bill.
Legislative gimmes to close a deal are nothing new. Democrats did it when passing the Affordable Care Act, also known as Obamacare, in 2010.
But what's extraordinary about Republicans' many attempts to repeal the law this year is how slapdash the process has been. Democrats wheeled and dealed during months of public hearings and bipartisan debate. At the very least, the Democrats who voted “yes” and the Republicans who voted “no” knew what legislation they were voting on and what effect it would have on the health-insurance market and the federal budget.
Republicans have rushed through bills almost entirely behind closed doors. A few days before July votes on a repeal of Obamacare, what I called the legislative equivalent of throwing spaghetti at a wall to see what sticks, key GOP senators said they still had no idea what they were voting on.
The same goes for this bill. The Senate could vote this week on a measure that has been public for two weeks — the latest version only a couple of hours — and that the official Congressional Budget Office won't have time to grade on how it could affect insurance coverage and costs. (Republicans are running up against a Sept. 30 budget deadline that lets them duck a Senate Democratic filibuster.)
The whole ugly process resonates beyond how bills get made. It suggests that Republicans are more concerned about sending a political message to their base than any real attempt to follow through on their campaign promise to change health-care policy for the better. That may have had an effect on Cassidy-Graham's popularity. A new Washington Post-ABC News poll finds that more than half of Americans prefer Obamacare to this proposal.
Rushing through an Obamacare repeal bill might be politically prudent for Republicans, or politically disastrous.
The Post-ABC News poll also finds that a solid majority of Americans (69 percent) disapprove of congressional Republicans right now. Less than a quarter of Americans (22 percent) approve of the job they're doing.
And of Americans who describe themselves as very conservative, just 31 percent approve of congressional Republicans. A majority of Americans who describe themselves as somewhat conservative and conservative also disapprove of the job Republicans are doing.
(Democrats don't benefit from Republicans' unpopularity. The poll finds 57 percent of Americans disapprove of them, about the same popularity as President Trump.)
Part of Republicans' struggles undoubtedly comes from their very public inability to repeal Obamacare. And if they could do something, anything, to make good on that, maybe public opinion of them would ease up.
“Voters have short memories for the unpleasantness around the sausage making,” said GOP strategist Alex Conant, speaking to The Fix in July, “but ultimately, Republicans and the president will be judged by what happens with the health-care system next year.”
That's also why Republicans rush this legislation through at their own risk. If they end up passing something that was slapped together to get votes, they'll have to own it.