Benjamin Studebaker

The CBO has released its report on the senate’s version of Trumpcare and the numbers are once again pretty grim–22 million additional Americans would be without insurance by 2026. 15 million of the 22 million would already be kicked out by the 2018 midterms. Senate Majority Leader Mitch McConnell thought he could get Senate moderates to vote for the bill by delaying its Medicaid cuts, but the cuts are even larger than the House bill’s when they do come. There is deep opposition to this bill within the Republican ranks, and I seriously doubt whether the Republicans are capable of passing this bill, or any other major healthcare bill, for that matter.As we discussed last month, there are a lot of moderate Republican senators who don’t like the House bill:

1. Susan Collins (R-ME), who is against cuts to Planned Parenthood.
2. Rob Portman (R-OH), who is against cuts to Medicaid.
3. Shelley Moore Capito (R-WV), who is against cuts to Medicaid.
4. Cory Gardner (R-CO), who is against cuts to Medicaid.
5. Lisa Murkowski (R-AK), who is against cuts to Medicaid.
6. Dean Heller (R-NV), who is against cuts to Medicaid.
7. Bill Cassidy (R-LA), who is against big coverage reductions.
8. Ron Johnson (R-WI), who is against hurting the poor and helping the rich.

The CBO confirms that the Senate bill also cuts Planned Parenthood and Medicaid. It also has big coverage reductions and it also hurts the poor and helps the rich. With all 48 members of the Democratic caucus prepared to vote against the bill, only three of these eight have to remain true to their principles to kill the bill in the Senate. Already, Collins has said she is going to vote against it:

Heller has also said he won’t support the bill in its current form:

If this is the bill, if this is the language on that procedural motion on Tuesday, I won’t be voting for it.

Rand Paul (R-KY) also doesn’t like the bill, albeit for right wing reasons–he thinks it’s too similar to Obamacare. Regardless of his motivations, he also says he’s going to vote against it:

On the current bill I’m not voting to get on it unless it changes before we get to it.

That’s three. This bill is not going to pass, not without significant changes. The thing is, it’s not as if McConnell conceived this thing out of thin air–the bill is the product of almost two months of closed-door deliberations. The Republican Party doesn’t agree about healthcare. Even this quite conservative bill has both right and left opposition within the party. Any attempt to make Collins and Heller happy would likely push more conservative Republicans into the Paul camp, and any attempt to make Paul happy would likely augment moderate opposition.

I’m reminded of the Social Security debate in 2005. Remember that? President Bush tried to privatize Social Security. In his state of the union that year, he said:

Here is how the idea works. Right now, a set portion of the money you earn is taken out of your paycheck to pay for the Social Security benefits of today’s retirees. If you’re a younger worker, I believe you should be able to set aside part of that money in your own retirement account, so you can build a nest egg for your own future.

Here’s why the personal accounts are a better deal. Your money will grow over time at a greater rate than anything the current system can deliver, and your account will provide money for retirement over and above the check you will receive from Social Security. In addition, you’ll be able to pass along the money that accumulates in your personal account, if you wish, to your children and—or grandchildren. And best of all, the money in the account is yours, and the Government can never take it away.

The Republicans controlled both the House and the Senate in 2005, but all the Democrats opposed the move and once again the Republicans couldn’t agree on how to do it. In the meantime, Bush haemorrhaged approval rating. Over the course of the year he lost about 10 points, dropping from around 50% to around 40%:

Privatization was one of Bush’s signature policies, and in 2004 the Republicans had gained seats. It didn’t matter. The president wasn’t popular, and his Social Security reforms weren’t popular either, and congressional Republicans could see that. They quietly shelved the whole thing. Today, Obamacare is more popular than ever before:

President Trump’s approval ratings are roughly the same as Bush’s in late 2005, perhaps even 2006:

And unlike Bush, who was at least quite clear about what he wanted, this president has gone on the record saying he doesn’t want what his own congress is passing. During the campaign he said there would be no cuts to Medicaid:

And after initially acting like the House bill was a slam dunk, the President U-turned, calling the House bill “mean” and saying that the Senate bill needs “more heart”. Republican presidents’ entitlement cuts have always been unpopular and Republican congresses have always been divided on policy, but this time we also have a president who doesn’t even seem to know what he wants. If they couldn’t privatise Social Security in 2005, why should we expect them to be able to pass a healthcare bill?

I think this bill is going to die, and I don’t think they’re ever going to agree on a replacement. Let’s see if I’m right.