The Maverick went Maverick, and Republicans are livid.
When Senator John McCain gave his dramatic thumbs down to “skinny repeal” early Friday morning, he sunk (for now) the Republicans’ seven-year effort to “repeal and replace” Obamacare. The GOP backlash was quick and fierce. The normally stoic Senate Majority Leader Mitch McConnell was red-faced as he gave flustered and angry remarks immediately following the vote, President Trump lashed out on Twitter, and conservative activists railed against the Senator’s treachery.
But what McCain did wasn’t a betrayal. It was a bailout.
Yes, the GOP rose to political hegemony largely by banging on Obamacare and pledging to get rid of it. And yes, politicians ought to try to keep their promises to voters. But somewhere along the line, this pledge – which was always presented as a way to improve the health care system – gave way to a sort of collective psychosis that the party had to pass something, anything, that could conceivably be labeled “repeal,” or else all would be lost. Even now, this continues to be the conventional wisdom, accepted as a given in much of the analysis of the collapse of the repeal effort.
Yet “psychosis” really feels like the right word for it, because you have to be nearly out of your mind to think that passing legislation that has 14% approval, and which somehow cuts insurance coverage by tens of millions of people AND raises premiums, is your ticket to reelection. Thankfully for Republicans, Senator McCain (along with Senators Collins and Murkowski) was savvy enough to recognize this was a suicide mission before it was too late.
Voters, even solidly Republican voters, are much less ideological than pundits and the types of people who collect paychecks from think tanks would have you believe. They certainly favor a smaller government, but that is borne of a mistrust of a frequently incompetent bureaucracy more than it is a philosophical exercise. And they really hate paying taxes, because who doesn’t?
But what these voters really hate about Obamacare is not so much that it fails to meet some litmus test of conservative principles. They resent their rising premiums and copays, restrictions on which doctors they can see and when, and the savagely convoluted red tape that comes with dealing with insurance companies. Now, there are reasonable arguments that Obamacare didn’t cause these problems, and may in fact have slowed their development. But that’s largely beside the point here. By embracing the term “Obamacare,” President Obama and Congressional Democrats willingly took ownership of the American health care system, for better or worse.
Inconceivably, Republicans convinced themselves that it was vitally important to their continued legislative majorities that they steal the mantle of health care ownership while actively making the system worse. None of the four bills the Senate wound up considering – the House-passed American Health Care Act, the Better Care Reconciliation Act, outright repeal, or even the so-called “skinny repeal” of the Health Care Freedom Act – would have addressed the underlying stresses that most people feel. Instead, each version would have massively disrupted the individual markets and Medicaid population, while providing effectively no relief for the vast majority who get their health care through an employer. Most policy changes involve some level of trade-off, but this was a rare instance in which there were no obvious winners but millions of losers.
Now, it should be noted here that many Republicans would argue the policy work was not done, and that McCain and his fellow Republican Mavericks cut off the negotiations preemptively. The skinny repeal option was (allegedly) never intended to become law. Instead, it was just supposed a vehicle to pass something from the Senate so that they could conference with the House and produce a final-final bill that could clear both chambers (Senator Lindsey Graham perhaps best demonstrated the contortions involved here by calling the bill a “fraud” and a “disgrace” at a press conference approximately eight hours before voting for it). But there is no evidence that what would have ultimately come from that effort would have been significantly different than what was produced to this point, nor anything to suggest that it would have resulted in something that could have passed easily and prevented a prolonged and embarrassing stagger to a similar finish line.
In the end, of course, the policy here was secondary to the politics. How, it is asked, can Republicans go back to their base and ask for support if they couldn’t fulfill their main campaign pledge? But that underestimates the strength of the Republican Congressional support, and misreads its causes.
As I’ve documented here before, we have a 20+ year history of Republicans dominating Congressional races. The one blip was when the Iraq War was in its most dire stages and the economy collapsed. In other words, in the absence of major mitigating factors, Republicans enjoy a natural advantage. Not actively blowing up the healthcare markets probably works out just fine for them, particularly with the overall economy continuing to improve and no major international crises (at least for now).
Then there is the question of how disenchanted the Republican base will be by not racking up conservative policy achievements. But again, I think this misreads where those voters’ interests really are. GOP voters seem much more motivated by serving as a brake on a liberal activist agenda than by implementing the sort of policy-making proposed by the Heritage Foundation and AEI. I see no reason why raising the threat of Speaker Nancy Pelosi and crew raising taxes, confiscating guns, monitoring energy consumption, and otherwise hyper-regulating and moving liberal social policies won’t continue to work as it has for years. Heck, you can probably even convince some voters that the health care failure just means that you need even more Republicans in Congress to get things done. This, to me, seems like a much more preferable landscape to run in than against a highly-motivated and angry group of Democrats who just saw their signature achievement upended.
If GOP leaders were smart, they’d breathe a sigh of relief that McCain saved them from themselves on health care, and they’d move on to some smaller-bore items where they can rack “wins” while not upending the status quo. Go back to the drawing board on health care and think seriously about addressing the underlying problems – premium and deductible costs, along with access to the doctors of their choosing – that voters feel most acutely. There are many reasons to believe that such a scenario will work to their benefit, or at least keep any standard midterm losses to a minimum.
Of course, the President seems to be going in a different direction, so… I guess we’ll see.
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