The Republicans might yet pass a healthcare bill in the US—but whether it’ll save them is debatable.
On Tuesday, Mitch McConnell, the party’s leader in the Senate, dramatically pulled his proposed bill, which would have undone key Obamacare provisions and dramatically cut Medicaid, because he couldn’t get enough votes to bring it to the floor—let alone pass it.
All hope is not yet lost for the GOP, though. We’ve been here before, after all. A couple of months ago, McConnell’s colleagues in the House of Representatives were in the same position. Their bill was pulled because of a Republican rebellion but, a few weeks later, a new version was produced and they managed to pass it—just.
"Was portrayed as an attack on freedom, the creeping expansion of Soviet-style socialism"
Yet even if they do manage to scrape together the 50 votes needed to pass a bill in the Senate, healthcare has become the party’s albatross. Republicans have been making gains ever since Obama won the presidency in 2008, first winning the House in 2010, then the Senate in 2014 and finally, last year, the presidency. The obsession with repealing Obamacare—officially called the Affordable Care Act (ACA)—has been central to that success: appealing to a voter base which is equally suspicious of socialised medicine and the outgoing president.
Now that the Republicans have power, though, they are behaving like the dog that finally caught the car: they don’t know what to do with it.
The GOP has suddenly realised it’s easier to be an obstructionist than an initiator. Their famous “repeal and replace” is all very well as a slogan when you’re sitting on the sidelines. Finding a unifying message that appeals to all wings of your party when you’re in power is much harder. While (virtually) all Republicans were able to unite around a promise to “repeal”, agreeing on the “replacement” is another matter altogether. And when the non-partisan congressional watchdog says your proposal will see 22 million people lose their health coverage, your populist slogan stops being effective.
Political parties in the US are even broader churches that those in the UK. There are, effectively, only two of them, and last year’s presidential primary campaigns showed just how wide the differences are within each. Just look at the Democrats as an example - on some issues, there was as much difference between Hillary Clinton and Bernie Sanders during their intra-party primaries fight as there was between Clinton and Donald Trump in the final run-off.
That means one wing of a party can hold very different views from the other; in the GOP's case, a lot of its problems hail from the talkshow hosts on the Republican right. These bombastic celebrities, such as Sean Hannity on Fox News and Rush Limbaugh, made the repeal of Obamacare such a cause célèbre with their followers that many Republicans had no choice but to follow suit, even those who knew they were boxing themselves in. (Limbaugh, referring to Obama's efforts to pass the original legislation, called the former president "sociopathic".)
"If you pass repeal without replace, anything that happens is your fault." —John Boehner
This much has been apparent since the original fight over the introduction of the ACA, when genuine conservative concerns over the restructuring of healthcare were dwarfed by scaremongering and conspiracy theorists. A large swathe of the GOP base became convinced that government involvement in healthcare, along with the supposed “death panels”, is tantamount to a state takeover of their lives. It was portrayed as an attack on freedom, the creeping expansion of Soviet-style socialism and the beginning of the end of the republic.
Away from the fray, politicians are sometimes more measured. John Boehner, the former leader of the Republicans in the House of Representatives who quit because simply holding together the different wings of his caucus became a full-time job, has claimed the party will never repeal Obamacare.
“In the 25 years that I served in the Congress, Republicans never, ever, one time agreed on what a healthcare proposal should look like. Not once,” he said earlier this year.
“If you pass repeal without replace, anything that happens is your fault. You broke it.”
It’s a shame Boehner was not so honest when he was holding the speaker’s gavel—yet his reticence highlights the pressure coming from the Republican base.
Meanwhile, Trump has been his trademark self, flip-flopping and giving out contradictory messages. He invited all the Republican members of the House to a celebratory press conference after they passed their bill last month, only to subsequently call the legislation “mean.”
Unlike when Obama drove forward his plan, Trump does not appear to have the backs of his congressional colleagues, thus making it less likely he’ll win over any waverers. Why take a gamble and vote for an unpopular bill to help a president who is just as likely to criticise you for doing so than thank you?
Now, the healthcare shambles has hit the GOP’s poll ratings. Opponents have successfully portrayed them as being anti-poor and heartless, and the proposals poll very badly—a fact which could hurt them during next year’s mid-term elections.
The Democrats need just three seats in the Senate to win back control, and, although they need bigger gains in the House, they will be gunning for many of the GOP members who voted for their Obamacare repeal bill in May. The very issue that propelled so many Republicans into office could soon be responsible for their departure from it, too.
No wonder McConnell is struggling to herd his troops.
