For me as much as anyone, since I am a ball of nerves right now regarding this healthcare vote. I draw comfort from looking at logistics.
- This is not the final vote. This may be a step closer than we want to be, but it’s not a done deal. Likelihood is that it will die in the Senate, or go to the Senate and get completely re-vamped, and then need to go back through the House and the Senate again. Chances are the re-vamped bill would be more moderate and have that whole “not evil enough” problem with the Freedom Caucus again.
- If the bill passes the House today, in its current form, it cannot pass the Senate unless they change their rules to need a simple majority for legislation. However, Republican Senators are already unsure of the bill as it is. Changing the rules was easy to do for Gorsuch b/c they had (more than) party line support for him, and because the “nuclear option” was actually returning to how the rules were before the early 2000s. However, this will be less easy because we have some moderate Republicans who may not be on board with this. Also unlikely because their lead in the Senate is very slim and they would probably be sorry sooner than later, in that the Democrats could use this to their advantage in the future. If the Senate Republicans see they lost seats come 2018 or 2020 and want to change the rules back before their terms end, they can, but then the precedent has been set for the Democrats to do the same to them once they take power.
- There are a few moderate Senators who have vowed they will not vote for anything that compromises Medicaid, because they come from swing states or states that accepted the expansion. I can’t find a complete list, but among them are Susan Collins and Lisa Murkowski - who also are moderate on women’s rights issues and would probably not go for the discrimination angle of this bill. Bill Cassidy (my Senator) has been hawking an also stupid plan, but it’s somewhat different from the House one, so he and his plan’s supporters may also not go for the House bill, with their eyes on their own political wins.
- If the Senate wants to pass this with a simple majority and without changing the rules, it has to fall under Budget Reconciliation (by the Byrd Rule). A lot of the more political pieces of the House bill would have to be stripped out for this to work (like the pre-existing condition stuff), but that would then be met with a lot of opposition from insurance companies kind of making it a LITERALLY no one wins situation (downgraded from the current ALMOST no one wins). Another caveat to that is that for reconciliation, an actual analysis of the bill’s affect on the deficit would have to happen (unlike right now). When the CBO’s analysis shows the adverse affects of the bill, they can still pass it, but it will be harder to justify to their constituents who are obsessed with the deficit, and there are some hardline conservatives in the Senate who say they will never vote for anything that increases the deficit.
- If they manage to pass a bill that is solely budget based under reconciliation, that will pretty much fall into the “let Obamacare implode” category of things, in practice. The advantages to that are that we have some time to reverse the scenario the next time the budget is reconciled, and also that the Republicans will STILL pay politically (maybe even more?) if people lose their healthcare AND they didn’t repeal Obamacare.
- Republicans are going to pay somewhat for this politically if it goes anywhere, in almost any form. I’m not going to be naive and say that it will be a great purge in 2018, but this is very unpopular (particularly because there has been no CBO analysis).
- If this dies in the Senate, the House Republicans have voted the unpopular direction, which politically you should only take the hard road if there is payoff. It’s possible they want the credit for voting for something but not the backlash for its actual effects, but I’m not sure that will go as far as they might be counting on.
- If this passes the Senate in or close to its current form, people will lose their healthcare and they will lose it fast, even if they try to delay the timeline of it being implemented. The reasoning is that Obamacare will implode more quickly with these pending changes lingering around (Iowa is already having this problem). This will enrage their constituents.
- Republicans seem to think they can pass this off on the state governments and not take the blame for the fallout, presumably. However, national eyes are on this and we are all watching Congressional Republicans basically open the door for the states to fuck their own people over. People will not be confused.
The bottom line is still always going to be this: people want affordable access to healthcare, and the Republicans literally refuse to do anything that actually makes that a priority. People are waiting and watching and whether they realize it or not, are used to a new standard for healthcare and when the standards go down, they’ll feel it. There are more voters in the “I need affordable healthcare for myself” category than there are in the “I can afford my own healthcare and fuck you all!” category, thanks to the growing inequality in our country. There are many in the former category who think their own healthcare woes are because others have healthcare, and they are not going to be placated when their problem is worsened.
They once again are suffering under the delusion that people want more freedom to not be able to have healthcare access, instead of addressing the actual reason their voters voted them in to repeal Obamacare.
I have long thought the best thing that the Republicans could do, politically, was take Obamacare, make it better/stronger/more liberal, rename it Trumpcare, and then take credit for the improvement in healthcare. Good thing they’re clearly too stupid or selfish to do that.