After seven years and four months, the Republican quest to repeal
Obamacare has taken on vampiric qualities. A number of times since
March, it has appeared to be dead, but each time it has resurrected
itself. The latest occasion came on Tuesday afternoon, when
Vice-President Mike Pence broke a tie in the Senate on a procedural
motion that Mitch McConnell, the Senate Majority leader, had put
forward.
If this motion, which called on the Senate to take up discussion of the
health-care bill that the House of Representatives passed in May, had
been defeated, the repeal effort would likely have been finished. But
McConnell and his colleagues managed to cobble together just enough
votes to keep their ambitions alive.
The swing vote was cast by Shelley Moore Capito, the junior senator from
West Virginia, who, last week, had joined with two of her Republican
colleagues, Maine’s Susan Collins and Alaska’s Lisa Murkowski, to block
McConnell’s idea of having a vote solely on repealing the A.C.A.,
without putting in place any replacement measures. If Capito had stuck
with Collins and Murkowski, both of whom voted against the procedural
motion on Tuesday, it, too, would have failed. But, after meeting with
Donald Trump in her home state on Monday, Capito put party loyalty
before the interests of her constituents, about a third of whom are on
Medicaid.
The vote was also marked by the dramatic appearance of John McCain, who
returned to the Senate for the first time since being diagnosed with
brain cancer. After receiving a standing ovation from his colleagues,
McCain cast a vote in favor of McConnell’s motion, and then spoke from
the floor of the Senate with great passion. After referring to his
thirty-year career in the Senate, and his work with politicians of
widely divergent views from both parties, he went on:
These were stirring words, and they contained a lot of truth. But what
good did this verbal tour de force do? In voting for McConnell’s motion,
McCain participated in precisely the sort of cynical partisan political
maneuver that he inveighed against. For months now, McConnell has been
scheming to shove through a monumentally consequential reform without
any hearings, markups, or efforts to reach out to Democrats. After last
week, when this scheming looked destined to fail, he called for
Tuesday’s vote on the “motion to consider”—even though he had not made
clear what sort of measure the members would be taking up.
McCain supported McConnell’s motion. In doing so, he helped enable the
Majority Leader to pursue his fallback strategy: getting practically any
sort of measure passed and tossing the details of reform over to a
Senate-House conference, which would deliberate in secrecy, with little
input from anyone outside the G.O.P. leadership.
The Senate is now set to vote on three bills that have practically no
chance of getting fifty-one votes: a repeal-only bill; the
“repeal-and-replace” bill that McConnell originally proposed; and a
revised version of the McConnell bill that includes an amendment from
Ted Cruz, of Texas, which would allow insurers to sell cheap
catastrophic-insurance policies outside of the Obamacare exchanges.
After these votes are held, McConnell is expected to propose a
so-called “skinny” repeal bill, which calls for the repeal of the
individual and employer mandates but leaves everything else to be
decided by the House-Senate conference.
If he had been following his own advice, McCain would have broken with
McConnell and voted against the motion. If the motion had failed, the
Republican leadership would have had little choice but to start talks
with the Democrats about patching up the Obamacare insurance exchanges
and, perhaps, making modest changes to Medicaid. Indeed, earlier this
month, after McConnell’s repeal-and-replace bill failed to garner the
support of fifty-one Republicans, Lamar Alexander, the chairman of the
Senate health committee, announced plans to convene bipartisan hearings
on ways to stabilize the individual-insurance markets. Now that
McConnell’s motion has passed, such plans are in abeyance.
To be sure, this is only an interim victory for the Republican
leadership: the ultimate outcome of their repeal efforts remains
uncertain. Even if McConnell succeeds in punting the ball over to a
House-Senate conference, the full Senate will eventually have to vote on
a final piece of legislation, which will have specific terms that can be
analyzed and discussed. Getting a final bill passed won’t be easy.
For now, though, the G.O.P. campaign against Obamacare is still alive,
and it owes its life to subterfuge. In the House, Speaker Paul Ryan
managed to assemble a majority for his bill only by persuading his
colleagues that any flaws it contained would be fixed in the Senate.
That didn’t happen. Instead, McConnell now wants to abdicate the
Senate’s deliberative responsibilities and kick things back to the
House.
As McCain noted, these “responsibilities are important, vitally
important, to the continued success of our Republic. And our arcane
rules and customs are deliberately intended to require broad coöperation
to function well at all. The most revered members of this institution
accepted the necessity of compromise in order to make incremental
progress on solving America’s problems and to defend her from her
adversaries.”
For his long record of service to the country, his bravery, and his
acerbic streak, McCain is himself widely revered. It is a great pity,
indeed a tragedy, that he and many other Republican senators didn’t act
upon his words.