Trumpcare Is Dead.
Long Live the Trumpcare Opposition.
It’s over. And it’s not over.
The effort to take away health insurance from millions of people — known by the name it deserves, Trumpcare — seems to have failed again. The latest version, the Graham-Cassidy bill, looks doomed, with three Republican senators joining all 48 Democrats and independents in opposition. Three plus 48 equals 51, and 51 no votes equal defeat.
Thank goodness. More specifically, thank goodness for the citizens who have rallied against the bill — the disabled activists who protested on Capitol Hill yet again on Monday, the callers who flooded the Senate switchboard, the experts who dispassionately explained the bill’s brutal effects, and many others.
This outpouring has left Republican leaders without the votes to pass a bill by Saturday, the end of the federal fiscal year. If they don’t meet that Sept. 30 deadline, Senate rules force them to start the process all over again. Which is why many observers are declaring Obamacare repeal to be dead.
But it is not dead. By now, everyone should have learned that President Trump and Mitch McConnell are not going to give up until absolutely forced to.
They didn’t give up when bills failed this summer, and they won’t give up if they miss the Sept. 30 deadline. They have promised their base and their donors that they will repeal Barack Obama’s signature achievement — extending decent medical care to the sick, the poor and the middle class. As long as Trump and McConnell believe that they are close to finding 51 votes, they will be tempted to try again. They can restart the process in October or beyond.
That’s why the next few days are important. Of particular importance are the positions that the remaining undecided senators take, starting with Alaska’s Lisa Murkowski.
For one thing, it’s not Sept. 30 yet. McConnell can still try to flip the bill’s opponents. Susan Collins, John McCain and Rand Paul all look like solid no votes, but nothing is guaranteed. Trumpcare has tended to fare best when people assumed it was kaput and stopped paying attention.
And the margin of defeat matters, too. The more senators who oppose Graham-Cassidy, the less likely that yet another version of Trumpcare will emerge.
For Murkowski, the decision is a character test, as it was for McCain. He passed his test, keeping a promise to oppose any rushed, secretive bill that made a mockery of the Senate, as Graham-Cassidy has.
Murkowski’s promises are different, but no less stark, as The Washington Post’s Greg Sargent has noted. She has said, “We must continue to prohibit insurers from discriminating against pre-existing conditions.” Graham-Cassidy would instead allow insurers to price sick people out of the market.
Murkowski has also insisted that Alaska not lose federal health care money, and the bill’s authors have tried to buy her vote with late changes. But the bill still reduces Alaska’s funding — and claims otherwise with a blatantly misleading data table. It was quickly debunked by health care experts.
The question for Murkowski is whether she is willing to let her vote be bought — for a cut-rate price, no less. My hope and guess is no. She stood firm against earlier versions of Trumpcare. But her lack of an answer so far is worrisome.
There are several other uncommitted Republicans, as well. Shelley Moore Capito of West Virginia and Rob Portman of Ohio are on the list, and both of their states would suffer badly under Graham-Cassidy. Ted Cruz of Texas and Mike Lee of Utah also have not announced their stances. All are now freed from the pressure of being the decisive vote.
The margin of Graham-Cassidy’s defeat (regardless of whether the Senate actually votes) will shape the next steps on health care. If Republicans come to terms with their total lack of a reasonable repeal plan, more of them will be open to a bipartisan compromise to fix Obamacare’s flaws. Such a compromise would encourage red states to sign up fully for Obamacare and, in turn, make future repeal efforts less likely.
To his credit, Lamar Alexander, the Tennessee Republican, started work on a bipartisan deal, before abandoning it last week, out of partisan loyalty to Republicans pushing Graham-Cassidy. But if the bill seems permanently defeated, Alexander will be able to resume the role of Senate statesman. He is well suited for it — in his third term, having previously been a governor and a cabinet member — and he doesn’t need to let himself get pushed around again.
The off-again-on-again fight over Trumpcare has been grueling. The activists, congressional staff members and others who have done heroic work in defense of their fellow citizens have good reason to feel exhausted. Unfortunately, it’s still not time to rest or celebrate. But victory is getting closer.