In normal political times, under normal political conditions, the Republican Party's insistence on passing its plan to "repeal and replace" Obama would be almost inexplicable.
After all, their plan is deeply, deeply unpopular, and they know it. They tell you that they know it by conceiving it in total secrecy, to the point of keeping fellow Senate Republicans in the dark about its contents, before rushing to try to enact it. They tell you that they know it by point-blank lying about its impacts and intentions. They also tell you they know it by the fact that they are spending the congressional recess hiding from the public and the press instead of going out to at least try to build public support for a plan already on political life support.
Where are the champions of this bill, those willing to be defined by their support for it? Apparently they don't exist.
They can't build public support for their plan because they have no foundation on which to start. Their approach has two basic elements, and each element, by itself, is also deeply unpopular. By margins of two-to-one, three-to-one or even five-to-one, Americans oppose cuts to Medicaid and oppose rolling back Medicaid expansion. The second major element of the bill -- cutting taxes on the wealthy -- is opposed by even larger margins. When Gallup asked the question in April, for example, just 10 percent of Americans believed that upper-income Americans are taxed too much.
Combine the unpopularity of Medicaid cuts with the unpopularity of tax cuts for the rich, and you have a plan that ought to be poison at the ballot box. So the question then arises: Why? Why would a political party feel compelled to link its fortune to passage of such a bad bill?
Like most complicated questions, no single factor explains it. But here are three of the most important:
1.) Republicans don't know what else to do. Dating back to the time of Reagan, Republicans have defined themselves by their support for "supply-side economics," derided by their opponents as "trickle-down economics." For much of the past decade, they have also used their crusade against Obamacare as a symbol of their larger effort to dismantle the social safety net. They have nothing else in their policy toolbox, nothing better that they can propose that might come across as a 21st century approach to a 21st century situation. They're doing this because, well, this is what Republicans always do.
2.) Thanks largely to Citizens United, Republicans have become hostage to and subservient to their donors. (And yes, it is also true, if to a lesser extent, among Democrats.) Take the situation in Nevada, where Republican Sen. Dean Heller announced that he will vote against his party's "repeal and replace" plan. Politically speaking, Heller's position is a no-brainer. He faces a tough re-election battle next year in a state where the Republican governor embraced Medicaid expansion, and where 400,000 people might lose health coverage under the GOP plan. (That's in a state with a population of 3 million.) Not surprisingly, polls indicate that just 10 percent of Nevada voters support cutting Medicaid, while 76 percent want Medicaid funding to be maintained (43 percent) or increased (33 percent).
However, Heller's stance has reportedly outraged billionaire casino owners Sheldon Adelson and Steve Wynn, both of whom invested heavily in Heller and now feel betrayed. (By one estimate, Adelson alone would save $40 million a year in taxes if the Senate bill becomes law.) Heller is already being warned that his financial backing is at risk, and that he may face a primary opponent next year with extensive support in the form of "independent expenditures." Other Republicans are watching his fate closely.
3.) The impressive party discipline within the modern GOP has two primary sources. As we've seen, one is the donor class. The second is the conservative political-entertainment complex, which generates its profits almost exclusively within the narrow confines of the GOP base. The Sean Hannitys and Rush Limbaughs of the world don't have to face a mixed electorate; they don't have to govern. All they have to do is pander to the party base, and as enforcers of party purity, they are every bit as effective and intolerant as the commissars of the old Soviet Union. They don't see pragmatism as a viable policy option; they see it as a threat to their livelihood.
4.) Finally, we have to acknowledge that many Republicans are simply true believers. They honestly believe that having no health insurance is better than having government health insurance, that health care is not a right for all but a reward best reserved for the prosperous, that as Americans, our obligations to each other are satisfied by doing well for ourselves individually. Moreover, they believe that a majority of their fellow Americans either share those beliefs or can be convinced to do so. And they can point to their control of Congress and the presidency as supporting evidence of that last claim.
However, there's one big problem. Donald Trump was elected on a promise that he would not cut Medicaid, that deductibles and premiums would go down while coverage improved. He was elected on a theme of protecting the little guy from the powerful elite. Republicans in general, especially in swing states and districts, were elected on the vague promise that they had something better, more effective and generous in mind than Obamacare. In short, what Republicans told each other about their goals and intentions through conservative media, and what Republicans told voters in general, were profoundly different.
What we're seeing now is Republicans in power, struggling to reconcile those two visions. The House and Senate bills represent their effort to satisfy the expectations they have built within their own base; the distortions, lies, secrecy and lack of enthusiastic GOP support for those bills represents an acknowledgment that the public as a whole finds that approach unacceptable.
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