Commentary

Why Democrats shouldn’t be too giddy about the GOP’s health-care disaster

(THE WEEK) Scott Lemieux, March 27, 2017 — Democrats just won a big health-care battle. But the war is still on.

Make no mistake: The GOP yanking its plan to repeal and replace the Affordable Care Act to preempt its inevitable defeat in the House of Representatives is a yoooge win for the Democratic Party and the American people, and a humiliating defeat for the Republican Party.

But it’s still just one win in a much bigger fight.

The most important thing about the defeat of the American Health Care Act is that the major gains that ObamaCare has made in expanding insurance coverage will mostly remain in place. But it’s also worth asking why the plan failed and what it means going forward. It’s a defeat that reveals real tensions and weaknesses within the Republican Party. But that doesn’t mean that the GOP is doomed either.

Many of the juicy postmortems have focused on failures of leadership on the part of President Trump and Speaker Paul Ryan. And, indeed, both seem in over their heads in ways that will complicate passing the Republican agenda going forward. Ryan’s alleged mastery of policy was revealed as a complete fraud, and Trump’s various efforts to persuade recalcitrant lawmakers were ineffective. But it’s extremely unlikely that even stronger leadership could have gotten a replacement for the ACA passed. The votes were never going to be there.

The reason the votes weren’t there is simple: The proposed legislation was unimaginably terrible. And this isn’t just because it was a hastily cobbled together mess that even wonks sympathetic to conservative health-care ends generally wouldn’t defend. The central problem is that taking health insurance away from more than 20 million people and making insurance worse and/or more expensive for those who retain it in order to pay for a massive upper-class tax cut is an idea with no popular constituency. To pass a statute that would directly affect the lives of many voters and was supported by less than 20 percent of the public would have been political suicide.

As University of California political scientist Paul Pierson has shown with extensive evidence, repealing major social programs is enormously difficult, even in political systems with fewer barriers to changing the status quo than the American one. The weak Republican leadership didn’t help, but particularly given the relatively small Republican House majority and the even narrower margin they had in the Senate, the AHCA was probably always destined to be stillborn.

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