Republicans' last tilt at ObamaCare

There are any number of things Republicans in Congress could be doing with the last golden days of summer. They could be eating what remains of the Iowa sweet corn and grilling brats. They could be taking in ballgames or enjoying drinks outdoors before the fell winds of autumn descend. Ted Cruz and Lindsey Graham could bond over a last-minute camping trip in the beautiful secluded reaches of the Blue Ridge Mountains just before the equinox. Or they could even pass an immigration bill that permanently settles the legal status of millions of young Americans whom President Trump has said he does not want to see deported.

Instead, after more than 70 — yes! — previous cracks at it, the GOP is trying once more to repeal and replace the Affordable Care Act. I am inclined to think that this will be their final attempt.

It will fail, of course. Blossoms fade, trees wither, and the glorious dreams of summer die. This particular fancy has already seen too many winters. The first time Republicans tried to repeal the Affordable Care Act in January 2011, via a bill with the ridiculous actual title of "Repealing the Job-Killing Health Care Law Act," the world was one that now looks barely recognizable. Osama bin Laden and Moammar Gadhafi were still alive; His Royal Highness Prince William of Wales was unmarried and childless; the Supreme Pontiff of the Catholic Church was His Holiness Pope Benedict XVI; Julian Assange did not live in a box in the Ecuadorian Embassy in London. Since then Republicans have written millions of words of legislation and cut thousands of hours of scare-mongering campaign ads, staged filibusters, threatened to cut funding — all to no avail. Somewhere President Obama must be laughing.

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Which brings us to 2017. After a year of further desperate efforts, the consensus among avowedly moderate Republicans like Sens. Lisa Murkowski (Alaska) and Susan Collins (Maine) is that even a so-called "skinny repeal" is a non-starter. Many conservative hardliners, like Sen. Rand Paul (Ky.), agree for opposite reasons — though at some level, which must enter into their calculations, many of them realize that millions of people in their home states would lose out under their proposed schemes: For them, the perfect is the best friend, not the enemy, of the good.

The best thing that can be said for the latest — and last — bill sponsored by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) is that it is of a piece with its forerunners. It would give the states (less) money to administer ObamaCare's popular and successful federal expansion of Medicaid on their own through some kind of inadequately funded block-granting program. It would cut subsidies for people buying health insurance in the individual market, the last Jenga block keeping the absurd system propped up. It would also reduce, if not totally eliminate, protection for such pre-existing "conditions" as fertility. It would toss the individual mandate and presumably allow insurance companies to heap fees on those whose coverage has lapsed. It would be cruel, capricious, and unstable — and not, for all that, even remotely "principled" in the conservative sense of getting government out of health care. There is simply no chance that it will pass the Senate, much less make it to President Trump's desk and become law.

Going forward, the only possibility that remains for the GOP is silence and deflection. Middle-class Americans are making their peace with the idea of their fellow citizens getting health care; support for single-payer is quietly increasing. Meanwhile, drawing attention to the issue by making further idle promises and drafting ridiculous compromise legislation, with departures from existing law chosen seemingly at random, will do them no good. It's time to face reality.

There is a cliché in movies and television shows, especially those in the fantasy genre, in which the heroes, at the end of a long and seemingly fruitless quest, realize that the end for which they have striven so valiantly has been within their grasp the whole time. Maybe the real ObamaCare repeal was the friends we made along the way. Republicans didn't need to take Medicaid away from millions of Americans to prove that they are slightly less bad at winning elections than their Democratic rivals and to raise billions of dollars in future campaign funds: The power was inside them all along. ObamaCare was just a state of mind.

I guess there is some kind of a lesson here.