Posted by: maboulette | July 31, 2017

GOP Had 7 Years to Write a New Healthcare Bill -They Only Have Themselves to Blame


trump healthcare

The Republican Party’s seven-year dream of dismantling the Affordable Care Act came to what seemed like a climactic end early Friday, punctured by the Senate’s vote to reject a last-ditch proposal to repeal a few parts of the health law.

SKINNY REPEAL BILL

With the vote on a “skinny” repeal bill, Republican leaders were trying what amounted to a legislative Hail Mary pass. But they could only afford to lose two of their members, and three Republicans voted no: Susan Collins of Maine, Lisa Murkowski of Alaska and John McCain of Arizona.

Here are some key lessons from the evening.

THE PROCESS MATTERS.

Republicans grumbled about the secretive manner in which the majority leader, Senator Mitch McConnell of Kentucky, put together his repeal bill. There were no public hearings or formal bill-drafting sessions, and Republicans used a fast-track procedure meant for budget matters as they tried to enact complex health policy and avoid a filibuster.

MCCAIN OUTSPOKEN CRITIC

Mr. McCain was an outspoken critic. In June, asked his comfort level with the process, he cut off a reporter. “None,” he said

The final hours of the repeal effort seemed worse than ever: Republican leaders unveiled their bill and then expected their members to vote for it just hours later, and in the middle of the night, no less.

PRESIDENT TRUMP WAS NO HELP.

Without the election of Mr. Trump last year, putting a Republican in the White House, the repeal effort would have been an academic exercise, ending in a certain veto. But Mr. Trump did not prove persuasive in recent days.

TRUMP COULDN’T MAKE A DEAL

In public, he did not show much fluency in the basics of health policy, let alone the ability to persuade Republicans on complicated issues like the growth rate of Medicaid payments. And he did himself no favors by changing his demands about exactly what he wanted the Senate to do.

BULLYING ISN’T EFFECTIVE.

After Ms. Murkowski voted against beginning debate on care, Mr. Trump went after her on Twitter. It was not a fair fight: He has more than 34 million followers, and she has about 99,000.  But that is not the real point – the real point is that bullying might be effective for deals made in real estate but is not the way to get a Senator’s vote – in fact it can push the Senator to never cooperate with the White House again.

Mr. Trump also directed the Interior secretary, Ryan Zinke, to call Ms. Murkowski and remind her of the Alaska issues controlled by his department.

TRUMP DOESNT FIGHT KNOWING ALL THE FACTS

It wasn’t a subtle move, and this time, Ms. Murkowski held the whip hand: She chairs not only the Senate Energy and Natural Resources Committee, which has jurisdiction over Interior, but also the appropriations subcommittee that funds the department. Ms. Murkowski voted no.

THE ABORTION DEBATE DIDN’T MAKE THINGS EASIER.

The politically vexing task of coming up with sweeping health legislation was made even more challenging by differing views of abortion, an issue that was at the sideline of the Republican efforts but was a tenacious complication.

The slimmed-down bill, like the comprehensive Senate legislation before it, would have cut off federal funds to Planned Parenthood for one year, a key demand of conservatives and outside groups like the Susan B. Anthony List. Ms. Collins and Ms. Murkowski both opposed that provision. Just hours before the vote, Ms. Collins said the bill “unfairly singles out Planned Parenthood.”

A SLIM MAJORITY HAS ITS LIMITS

Senate leaders ultimately could not overcome a fundamental problem: Ms. Collins has a very different view of health policy than, say, Senator Rand Paul of Kentucky.

SUCH DIVERGENT VIEWS

Such divergent views might not be a problem if Republicans held a big majority in the Senate. But Republicans hold only 52 seats, and as a result, their leaders have had to worry about pleasing both the most conservative and the most moderate members. In an otherwise disappointing year for the party, Democrats won Senate seats in Illinois and New Hampshire in 2016, and their freshman senators, Tammy Duckworth of Illinois and Maggie Hassan of New Hampshire, made all the difference


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