Yesterday the Senate Republican leadership decided against holding a vote on the last-gasp effort to replace Obamacare. This would have happened under budget reconciliation rules allowing a simple majority vote to put it on the statute books. After 30th September, a replacement bill will require a supermajority of 60 votes to pass, an unattainable target in the current Congress.
Even by the standards of recent US politics, the so-called Cassidy-Graham proposal (after sponsors Bill Cassidy of Louisiana and Lindsay Graham of South Carolina) constituted a new low in cynicism, mendacity, and heartlessness. It was an attempt to bounce through a measure that would harm the interests of millions of Americans without allowing proper time for its consideration by a body supposed to be one of the world’s greatest chambers of deliberation. It contained inducements in the form of enhanced benefits for the home states of two senators—Susan Collins of Maine and Lisa Murkowski of Alaska—who voted against the last Obamacare replacement bill and whose “ayes” would have put Cassidy-Graham over the top. It promised a healthcare fix but was nothing of the sort—it was a very much worse alternative to Obamacare and would actually have exacerbated its shortcomings.
Why did so many Republican senators risk promoting an ill-conceived, hastily produced measure that had almost zero prospects of enactment? They are in a funk after a month’s recess talking to the “plain folks” back home—aka ideologues, activists, and rich donors who demanded action to get rid of the “hated Obamacare.” Many are frank in admitting the political imperative of killing the Affordable Health Care Act regardless of the inadequacy of what replaces it. They also worry about holding onto their seats in the midterm elections with the donor spigot showing signs of drying up. As Pat Roberts of Kansas acknowledged, “If we do nothing, it has a tremendous impact on the 2018 elections, and whether or not Republicans still maintain control and we have the gavel.”
“Most Americans want the support of a benevolent state—not to risk the vagaries of a so-called free market”Cassidy-Graham sought to replace Obamacare from 2020 with a Washington-subsidised programme that gave the states considerable discretion over how federal funds for healthcare were to be spent and on what terms. The immediate losers would have been the 17 million people, many of them with existing health problems, who receive a direct federal subsidy to purchase health insurance. Within a decade, according to reputable analysts, the states would also have had to top up federal funds from their own coffers in order to maintain provision at its current level. Many would be politically unwilling or fiscally unable to do so.
Ultimately, Susan Collins’s announcement that she could not support Cassidy-Graham left it dead in the water. Another Republican dissenter, John McCain of Arizona, suggested it was time for both parties to come together to find a workable solution for Obamacare replacement, an intervention that earned him a furious Tweet rebuke from Donald Trump and in turn a staunch defence from Lindsay Graham that he had the right to stand by his principles. Meanwhile, Lamar Alexander of Tennessee and Patty Murray of Washington, respectively chair and senior Democrat on the Senate Health Committee, plan to work together on constructive improvement of Obamacare through legislation to stabilize insurance markets and hold down premiums. It is highly unlikely that this bipartisan cooperation will receive support from the GOP leadership.
The Obamacare repeal/replacement imbroglio has underlined the GOP’s failure to be a party of government. It is mired in an opposition mentality preventing recognition that compromise is usually necessary to get things done in politics. Republicans are now hoist on the petard of the lies they have peddled on Obamacare since its 2010 enactment. They were blind to its necessity and made unfulfillable promises of how much better off Americans would be without it. Testifying to such ideological inflexibility, Senator John Thune of South Dakota declared that his party would fight for Cassidy-Graham’s principles in 2018: “Single payer, socialism—or federalism, returning power to the states. I think that’s a great contrast for us, and I think that’s an argument eventually we can win.” However, a new Washington Post-ABC poll found that 52 percent of respondents preferred Obamacare to Cassidy-Graham with only 33 percent favouring the latter. The ultimate irony of the conservative crusade against the 44th president’s “socialised medicine” initiative may therefore be to show that most Americans want the support of a benevolent state for their healthcare needs rather than to risk the vagaries of a so-called free market.
