But there's a reason the GOP was pushing a bill that would have taken everything people don't like about the health-care system and made it worse. That's the fact that it would have allowed them to pass two permanent tax cuts for the rich. Anyone, you see, can pass a tax cut that expires after 10 years. But if you want to make it last — and you don't have 60 votes in the Senate — then you need to find a way to pay for it (or at least look like you did). Taking health insurance away from poor and sick people would have done just that for the Obamacare taxes, which primarily hit people in the top 1 or 2 percent.
When the balky hardliners of the House Freedom Caucus visited the White House earlier this week, this was Steve Bannon's opening line, according to people in the conference room in the Eisenhower Executive Office Building:
Guys, look. This is not a discussion. This is not a debate. You have no choice but to vote for this bill.
- Bannon's point was: This is the Republican platform. You're the conservative wing of the Republican Party. But people in the room were put off by the dictatorial mindset.
- One of the members replied: "You know, the last time someone ordered me to something, I was 18 years old. And it was my daddy. And I didn't listen to him, either."
- Started on the wrong foot: Repeal-and-replace was always snakebit. Ryan had begun the process before Trump's inauguration. "He boxed us in," said one person close to the fight. "We didn't have any choice."
- Was always wobbly: Trump relied too long on assurances from Chief of Staff Reince Priebus and HHS Secretary Tom Price that they had the process in hand. And "Ryan was telling him it was fine, and they'd bring it together at the end." Instead, the bottom fell out.
Paul Ryan Failed Because His Bill Was a Dumpster Fire
It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare
So why did Republicans fail? In a word: insincerity. Republicans had seven years to do their own hard work, to coalesce around a credible conservative alternative to the ACA. They might have used this time to work with Republican governors, to explore which conservative policy ideas seem to stick, which aspects of ACA needed to be retained. They might have crafted a more moderate bill along the lines of the Cassidy-Collins bill, which would have given liberal states and Republican governors who adopted Medicaid expansion much greater leeway. Or they might have refined another conservative model, such as Avik Roy’s modifications to ACA exchanges, to turn ACA’s exchanges in a more conservative direction. They might have prepared the American public for whatever plan they chose.
They didn’t do any of this, perhaps because they believed they would never have to.
David A. Hopkins:
Why Wasn't Obamacare Repealed? The Answer Is the Party, Not the President
Those not inclined to solely blame Trump for the demise of repeal-and-replace—including the White House itself—have mostly aimed their shots at Ryan instead. Liberals who have rolled their eyes for years at Ryan's boy-genius reputation in Washington claim righteous vindication from this week's events, while some conservatives sympathetic to Trump have sought to shift responsibility to the speaker for drafting an unpopular and politically risky bill that could not make it through his own House.
While it's certainly true that both the president and the speaker made mistakes in handling the health care issue, it's inaccurate to portray the demise of the AHCA as primarily a consequence of individual failures of leadership or strategy. Replace Trump and Ryan with Marco Rubio and John Boehner, or Jeb Bush and Kevin McCarthy, and the results would almost certainly be more or less the same. The bill died so quickly, and was so far away from success when it did fail (remember, the House was by all accounts the easier lift of the two chambers), that the specific day-to-day behavior of the principal actors seems inadequate to account for the result.
The real obstacle to the passage of health care reform is the Republican Party itself, and any full reckoning with what just happened has to grapple with that fact.
Robert Draper/NY Times, worth the long read:
For now, [Raul] Labrador and other Freedom Caucus members have been willing to blame House leaders like Ryan and McCarthy for drafting a health care bill that was not to conservatives’ liking. They aspire to remain philosophical whenever Trump’s daughter Ivanka persuades her father to propose initiatives like paid family leave, as he did during his joint-session speech. “I didn’t stand up when he said that,” Labrador said. “That’s the only part of the speech where I thought, That’s not even close to what my party stands for.”
To House conservatives like Labrador, the Republican Party stands for limited government. To Trump and Bannon, big-ticket items like a border wall and infrastructure take priority over shrinking America’s debt. As Chaffetz admitted to me, “On the spending front, things could slip away really quickly.”
Trump’s budget blueprint is regarded by deficit hawks as fundamentally unserious, because it does not touch entitlements. Instead, it ravages perennial (and already pint-size) conservative piñatas like foreign aid, public broadcasting and the National Endowment for the Arts, in addition to downsizing the Environmental Protection Agency and the Interior Department — cuts that focus on the 27 percent of the federal budget that is not mandatory spending or devoted to defense. And for all the Republicans’ chesty rhetoric on cuts like these over the years, as a top House Republican staff member told me, “even the cabinet secretaries at the E.P.A. and Interior are saying these cuts aren’t going to happen. They’re going to protect their grant programs, their payments to states, their Superfunds. So how do you cut 31 percent of the E.P.A. out of the 5 percent that isn’t protected? And a bill that cuts all money for the N.E.A. will not pass. For Republicans in the West” — states whose vast rural areas benefit disproportionately from N.E.A. grants — “that’s a re-election killer. The campaign commercials write themselves.”
Jeremy Adam Smith/SciAm with a possible Trump voter explainer:
How the Science of "Blue Lies" May Explain Trump's Support
They’re a very particular form of deception that can build solidarity within groups
This has led many people to ask themselves: How does the former reality-TV star get away with it? How can he tell so many lies and still win support from many Americans?
Journalists and researchers have suggested many answers, from hyper-biased, segmented media to simple ignorance on the part of GOP voters. But there is another explanation that no one seems to have entertained. It is that Trump is telling “blue” lies—a psychologist’s term for falsehoods, told on behalf of a group, that can actually strengthen the bonds among the members of that group.
It won’t last:
Daniel Dale/Toronto Star:
Charlie Sykes, the Trump critic and former conservative talk radio host in Wisconsin, says there is an “alternative reality bubble” within the right, created in part by conservative media. Trump, he said, is both developing and exploiting this “post-truth environment,” elevating once-fringe conspiracy theorists and propagandists who will then amplify his lies.
“He is extremely aware of his ability to sort of throw these giant turd bombs out there and create disruption. And to a certain extent that’s all he really needs to do. Just create enough doubt, spread enough chaos, and he will survive.” In the long term, Sykes said, “the destruction of his credibility is potentially fatal” — but “news cycle by news cycle, it probably works for him.
When jobs don’t materialize, when health care is at risk, when things that matter don’t happen, or on immigration if they do, fantasy land is over. You can’t judge this by the first 65 days.
Who knew health care could be so complicated? — a brief history lesson from @JohnDingell
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