The Fight to Save the ACA

I will hopefully have something longer about this soon, but the conflicts within the Republican Senate conference identified by Chait and Kliff are worthy of immediate discussion.

• The battle to preserve the most important elements of the ACA is far from over and will require a lot of work. McConnell might be able to get repeal n’ delay rammed through. But the destruction of the ACA is clearly not inevitable. The fight was won on Social Security; it can be won again.
• It’s very clear that the Democrats are not going to deal, which is the first prerequisite. This will have to be done with Republican votes, and Republicans also count can’t on political cover later on if they repeal without replacement. If you have a Democratic senator, make sure to contact them and urge them to not offer anything, including the fee for the gaming license.
• Portman signing the “kick the can into next month” letter is key, because I suspect the strongest firewall the ACA has is Ohio, Pennsylvania and Michigan having accepted the Medicaid expansion. Note that, for example, while Matt Bevin was able to win while running against the ACA, Kynect is still standing. Any Republican without a very strong substantive commitment to denying health care to poor people is not going to like the politics of huge Medicaid cutbacks in three crucial swing states. Would Paul Ryan do this anyway? Absolutely. Is this the hill Mitch McConnell wants to stake his majority leadership on? It’s possible, but I’m not sure. The lack of cohesion we’re already seeing would seem to indicate that he’s less than fully committed.
• As Chait says, the next 6 weeks or so is critical. Repeal and bullshit works best if it’s nearly immediate; the politics for the Republicans just get steadily worse the longer they can’t do anything. Stopping a even a Potemkin repeal, while far from the end of the war, would be yooge. And I think it’s possible.