The Terrifyingly Realistic Chance of TrumpCare Passing
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Republican senators appear closer to ultimately passing a bill that would repeal the Affordable Care Act and replace it with legislation that would dramatically reduce health insurance coverage for low-income people, only in a less severe fashion than the House measure.
Senators still lack an actual bill, and the compromises needed to pass the Senate could imperil the legislation in the House, which will also have to back it. But Tuesday was a pivotal day for discussions in the upper chamber ― and seemingly a positive one ― as Republicans try to build a 50-vote coalition to repeal Obamacare.
“We’re getting close to having a proposal to whip and to take to the floor,” Senate Majority Leader Mitch McConnell (R-Ky.) told reporters, after nearly three hours of closed-door meetings.
McConnell knows what he’s doing — he wouldn’t be talking like this if the bill didn’t have a solid shot of passing. And given that some people had put hope in Cassidy holding out, this is a really bad sign:
Cassidy said the protections for people with pre-existing conditions were a big factor for him, as well as the slower rollback of the Medicaid expansion, which has helped states like his insure more people almost entirely on the federal government’s dime.
“What we’ve been told so far, states would have the ability, a lot more power than they do under Obamacare, to shape their future, and I think we’ve gotta return the power to the states,” Cassidy said, seemingly referring to a proposal to set per-capita limits on Medicaid, which would push states to put tougher restrictions on who’s eligible for that program.
Asked if the phaseout of the Medicaid expansion was still a concern of his, Cassidy said it was. “I think there’s obviously more to be done, but the phaseout is further down the road and states have a chance to adapt,” he said.
Obviously, on the merits this is all really dumb. Massive cuts to Medicaid don’t give states more “freedom” in any meaningful sense — they just compel them to cover many fewer people. And phasing in the cuts more slowly isn’t about giving states time to adapt so much as it is about making the numbers of uninsured look marginally less ghastly for an election cycle or two. But the quality of the arguments doesn’t matter — this is a very clear indication that Cassidy will roll. Even assuming arguendo that Collins and Paul are nays, seeing the where the third one would come from. It won’t be Lee or Cruz, I’ll tell you that.
Indeed, at this point, the best chance of the bill failing might be if Ryan can’t sell the House on the conference bill. It’s far from a lock, but this is really bad news.