Republicans Lose, Bigly

The Republicans have been trying to repeal Obamacare for seven years. While Obama was president, they passed bills over 50 times repealing the ACA, only to have them vetoed by the president (or die in the Senate). Back then, that was easy because they knew it wouldn’t ever become effective, so they would not have to suffer the blowback from 25 million people losing their health care.

But now, the GOP controls both houses of Congress and the White House, and they failed. Wasn’t even that close. It was so bad, they didn’t even dare bring it up for a vote.

Of course, immediately afterward Trump tried to blame the Democrats because none of them voted for a bill that would dismantle one of Obama’s greatest achievements:

Seriously? Is he saying he expected Democrats to vote for a bill that would take away health care from 25 million people and was deeply unpopular with Americans (even the Fox News poll showed opposition of 54% to 34%). If so, he really is insane.

The real truth is that the repeal failed because the House Freedom Caucus didn’t think the new bill was cruel enough. At the last moment, they talked Trump into adding a provision to the bill that would make it so that health insurance would not have to cover essential health benefits, including prescription drugs, emergency room visits, outpatient care, laboratory services, and even hospitalization. That just made Republicans from moderate districts realize that they would certainly lose reelection and drop the bill.

One reason the bill was so unpopular was that Donald Trump promised repeatedly that his Obamacare replacement plan would provide “insurance for everybody” and would lower the cost of insurance (for example, by allowing Medicare and Medicaid to negotiate directly with drug companies). He also promised that he would not cut Medicaid. Trump said his replacement would provide “great health care. It will be in a much simplified form. Much less expensive and much better.” But this bill was none of those things.

The lies don’t stop there. Trump promised that he was the ultimate deal-maker. Instead, he ended up looking incompetent.

This might look like a big victory for the Democrats, but it isn’t over. Trump claims that Obamacare is in a “death spiral” and that when it fails on its own, the Democrats will be to blame. First of all, according to fact checkers, the ACA is not in a death spiral. Yes, there are many things that could be done to improve the ACA, but this is not unusual. Medicare required decades of improvement to get to where it is today. Indeed, the Republicans even added prescription drug coverage under Dubya, although the ACA had to fix the big “donut hole” problem with that.

The problem is that Republicans will not allow any improvements to the ACA. In addition, there are many ways that Tom Price, Trump’s Secretary of Health and Human Services, can sabotage the ACA and make it worse. After all, the Republicans sued the government to try to kill the ACA, and (as a direct result of one such suit) 19 Republican-controlled states refused to expand Medicaid, resulting in millions of people not getting health insurance.

I predict that this is their plan. Sabotage Obamacare so that costs rise dramatically, so they can repeal it later. Unless we are vigilant, that might work.

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