It was bad policy, not poor tactics or negotiating skills, that doomed the GOP’s efforts to repeal and replace Obamacare.
he and his allies crafted a poorly constructed and radical bill that would sharply cut support to low-income Americans and those with serious health conditions, while enacting big tax cuts for the wealthy.
.. Speaker Ryan’s crafting of AHCA was a slapdash enterprise.
.. even leading health-care experts were confused by the changes. As Timothy Jost noted at Health Affairs: “This comprehensive a repeal of the ACA would have far-ranging consequences for our health care system that can scarcely be described, much less understood, in the hours that remain before a vote.”
.. wondered whether the game plan was just for the House to pass something—anything—and then let the Senate do the real work.
.. So why did Republicans fail? In a word: insincerity.
.. they might have refined another conservative model, such as Avik Roy’s modifications to ACA exchanges, to turn ACA’s exchanges in a more conservative direction.
.. Secure in the knowledge that they would face President Obama’s veto, Republicans rammed through a succession of extreme repeal-and-replace bills that resembled AHCA’s original draft. These bills excited the Republican base, but would have horrified most other Americans if they ever found sufficient reason to look.
.. Congressional Republicans suffered what George W. Bush might call a “catastrophic success” with Donald Trump’s unexpected victory.
.. leaving people in plans where the “deductibles are so high that it’s really not worth much to them.”
.. He vowed to replace the “failing,” “horrific” Obamacare with “something terrific.”
.. Republican plans are designed around higher deductibles and narrower benefits, not to mention more limited Medicaid.
.. smaller financial subsidies for people with chronic health conditions. That was the clear intention, but Ryan refused to admit it.
.. Many in the GOP, above all President Trump, seemed strangely uninterested in the policy details.
.. To the extent Republicans did have an animating passion, it was to puncture President Obama’s legacy—and to avoid looking foolish by failing to honor their “repeal and replace” rhetoric.
.. For all their endless warnings about how Obama’s signature health law was hurting American families, driving up costs and putting us on the path toward socialism, it turns out they didn’t care enough to put in the work.
Why Hillary Wins
First of all, who was this other, stronger candidate that the G.O.P. might have chosen? Remember, Mr. Trump won the nomination because he gave his party’s base what it wanted, channeling the racial antagonism that has been the driving force for Republican electoral success for decades. All he did was say out loud what his rivals were trying to convey with dog whistles, which explains why they were so ineffective in opposing him.
.. Many people remember Mr. Rubio’s brain glitch: the canned lines about “let’s dispel with this fiction” that he kept repeating in a disastrous debate performance. Fewer seem aware that those lines actually enunciated a crazy conspiracy theory, essentially accusing President Obama of deliberately weakening America. Is that really much better than the things Mr. Trump says?
.. That is, in fact, a general problem for establishment Republicans. How many of them really believe that tax cuts have magical powers, that climate change is a giant hoax, that saying the words “Islamic terrorism” will somehow defeat ISIS? Yet pretending to believe these things is the price of admission to the club
.. When political commentators praise political talent, what they seem to have in mind is the ability of a candidate to match one of a very limited set of archetypes: the heroic leader, the back-slapping regular guy you’d like to have a beer with, the soaring orator.
.. there’s one thing Mrs. Clinton brought to this campaign that no establishment Republican could have matched: She truly cares about her signature issues, and believes in the solutions she’s pushing.