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McCain, Healthcare, and Partisanship


This interview between Chotinier and Geoffrey Kabaservice is very good, particularly the Goldwater comparisons.

Jodan Weissmann, meanwhile, has a good piece on McCain’s complicated health care legacy. His initial, shocking vote to kill skinny repeal was critical, and my views on the subject haven’t changed: he did it, it was very good that he did it, and it doesn’t matter at all why he did it. Weismann discusses his role in killing Graham-Cassidy, which is at least equally significant given that it was an even worse bill than skinny repeal. (It’s also worth noting that one reason people gave for denying McCain credit for his first vote is an assumption that multiple additional Republican senators also opposed the bill and he was just taking the hit/hogging the credit. There was, AFICT, zero evidence for this at the time, and the fact that two of the senators most often cited as being McCain’s secret allies revived the repeal movement makes that less than zero. If McCain votes yea, skinny repeal almost certainly passes.)

There is, however, a caveat:

Unfortunately, the story didn’t end there. Late last year, McCain locked arms with his fellow Republicans and voted to scrap the individual mandate as part of the Republican tax bill—a move the Congressional Budget Office predicted would leave millions of Americans uninsured. This is precisely what skinny repeal would have done too—which, again, is why McCain supposedly opposed it. The senator justified his flip-flop by calling the mandate “an onerous tax that especially harms those from low-income brackets”—which of course did little to explain why he opposed killing it before.

McCain’s legacy on the ACA, at least for now, remains positive. Skinny repeal would have been worst — not least because of its defunding of Planned Parenthood — and G-C much worse. Repealing the mandate is bad, and will cause the rate of uninsured to climb and the cost of insurance on markets to increase. But it won’t necessarily create a death spiral, particularly in the states determined to make it work, because it doesn’t affect either customers on the low end of the income spectrum for whom the exchange offers a good deal, and those on the high end who chose to risk the tax penalty. (Indeed, one lesson here is that a two-legged stool can work out OK, as long as the subsidy leg is wide enough.) But voting to repeal the mandate does undermine his salutary efforts to block repeal.

The story isn’t over yet, though. In an object lesson in how “moderate” Republicans have enabled Trumpism, on the one hand Anthiny Kennedy retired while still able to do his job, ensuring that Trump would be able to fill his vacancy for decades barring force majeure. On the other hand, John McCain — who was far to ill to do his job for many months — did not resign and allow Arizona voters to choose his replacement. If the GOP narrowly retains the Senate, Trump (God Forbid) is able to get a replacement for RBG or Breyer confirmed, and a Supreme Court supermajority strikes down or ham-handedly re-writes whatever healthcare legislation is passed by the next Democratic government, well, that’s part of his legacy too.

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