For the past several years, no one has been more opposed to experimentation in the realm of Obamacare replacement plans than Mitch McConnell. He spent years discouraging Republicans from advancing replacement plans with the stated reason being that he alone would be in a position to forge a deal that allowed such plans to come to fruition. He maintained an image of confidence that when the time came, he would be able to balance the needs of insurers and providers, conservatives and moderates, reformers and those who favored the status quo in such a way as to achieve repeal and replacement. While the House of Representatives let a dozen plans bloom with co-sponsorships and internal debate, McConnell squelched any possibility of pre-gaming consensus on the Senate side. It was a gamble, a bet on his own ability as leader, and he lost.
At the end of the day, it wasn’t small government ideology that killed this bill. Mitch McConnell’s crafted backroom solution couldn’t even get the support of Jerry Moran. The joint announcement yesterday that neither he nor Mike Lee could support this bill was a kindness, saving face after it became clear this was headed toward defeat – and not because of Ted Cruz, who was always going to get to yes, but because of a collection of moderates who spent years lying about their opposition to Obamacare for political reasons. Murkowski, Hoeven, Capito, Heller, Portman, and Collins wanted to have it both ways: they wanted to defend the Medicaid expansions (that bolsters the budgets in many of their states) while making noises about fixing the private insurance markets that have devastated their middle class. This is a failure of imagination and policy, and a reminder that moderation does not equate to intelligence.
You’re welcome to disagree with this frame of what has happened to health care on the Senate side. But if you do, you’re wrong. Sources on all sides of this have reached the same conclusions, and the line used most often by staff and Senators as far apart as McCain and Lee is: “the last straw.” This was a devastating and embarrassing failure by a leader who had promised the president and his conference that this would get done. Wouldn’t a more trusted majority leader, one who didn’t need cliffs to govern, have pulled this legislation over the goal line? Even now, should Senators take McConnell’s announcement of the next steps – a vote for straight-up repeal and a two year delay – as a concession? A good faith gesture? Or as a trick, a trap he’s setting for them? If the latter, how can he possibly ‘lead’ the conference?
It’s not just that McConnell failed to get the job done: typically deferential Senators are now defying him and openly rejecting the way he runs the Senate. Moran and McCain sounded the same note yesterday: move on to an open process, regular order, and a bipartisan healthcare bill. Such a move may sound like pie in the sky, but the reality is that the monopartisan backroom approach has utterly failed, and running the Senate like McConnell’s personal fiefdom isn’t working. The conservatives have been frustrated with this for some time. Now, they’re no longer alone.
There’s one more aspect of this that’s interesting: For all of his willingness to slam people who go against him, President Trump has not slammed the defectors on this. Perhaps he just doesn’t want to alienate his friends. Or it could be, despite his lack of interest in policy, that he has a grudging respect for the guys willing to walk away from a bad deal. If it’s the latter, this could be a moment – as we saw with Paul Ryan before – where this president learns that he cannot trust the Republicans who come down Pennsylvania Avenue to say to him “trust me, we’ve got this.” And that lesson will have consequences.