Why Republicans' health-care debacle will haunt them for years

The effects of this debate are likely to persist long after 2018

Sen. Mitch McConnell.
(Image credit: Illustrated | iStock, Netflix)

The July 4 recess is a time when members of Congress head back home to put on their "casual" clothes (khakis, patterned Oxford shirt) and hang with the regular folks, munching on hot dogs and walking in a few Independence Day parades. It's a chance to convene with the constituents, listen to their thoughts about the issues and challenges our nation faces, then head back to Washington revived and recommitted to this great experiment in self-rule.

But not this time.

On Tuesday, Senate Majority Leader Mitch McConnell abandoned his goal of staging a vote on the Republican health-care bill before the recess, which he had hoped to accomplish before opposition to the bill could become too intense. That hope faded as GOP senators attacked the bill from both the left and right, making clear that it didn't have the votes to pass. So now the senators will head back home, to get confronted and yelled at by constituents angry about that abomination of a bill. While it's theoretically possible that over the break McConnell and the White House could induce more of them to vote yes, once they find out firsthand what their voters think, the chances of passage are likely to fade.

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And their troubles are only beginning. The best-case scenario for the GOP may be to just let this bill go and move on, then hope to accomplish some of their other policy goals. Some have suspected that was part of McConnell's calculation in pushing this bill through so fast: Just get it over with quickly, so if it fails the pain of defeat wouldn't linger. The only thing worse would have been if it actually passed, and then they'd have to endure the backlash after millions lost coverage and deductibles and premiums skyrocketed.

This was never what Republicans wanted in the first place. They're not generally interested in complex policy challenges — this is the party that wants to dismantle government, not figure out how to make it work better — and they were particularly uninterested in health-care policy. How many Republicans wanted to become conversant in community rating and guaranteed issue and medical-loss ratios and risk corridors and actuarial values? Not too many. But Barack Obama forced the issue on them and so they pretended to care, at least enough to make promises about killing his hated law and replacing it with a glorious free-market solution that would be great for everyone.

Somehow they were never able to locate that unicorn. And now they face the prospect of a demoralized base, one that for a long time will distrust their party's leadership when it tells them of great things to come if they turn out to vote Republican. In recent years when that base criticized the party's leaders as weak and ineffectual, at least they could say, "There's only so much we can do with a Democrat in the White House. Give us a Republican president with a Republican Congress, and just you wait to see all we'll accomplish." Well now they have it, and they can't seem to get anything done.

That could be a serious problem in 2018, since midterm elections are always determined in large part by which party's supporters are more motivated to get to the polls. Even more important than the likelihood of dispirited Republican voters, the Democratic Party's voters are riled up and angry, eager to deliver a blow to President Trump and the GOP, and this argument over health care has only shown them why the stakes are so high.

But the effects of this debate are likely to persist long after 2018. Republicans have validated so much of what Democrats say about them: that they're heartless and cruel, that they're incapable of governing, that all they care about is delivering tax cuts to the wealthy. What answer will they have when Democrats say, "The last time you were in charge, you tried to take health coverage away from 22 million people so you could give a tax cut to the rich. Why should we trust you now?"

One might ask if there was any better way to handle this challenge, or if it's simply impossible to design a health-care plan that would be consistent with conservative free-market principles yet not result in more people without insurance and higher costs for the poor and middle class. Perhaps the effort to repeal the Affordable Care Act was doomed from the start, particularly after the ACA had a few years to entrench itself within the health-care system. Perhaps Republicans created their own problem by being so vituperative and intransigent toward President Obama on this issue (and every other one).

We could debate those questions. But what we know for sure is that this attempt at health-care reform has been a complete debacle. It's hard to remember a piece of legislation that was as widely reviled as this one, and its chances of passage look worse by the hour as one Republican after another flees from its noxious odor. It won't get any better when they have some time to talk to their constituents over the holiday — in fact, it will almost certainly get worse. And they'll be paying the price for some time to come.

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