But Then They Went Too Far

Profile in courage Shelley Capito:

U.S. Sen. Shelley Moore Capito, R-W.Va., said Friday she wouldn’t support an amendment to the GOP’s health care overhaul pushed by far-right Senate conservatives, pouring cold water on prospects of unifying the party around any legislation.

Following Senate Majority Leader Mitch McConnell’s decision to delay a vote on the Better Care Reconciliation Act of 2017, a rewrite of the House-passed American Health Care Act. Capito came out against the bill as written, citing deep Medicaid cuts, the potential to worsen the growing opioid epidemic and how it could harm rural health care providers.

It’s good news that she won’t support the Cruz Amendment. But it’s still rather remarkable that she wasn’t willing to come out against BCRA before the vote was delayed. You would have to be an insanely horrible person to represent West Virginia and vote for this bill. It would cause the uninsured rate in West Virginia to climb from 6% to 25% by 2022. It would also have devastating effects on the state economy. And yet if McConnell had had 49 votes she probably would have been the 50th. And you can say the same thing about every Republican senator even if the effects aren’t quite as dire in their states.

In related news, public officials refusing the Medicaid expansion are monstrous. And the Supreme Court holding that enabled them — although the Court was not enforcing any specific textual provision, the controlling precedent upheld the use of federal spending power in case where the relationship between the spending and the objective was much less direct, and the standard created by the Court going forward is transparently incoherent and unworkable — was monstrous. Given the devastating consequences of the holding, it could be justified only if the legal reasoning was absolutely compelling — with textual support so clear no reasonable person could disagree. The Medicaid holding wasn’t even close to that standard.