WARNING: If Trumpcare passes, it will be the worst version of Trumpcare


Mitch McConnell has admitted that the ACA is easily fixable; but that’s a threat, not a concession

We know what it would have looked like if everything had gone wrong this week.

The Senate would have quietly enjoyed its recess while leadership got close enough to a deal on Trumpcare that one small concession would have enough to engineer a quick vote a few days after everyone got back into DC.

That’s what happened when the House went on break at the end of April.

But everything hasn’t gone wrong, unless you’re someone who wants to uninsure 22 million, end Medicaid as we know it and reduce the value of insurance coverage for all Americans.

Starting with the ADAPT sit-in at Mitch McConnell’s office on the day the Senate Republican proposal for “reform” was revealed, the narrative around the Trumpcare story began to change, which was a small miracle given how effectively the Senate GOP had hidden the bill from any scrutiny as 13 Angry Men crafted it in secret.

Just after the sit-in was broken up, four conservative Senators — one more than was needed to kill it — tripped over themselves to oppose the bill.

They argued that Senate Trumpcare — with its trillion-dollar cuts to Medicaid over two decades and the sneak attacks on people with pre-existing conditions with state waivers on essential benefits that had gotten the Freedom Caucus on board in the House — wasn’t cruel enough. They made this argument assuming the “swing Republicans” would crumble, as they had in the House. They hoped to define the debate as being about how many patient protections they could remove from the system the ACA built.

Mike Pence joined the fray by defining the bill within the the frame of “personal responsibility.” But he was too late. The visuals of the ADAPT activists being wrenched from their wheelchairs exposed the rank cruelty of such an argument, as Lisa Diedrich explains:

The rhetoric of personal responsibility denies the fundamentally interdependent condition of society. It relies on a simplistic eugenics logic that suggests whole groups of people might be deemed unfit to participate and left to die. The ADAPT activists know much is at stake in this battle over healthcare. For these activists illness and disability are not metaphors. They are real material conditions of life that require creative responses at the level of both the individual and society. They challenge us to adapt—not simply our bodies and our selves, but our society—so that everyone can participate in political and social life to the fullest extent possible. What we are seeing in this #summerofADAPT is democracy in action around the question of what kind of society we want—one that would enable the many to flourish and live valuable lives, or one that protects and enables the few?

The backlash has been vast and creative. And it has even Republican Senators we didn’t think were in play have found themselves on their heels.

At a town hall Thursday filled with Indivisible activists, Senator Jerry Moran — who revealed he was against Senate Trumpcare after a vote was postponed — criticized the shoddy process that generated the bill refusing to back or oppose it, while expressing concerns about its cuts to Medicaid and people with disabilities. (The bill doesn’t just cut Medicaid but it’s designed to drive those who might be eligible for it into debt and misery.)

That same day, Mitch McConnell was forced to acknowledge that “If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur.”

This is Mitch McConnell making a stark admission that Obamacare is easily fixable. It’s a huge revelation that’s like an onion layered with significance.

To Greg Sargent it reveals “a dirty little secret,” it that there isn’t 50 votes in the Senate to repeal Obamacare.

But there is “a latent majority in Congress — or at least one in the Senate — that has more or less made peace with the ACA’s spending and regulatory architecture and its fundamental ideological goals, either for political or principled reasons, or for some combination of the two.”

But McConnell is also making a threat.

He knows voters will hold Republicans responsible for the health care system whether Trumpcare passes or not. Some marketplaces are suffering due to targeted GOP sabotage and a lot of Americans who outside the range of subsidies need help. A bill will need to pass.

McConnell is saying, “Do you want to pass a bill that pleases our donors and our base that has demanding repeal for 7 years — or do you want to join the Obamacare team?”

Nevada’s Dean Heller, who came out against the bill in such severe terms that his 2018 opponent could just run his press conference as an ad against him if he turns tail, is reportedly facing a ton of pressure, along with Republican governor Brian Sandoval, from the White House and billionaire donors Sheldon Adelson and Steve Wynn.

Do you think Adelson is going to back down from the about half a billion dollars in tax breaks waiting for him in Trumpcare? And do you think Nevadans won’t know who he’s caving to if he does cave?

Who wins between this rock and a billionaire’s behind?

“The stakes in the debate are getting framed differently than GOP hoped,” former Obamacare chief Andy Slavitt tweeted. “Not OCare broken, repeal & replace, but Safety net vs, tax cuts.”

This is not the debate is not what McConnell wanted but he isn’t capitulating. He’s clarifying the stakes.

McConnell needs those four conservative votes to have any hope to pass this law. Ted Cruz has been pushing an amendment that would segregate people with pre-existing conditions into a segregated market where the costs of premiums would skyrocket. And another amendment could even allow states to end Medicaid completely.

(UPDATE: The final “urgent blitz” to sell Senate Trumpcare will begin when Trump returns from Europe ” with figures and analyses from conservative groups and Republicans that show more benefits and less disruption, should the bill pass, according to a White House official familiar with the strategy,” according to the Washington Post. Vice President Mike Pence is in charge of bringing back stray Republicans and Cruz is in charge of selling his colleagues on his amendment that would segregate the sick and bring back junk, unregulated plans.)

Multifarious ways to gut Medicaid are not the kind of things you consider when you’re trying to win over Dean Heller in a state that effectively expanded the program and almost passed Medicaid for all just a few weeks ago.

Slavitt says the intensity needs to be “full tilt” this week and amp up each following week for July to beat this thing.

McConnell, the White House and GOP donors will do doing the same. Because for them, a bipartisan bill without at least $400 billion in tax breaks for the rich and their corporations isn’t just a failure. It’s a threat that could end their careers. (Not that passing the most unpopular piece of legislation possibly ever proposed is a much better alternative.)

So keep calling (202-224-3121), showing up at offices and town halls, working with your Indivisible Group and help support National ADAPT, civil rights legends who helped make this debate about the kind of America we want to be.

[Image by Becker1999 | Flickr]