TrumpCare and the Senate
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There is no recent precedent for anything like this closed process for such a major bill. Republicans and their allies in the media presented a caricatured version of the Affordable Care Act in which its passage was speedy, non-transparent and entirely partisan. But this was always a ludicrous inversion of the truth; the ACA’s negotiations happened mostly in the open, took forever and continued to involve Republicans long after it was clear they wouldn’t support any reform whatsoever.
When then-House Majority Leader Nancy Pelosi (D-Calif.) made her often-distorted statement that “we have to pass the bill so that you can find out what’s in it, away from the fog of the controversy,” the bill had been public for three months. The public will be lucky to examine the handiwork of an all-male group of Republican senators for three days before they try to ram it through. Senate Majority Leader Mitch McConnell (R-Ky.) is running roughshod over basic democratic norms.
The truly terrifying thing is that his tactics might work. “The Affordable Care Act,” concludes Vox healthcare policy expert Sarah Kliff, “is in deep trouble.” And this isn’t because the Senate is likely to pass anything much different than the extraordinarily unpopular House bill. (Remember: If they thought the public wouldn’t hate their version, they wouldn’t be hiding it.) The pathetic faction of Senate Republicans who are inaccurately described as “moderates” are making it clear that they will cave in to the reactionary extremists who dominate the Republican conference, while getting virtually nothing in return. Probably the only concession they will win is to phase in devastating cuts to Medicaid over a slightly longer period than House Republicans proposed.
Of course the public eventually will see this horrible bill — just before it becomes law — and the public’s second taste of Trumpcare will be just as bitter. But McConnell’s gamble is that ramming through an unvetted overhaul of the healthcare system to inflict immense suffering on the poor while helping the rich won’t endanger the GOP’s Senate majority — at least not in the short term — and is therefore worthwhile.
The fact is that the 2018 Senate map is extraordinarily favorable to the Republican Party. Democrats hold 23 of the 33 seats up for election. Texas Sen. Ted Cruz won his seat in 2012 by 16 points, and yet this might be the best chance Democrats have to flip one of the three seats they would need to regain control of the Senate.
If Republicans were defending, say, 20 seats instead of 10, McConnell wouldn’t try to pass a horribly unpopular bill. He’d worry that doing so would lead to Democratic control of the Senate, and thus deprive him of his ability to rubber-stamp Trump’s judicial and executive branch appointments. In this alternative scenario, he would have made the bill go away quickly by forcing a losing vote.
But as things stand, McConnell knows that even a political wave that knocks Republicans out of control of the House probably wouldn’t cost them the Senate. And he knows that even if 2020 is an utter bloodbath for his party, he’ll have already secured control of the Supreme Court for generations to come.
I overstated a little there; it’s possible that McConnell would be ramming some godawful health care bill through irrespective of the political context. But I doubt it. Not only does McConnell care more about maintaining power than any particular policy outcome, he pretty clearly cares more about judges than health care. Whatever he is, he’s not dumb; he knows this is a political catastrophe and he’s acting like it. I think the ACA would be pretty safe for now if Democrats didn’t need a black swan event to take over the Senate. But as it stands, I don’t think it’s looking good at all.
UPDATE/CORRECTION: I missed the change when going over the final version, but I initially wrote that Cruz was the best chance to get the third seat, not “one of the three” seats. Obviously, Heller and Flake are more likely to lose — my point is that Democrats need a third seat to flip the Senate even assuming they hold everything, and it’s tough to see where it’s coming from.