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The Skinny On The Failure of Skinny Repeal

By  |  July 29, 2017, 10:56am  |  @captainkudzu


 

The last-ditch Republican effort to repeal the Affordable Care Act, the so-called “Skinny Repeal,” went down in flames last night as expected. In truth, the Obamacare repeal effort has been dead for quite some time. The more recent repeal efforts represent the hopeless, zombie-like staggering of the GOP towards its goal of almost a decade.

It has been obvious for months that the repeal effort was doomed to failure. As soon as the dust settled from the election, we knew that the GOP would have less than the 60-vote majority required for cloture on a full repeal of the ACA.

With “repeal-and-replace” out the window, Republican leaders shifted to a reform model. The effort immediately drew fire from both wings of the Republican Party. A quartet of moderates from Medicaid expansion states lined up to oppose anything that threatened the Medicaid payouts. With only a two-vote majority in the Senate, this would have been enough to kill the reform bill, but conservatives also lined up to oppose the bill because it fell short of full repeal, which was already a mathematical impossibility.

Conservatives such as Ted Cruz (R-Texas) and Mike Lee (R-Utah) were eventually won over to support the compromise reform effort. Moderates Rob Portman (R-Ohio) and Corey Gardner (R-Col.) also dropped their opposition to the bill.

The Republican “nays” who joined every Democrat in voting against the Skinny Repeal were two of the usual suspects, Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine). The third was GOP maverick John McCain (R-Ariz.) who explained his vote against the “shell of a bill” by arguing in a statement  that the bill, written in secret, wouldn’t actually improve the health insurance crisis gripping much of the country.

McCain will be pilloried for his vote, but to some extent he was right. No one, not even those who voted for it, think Skinny Repeal was a good bill. As Phillip Klein of the Washington Examiner described, the bill left the regulatory framework of Obamacare in place while eliminating the individual mandate. The result would most likely have been to increase the Obamacare death spiral rather than fixing it.
The worst part is that Collins and Murkowski could not even be persuaded to join their colleagues in such a watered-down bill. One has to wonder exactly what kind of health care bill, if any, that the pair would give their assent to.
Throughout the entire process, President Trump, a man who has repeatedly said that he wants universal healthcare, has been mostly AWOL. While Congress debated and dithered, the president spent his time tweeting and hurling insults at Jeff Sessions. To the surprise of few, this approach failed to swing votes to support the bill. In spite of the president’s alleged prowess at deal-making, his main role in the legislative process was to threaten to support a primary challenge against Nevada senator, Dean Heller.
At this point, Republicans have two choices. The first is to offer some concessions to Democrats to craft a bill with broader support. Such tactics will fall short of full repeal, but may help to fix at least some of Obamacare’s problems. It might even convince Collins and Murkowski to vote “yes.” Who knows?
The other alternative is to harden the party’s divisions with another of the circular firing squads so common in the wake of GOP defeats (and victories as well, for that matter). That will mean that Obamacare remains fully intact while Republicans wait on voters to grant them a supermajority (plus two more to offset Collins and Murkowski). In the meantime, Americans will suffer under Obamacare’s high premiums, few choices and the individual mandate. Never mind that voters are unlikely to give Republicans more power if they can’t get anything done with the power that they already have.
Some will say that Democrats win when Republicans offer a compromise, but it is the second scenario where Democrats really win. Obamacare will remain in place for the foreseeable future and Barack Obama’s legacy will be secure.
What most voters really want is for the two parties to work together to solve problems. Unfortunately, the current model has the country lurching from one-party rule to stalemate and back again as each party plays to its base and ignores moderates and independents. If neither party is willing to work with the other to get things done for the good of the country, then voters should consider firing them both.