Republican divisionsNot repealing Obamacare
Internal division does not hurt Republicans in elections. Governing is different
GRAPPLING to comprehend Donald Trump’s populist seizure of their party, some Republicans predicted it would re-emerge as a champion of working-class whites. Others expected Mr Trump to drop his proletarian shtick and help deliver the tax cuts they had always dreamed of. Republican senators’ failure to repeal Obamacare, a long-promised part of that tax-cutting hope, suggests the party is no closer to working out who it represents, or what it is for. Republicans are in control of every lever of government in Washington, but so internally divided as to appear incapable of governing.
The attempt to repeal Barack Obama’s health-care regime—which Republican congressmen had for seven years decried as an existential threat to America—reached the Senate after an earlier shambles in the House of Representatives. The House repeal bill was passed in May, at the second attempt, despite having been rejected by 20 Republican congressmen. It would have slashed Medicaid—government-provided medical insurance for the hard-up, which was expanded under Obamacare—and abolished a stipulation that everyone must have medical coverage. Senate Republicans promptly binned it; Conservatives said it left too much of Obamacare intact, while moderates objected to the fact that it threatened to deprive 23m people of medical insurance over a decade. But Senate Republicans’ own proposals, contained in two draft bills hatched, with telling secrecy, by Mitch McConnell, the Republican leader, were little better.
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According to the Congressional Budget Office (CBO), the second iteration, which stalled on July 17th, would have resulted in 22m fewer insured within a decade. Both bills were wildly unpopular—only 17% approved of the second. They were opposed by both moderate Republicans, led by Susan Collins of Maine, and conservatives, led by Rand Paul of Kentucky. Given that Mr McConnell could afford to lose no more than two votes to maintain his party’s majority, a vote on the bill was postponed after John McCain of Arizona, a two-time presidential candidate, was forced to undergo eye surgery for what later turned out to be brain cancer. The bill’s fate was sealed when two more conservatives, Jerry Moran of Kansas and Mike Lee of Utah, came out against it nonetheless.
Capito said kaput
There followed an effort, ordered by Mr Trump and dolefully launched by Mr McConnell, to repeal Obamacare without having an alternative in place. The CBO estimates that a straight repeal would result in 32m more uninsured by 2026, as well as leading to skyrocketing premiums. Average premiums for individuals bought on the exchanges Obamacare sets up would increase by 25% next year and then 50% by 2020, according to the CBO. Three moderate senators, Ms Collins, Shelley Moore Capito of West Virginia and Lisa Murkowski of Alaska, slammed the ruse. “I did not come to Washington to hurt people,” Mrs Capito tweeted.
This debacle will have big consequences, not least for health care. Having seemingly failed to repeal Obamacare, moderate Republicans want Mr McConnell to find a bipartisan way to address its shortcomings, including shallow insurance markets and rising premiums for middle-class policy holders. Fury on the left with Mr McConnell’s divisive tactics would not make that easy. Even so, a Republican senator claimed to know of ten Democratic senators ready to deal, and the fact that ten Democrats are up for re-election next year in states that voted for Mr Trump, including Indiana and West Virginia, makes that plausible.
Yet Mr McConnell, though not opposed to a bipartisan fix, may have more pressing concerns. He has always seemed less interested in health-care reform than in the fillip scrapping Obamacare might provide for the wider conservative agenda—especially its cherished tax cuts, part-funded by the $772bn Mr McConnell hoped to cut from Medicaid. With a series of unavoidable distractions looming—including budget negotiations and an impending fiscal crunch, which Congress must raise the debt ceiling to resolve—he may now prefer to drop health care and move on to tax. But that effort, in which he faces another intra-party battle, between fiscal conservatives opposed to unfunded tax cuts and more profligate sorts, has also got harder. Mr McConnell’s authority, which is largely based on his reputation for skilful deal-making, has been damaged.
Whatever he decides, support from Mr Trump, whose standing with his Republican colleagues is even more diminished, will be fickle. Having promised two years ago to replace Obamacare with “something terrific”, Mr Trump appears to have made little progress in working out the details. Depending on who he was speaking to, the president has oscillated between praising his party’s health-care plans and deriding them as “mean”. After being subject to the president’s periodic attempts to rally support for the various repeal bills, some perplexed lawmakers suggested Mr Trump did not seem to understand them. Nor, it appears, has Mr Trump mastered some basic details of how Congress works. In a recent tweet, he called on Mr McConnell to scrap the legislative filibuster in order to pass health-care and tax reform. Yet as the Republican leader was pursuing both through budget rules, which require only a simple majority, the filibuster was no obstacle to him.
Having fulminated against Obamacare for so long, Republicans in Congress should not have needed the president to tell them what to replace it with. At the same time, partisanship has made it so hard to pass bold legislation of any kind, even with an astute, well-briefed president providing impetus, it may be almost impossible without this. Reassuringly for Mr McConnell and his counterpart in the House, Paul Ryan, Mr Trump is said to be taking a greater interest in their tax plans. Yet it is not clear he is capable of the kind of sustained effort and skilful deal-making passing them would require. The likeliest outcome remains a temporary personal income-tax cut and a reduction in corporate rates (though probably not to the 15% level the White House wants).
Naturally, Mr Trump, who recently claimed to have “passed more legislation” than any of his predecessors, though he has in fact signed not a single bill of note, does not acknowledge his failure. “I think we’re probably in that position where we’ll let Obamacare fail,” he said. “We’re not going to own it. I’m not going to own it. I can tell you the Republicans are not going to own it.” In fact they do own it and, given the alternative plans Mr McConnell had in mind, that is probably a good thing for his party. With an approval rating of over 50%, Obamacare is considerably more popular than the Republicans. As they contemplate this latest trauma—the rejection by voters and collapse of a health-care reform that was for years their most fervent ambition—Republicans, omnipotent but unloved, need to reflect on why that is.