Must-Read: Matthew Yglesias: Senate Republicans’ approach to health care is bizarre and appalling

Must-Read: Matthew Yglesias: Senate Republicans’ approach to health care is bizarre and appalling: “Nobody can tell exactly what Senate Republicans are doing with Americans’ health care, largely because they keep lying about it…

…Five days ago, John McCain called on senators to pay more heed to governors’ words of caution about steep Medicaid cuts. Then he made a dramatic return to the Senate floor, denounced the entire process through which the Senate health care bill had been assembled, and then voted with leadership to continue the process. Nonetheless, he insisted that he opposed the underlying Better Care Reconciliation Act. But then when the BCRA came up for a vote, he voted for it, offering the excuse that the vote was procedural. But if denouncing both the process by which a bill has been assembled and the substantive ideas it contains doesn’t lead you to vote against leadership on procedural matters, then what do your words even mean?…

The health bill keeps shambling forward, since Republicans seem comfortable lying to the American people about essentially all aspects of the process, up to and including their own position on it…. The saga of the “skinny” repeal concept that emerged suddenly Tuesday morning with no hearings, stakeholder discussions, or public debate makes the point. In one interpretation, Republicans are now prepared to radically lower their horizons… skinny repeal would modestly cut taxes and blow up the exchanges while leaving Medicaid intact. In another interpretation, skinny repeal is… a placeholder and then go to a conference committee… [so] Senate Republicans will be faced with an up-or-down, no-joke binary choice between the hardline bill and no repeal at all, at which point they will presumably swallow the hardline bill…. Even as the Senate GOP caucus appears to be coalescing around the skinny repeal strategy, its members cannot agree as to which version of the strategy they are pursuing. The other is that neither interpretation accords at all with Senate Republicans’ stated public commitments…. And yet ahead they go.

At every step along the way, the argument that appears to propel Republicans forward is the notion that they have an obligation to fulfill their promise to repeal and replace Obamacare. In reality, everything they have done in pursuit of repeal is breaking promises…. Trump promised to protect Medicaid, lower premiums and deductibles, and cover everyone. Every single version of repeal that Republicans have considered does the opposite on every front…. Along the way, key senators have made up new tests to violate. Louisiana’s Bill Cassidy spent several weeks touting the “Jimmy Kimmel test” for legislation and then voted “yes” on a bill (ORRA) that the CBO says would cost 32 million Americans their health insurance coverage. Dean Heller did a joint press conference with his state’s Republican governor in which they promised to protect Medicaid expansion, and then he voted yes on the key procedural vote that has kept Medicaid at risk. Shelley Moore Capito from West Virginia, likewise, flip-flopped on the BCRA after changes were made that were totally irrelevant to her stated concerns….

This kind of up-is-down behavior where stated preferences are unrelated to underlying behavior is bizarre. After all, if Capito ends up eliminating West Virginia’s Medicaid expansion after promising not to, she isn’t going to be able to trick people into thinking it hasn’t been ended. Why pretend she was opposed to ending it if she actually wasn’t?… It’s striking how much the heaping piles of bullshit that surround the health care debate have nothing in particular to do with Trump. McConnell and his staff spent all of 2016 looking reporters in the eye and touting his commitment to “regular order” as a legislative approach. He sent a senior staffer to the Vox office who very seriously attributed 2015’s relatively productive legislative session to a return of regular order and promised that regular order would continue no matter who won the presidential election. McConnell and Paul Ryan then, entirely of their own volition, with no evident input from Trump, proceeded to enact the most fantastically irregular legislative process anyone has ever seen. And dozens of Republican senators proceeded to repeatedly bemoan the slipshod process even while continually voting to continue the process….

Since nobody involved can be trusted to keep a promise for even a full afternoon, nobody knows what they’re really thinking or what they’re genuinely trying to do. Millions of lives are at stake, and the best Republicans can do to explain what’s happening is to congratulate themselves on distracting some people with a piece of petty bigotry. It’s bizarre and, frankly, appalling.


Brad DeLong
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