Republicans are closer to killing ObamaCare than you think

While most of the political media is riveted by Trump's endless Russia scandal, especially the explosive testimony of former FBI director James Comey, Senate Republicans are stealthily moving forward on dynamiting health care for poor Americans.

The American Health Care Act (a tax cut for rich people paid for with Medicaid cuts, disguised as a health-care reform bill) is quietly working its way through the Senate. Now so-called moderates in the Senate have signaled their intention to support the bill, making passage far more likely. People who don't want a brutal reduction in the quality of American health care should watch out.

It's unclear exactly what changes Republicans in the Senate have made, because the process — just as in the House — is proceeding under a cloud of total secrecy. There have been no hearings, no committee markups, and no possibility for amendment, and there will be none. Sen. Claire McCaskill (D-Mo.) lambasted a visibly squirming Sen. Orrin Hatch (R-Utah) over the obvious fact that Senate Republicans are attempting to pass the bill before anyone can get wind of exactly what's in it:

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So far, it seems that the main stumbling block for Senate "moderates" is ObamaCare's Medicaid expansion. Several Republican senators are from states that did take the expansion, which is quite popular. Originally it seemed that they wouldn't countenance any health-care bill that rolled back the expansion, much less the savage additional cuts in the House AHCA bill.

But, as usual, the moderates look like they're going to cave. They just want to delay rolling back the expansion a bit so the pain won't really start to bite until after the next election. Sen. Rob Portman (R-Ohio) even came up with one of those signature moronic D.C. catchphrases for the idea, calling it putting the expansion on a "glide path." (A better phrase would be a "ratcheting noose.")

Tierney Sneed reports at Talking Points Memo that the further cuts — in essence, repeating the block grant-and-spending cap routine that mostly strangled traditional welfare — are still under discussion, but it should always be assumed that the so-called moderates will fold. As Josh Marshall writes, "The pattern is the same one from the House. The GOP moderates always cave."

However, negotiations are not settled yet, and the GOP majority in the Senate is quite small. All liberals would have to do is peel off three votes to stop the bill. Sen. Dean Heller (R-Nev.), who is up for re-election in 2018 in a state Hillary Clinton won, is probably the ripest target. Additionally, to be able to bypass the filibuster, Senate Republicans will at least have to get a score from the Congressional Budget Office. That will give a brief window where the full effects of the bill — which is certain to be horrible, even if it's somewhat less horrible than the poison out of the House — are known, and can serve as a rallying point.

As Ben Wikler argues, the only thing that might stop the bill is constituents absolutely deluging their senators with calls, letters, and visits. Outside pressure isn't guaranteed to work, but it's opponents' best hope. Conversely, if people lose interest and hope it simply won't pass — or believe that the ultraconservatives in the House will balk during the conference committee — this thing is probably going through. It's the Republican Party, always assume the absolute worst.

Finally, Democrats must not forget to advance something big, simple, and bold as a health-care counteroffer, whether the AHCA monstrosity goes through or not. While better than the previous status quo, ObamaCare still leaves tens of millions uninsured and tens of millions more under-insured — and Republicans are doing their level best to make it worse than it was before ObamaCare.

Medicare for all will finish the work that ObamaCare started, and give the American citizenry something to vote for in addition to something to vote against. The unexpected come-from-behind success of Jeremy Corbyn in the U.K. in the snap elections Thursday, partly on the strength of a full-throated left-wing manifesto, shows the potential of a genuinely bold agenda against conservative austerity politics. It's not enough to stop brutal Republican policy — a better world is possible.