McConnell will be employing at least two tactics. First, he will use several hundred billion dollars that CBO says the bill would save to try to buy off moderate opponents with side deals, such as increased funding for Medicaid or opioid treatment.
Second, McConnell will press the argument that if this bill does not pass, Republicans will have no choice but to negotiate over the future of the Affordable Care Act with Democrats. Multiple reports have said that McConnell has privately warned Republicans that failure would mean they must enter into talks with Democrats on ways to shore up the individual markets, which would effectively mean that a chance to pass a partisan repeal bill is gone... But, in making this latter argument — which will likely gain more scrutiny in the days ahead — McConnell is effectively destroying one of President Trump’s most cherished false narratives... Trump has spent months making several intertwined claims. He has relentlessly asserted that Obamacare is collapsing on its own. He has offered a variation on this by threatening to cut off the cost-sharing reductions to insurers that subsidize out-of-pocket costs for lower-income people, which would drive insurers out of the markets; Trump has said this threat will force Democrats to the table to “deal” with him... concedes a number of points. It concedes that, despite Trump’s claim of a desire for talks with Democrats, Republicans cannot work with Democrats, as long as Republicans remain wedded to their own priorities — that there is simply no bipartisan consensus possible.. McConnell is basically conceding that Republicans can’t just let the ACA implode, as Trump seems to believe... The Trump administration is likely to continue trying to sabotage the exchanges if this happens, by employing, among others, tactics such as continually refusing to clarify whether it will renew cost-sharing reductions and generally sowing uncertainty over the ACA’s future.
This dirty little secret is the real reason why repeal is so hard for Republicans
The Affordable Care Act has widely been held aloft as one of the leading drivers of the deepening polarization of American political life — it has been bitterly fought over for years and has loomed as a great embodiment of all that ideologically divides the two parties. Yet in a strange twist, the GOP debate over repeal has actually revealed that there is a surprising amount of hidden consensus on health care.
.. nutshell, what the debate has really shown is that the passage and implementation of the ACA has given rise to a latent majority in Congress — or at least one in the Senate — that has more or less made peace with the ACA’s spending and regulatory architecture and its fundamental ideological goals
.. GOP Sen. Jerry Moran of Kansas that neatly illustrates the point. Moran is a GOP loyalist who previously headed the GOP Senate campaign arm and sits firmly in the mainstream of today’s GOP. Yet even he is having trouble supporting the GOP bill.
.. He did not describe the task facing Republicans as repeal; it was “repair, replace, whatever language people are using.”
Pressed by activists and voters, Moran said that he did not want to cut back Medicaid. “I have concern about people with disabilities, the frail and elderly,” Moran said. “I also know that if we want health care in rural places and across Kansas, Medicare and Medicaid need to compensate for the services they provide.”
After the town hall meeting, Moran told reporters the version of the GOP’s bill that he opposed put too much of Medicaid at risk.
.. He is suggesting that, while able-bodied adults might allegedly be scamming their way onto the Medicaid expansion, this issue should not be taken to justify the deeper cuts to Medicaid. And this, as Weigel notes, unfolded in one of “the reddest parts of a deep red state.”
.. The bottom line is that Republicans who currently oppose the Senate bill object to it because it would roll back federal spending in a way that would hurt millions and millions of people. This includes Moran and moderates such as Dean Heller of Nevada, Susan Collins of Maine, Shelley Moore Capito of West Virginia, and Rob Portman of Ohio, all of whom have made variations of this argument. Some, such as Collins and Sen. Bob Corker of Tennessee, have even objected on the grounds that this would finance a massive tax cut for the wealthy, and that this is indefensible.
.. All of this is dramatically at odds with the ludicrous spin coming from GOP leaders such as John Cornyn of Texas and House Speaker Paul D. Ryan of Wisconsin, who argue that the millions left uncovered under the GOP bill will be choosing that plight, because they will have been liberated from the hated ACA mandate.
.. To summarize, Republicans are arguing both that
- millions won’t actually be hurt by these Medicaid cuts, either because they aren’t really cuts, or because everyone will have “access” to health care later; and that
- if many millions of people go without coverage who would otherwise have been covered, they did so by choice.
it is of course possible to make a principled argument against the mandate, Republicans are doing something else entirely: They are hiding behind their arguments against the mandate to evade acknowledging the true human toll their proposed Medicaid cuts would inflict.
What this really means is that they are basically fine with rolling back the ACA’s massive coverage expansion to facilitate a massive tax cut for the rich, but just won’t say so out loud.
But all indications are that moderate Republican senators — and even senators such as Moran — are not fine with this outcome.
Now, these objecting senators may still end up supporting a revised GOP bill in the end, due to party pressures and other factors. But if they do, they will only justify it by pretending that a few additional last-minute dollars (in relative terms) added to the bill would put a meaningful dent in the enormous coverage loss
.. This would mean their current objections were insincere.
Conservative Leaders Applaud Trump’s Tweet to Repeal Obamacare First, Replace Later
American conservative leaders welcomed President Donald Trump’s tweet suggesting to Republicans that they immediately repeal Obamacare first and then work together to replace it later.
.. Cruz’s proposal would allow health insurers to sell plans that do not comply with all of Obamacare’s regulations. The senator says that selling plans that do not adhere to all of the Obamacare insurance regulations would allow Americans to opt for more flexible and affordable healthcare plans.
.. if on July 10 we don’t have agreement on a combined repeal and replace plan, we should immediately vote again on H.R. 3762, the December 2015 Obamacare repeal legislation that the Congress passed but President Obama vetoed.
.. “Those who do have private insurance have very, very high deductibles, which means, in effect, they don’t have any insurance,” DeMint continued. “Under the current situation, the private health insurance market will probably not exist in five years.”
.. Andy Roth, vice president of government affairs of Club for Growth, said the “most underreported story” during the Obamacare replacement controversy is that “moderate Republicans are very supportive of keeping in place large parts of Obamacare.”
Roth criticized GOP Senate leaders for protecting moderates by hiding behind the parliamentarian and claiming that individual is preventing them from fully repealing Obamacare. He said moderate Republicans have been telling voters they want to repeal Obamacare when they actually intend to keep it in place.
Political Divisions in 2016 and Beyond
Tensions Between and Within the Two Parties
One way to understand the 2016 election, then, is to note that by making questions of national identity more salient, Donald Trump succeeded in winning over “populists” (socially conservative, economically liberal voters) who had previously voted for Democrats.
.. Trump’s candidacy has brought more economic liberals into the Republican Party, moving the party’s center of gravity on these issues to the left. Trump has also moved the party to a much more nativist position on questions of national identity.
.. The View That Politics is a Rigged Game
- Elections today don’t matter; things stay the same no matter who we vote in.
- People like me don’t have any say in what the government does.
- Elites in this country don’t understand the problems I am facing.
.. The Importance of Social Security/Medicare
- How important is Social Security to the respondent?
- How important is Medicare to the respondent?
Attitudes on Foreign Trade A battery of questions on the costs/benefits of free trade.
Attitudes On Gender Roles A battery of questions on the role of women in society.
Pride in America
- How proud are you of America’s history?
- I would rather be a citizen of America than any other country in the world.
The Perception That “People Like Me” Are Losing Ground
- Life in America today for people like me is worse compared to 50 years ago.
- In America, the values and culture of people like me are becoming rarer and less accepted.
Attitudes Toward African-Americans A battery of racial resentment questions toward African-Americans.
Feelings Toward Muslims
- Favoring or opposing temporarily banning Muslims from other countries from entering
- the U.S.
- Feeling thermometer rating toward Muslims.
Attitudes on Immigration
- Whether illegal immigrants contribute to American society/are a drain.
- Favoring or opposing a legal way for illegal immigrants already in the United States to
- become U.S. citizens.
- Whether it should be easier/harder for foreigners to immigrate to the U.S. legally than it is
- currently.
Attitudes on Moral Issues
- View on abortion.
- View on gay marriage.
- View on transgender bathrooms.
Attitudes on Economic Inequality
- Whether our economic system is biased in favor of the wealthiest Americans.
- Whether we should raise taxes on the wealthy.
- Whether distribution of money and wealth in this country is fair.
Attitudes Toward Government Intervention
- Whether we need a strong government to handle complex economic problems.
- Whether there is too much/too little regulation of business by the government.
.. Divides get much wider as we move toward questions of race and national identity. Trump voters have more negative attitudes than Clinton supporters about African-Americans, are much less supportive of immigration, and have much more negative feelings toward Muslims.
.. To summarize, supporters of Clinton and Trump are very polarized on identity and moral issues. Views on economic issues are more of a mix. Both candidates’ supporters are generally supportive of the social safety net, and somewhat concerned about trade. Yet they diverge very much on how concerned they are about inequality, and how actively they want to see government regulate business and intervene in the economy.
.. The data suggest that the main divide within the Democratic Party electorate is about attitudes toward the establishment and the existing order than it is about specific issue positions (with the exception of trade policy).
.. For the most part, Trump and Cruz supporters look fairly similar, though Cruz supporters are considerably more conservative on moral issues, and notably less concerned about inequality and the social safety net, and more pro-free trade. In other words, Cruz voters were more likely to fit the description of traditional
conservatives... For the most part, Kasich supporters are the true moderates, caught in between the two parties on almost every issue, both economic and social. Kasich supporters come closest to Democrats on their feelings about immigration and about Muslims specifically.
.. Looking at the correlates of candidate favorability, we can more clearly see the potential divide in the Democratic Party. Again, it is more about disaffection than issue positions. The strongest predictor of Sanders support (holding all else constant) is a sense that the system is rigged. Clinton’s biggest boosters, by contrast, are more comfortable with the system as is, are less likely to see things getting worse, and are generally prouder about America. They are also more supportive of free trade. Interestingly, support for Muslims is noticeably more highly correlated with support for Clinton than for Sanders. This is somewhat surprising.
.. Still, to the extent that many of these divisions are establishment/antiestablishment divisions, they are somewhat muted by Democrats now being the opposition party. By contrast, had Hillary Clinton become president, these disagreements might have widened, since governing requires the kind of compromise and incrementalism that would be most likely to drive the Sanders wing of the party into rebellion.
.. we can see that Trump’s biggest enthusiasts within the party are Republicans who hold the most anti-immigration and anti-Muslim views, demonstrate the most racial resentment, and are most likely to view Social Security and Medicare as important.
.. By contrast, the strongest predictor of support for Ted Cruz is a set of strongly conservative views on moral issues, and somewhat pro-free trade views.
.. Notably, among Trump supporters, the age gap is nonexistent on resentment toward African-Americans, and very small on immigration. There is a wider gap on feeling toward Muslims, with old Trump voters being more anti-Muslim.
.. The widest within party variation by age cohort is within the Democratic Party on the indexes measuring pride in America and the perception that “people like me” are losing ground. Younger Democrats are both the most optimistic about their own future, but the least enthusiastic about America. To the extent that politics is increasingly organized around a conflict over ethnonationalism versus multicultural cosmopolitanism, the vanguard of this struggle is younger Clinton voters opposed to older Trump voters.
.. In both parties, this donor class is both more conservative on economic issues and more liberal on social issues, as compared to the rest of the party. However, there is a slight but notable asymmetry between the two parties on identity issues. Among Democrats, the donor class is notably to the left of the working class on these issues.
.. Already, we saw that in 2016, many of the party switchers appear to have been motivated by identity issues.
.. What Divides The Parties Now?
The parties are divided on both social/identity and economic issues, but more so on identity issues. The gaps between the Clinton and Trump voters on questions of racial resentment, immigration, attitudes toward Muslims, and moral issues are consistently wide. There is very little overlap between the two camps on these issues... By contrast, although the parties are divided on economic issues, there is more overlap. Particularly in the Republican Party, there are a wide range of views on economic issues, now that the party has expanded to include more and more populists who were formerly Democrats.
.. Many of the Romney voters who supported Clinton did so because they were uncomfortable with Trump’s far-right positions on immigration and other identity issues.
.. Early indications suggest that Trump was serious about his ethnonationalist agenda, which will keep identity issues, especially immigration, at the center of our politics. If this happens, it may put pressure on the remaining pro-immigration Republicans and the remaining anti-immigration Democrats (some remain in both camps), further realigning the parties.
.. Democrats may also be pressured to move further left on these issues, given that both younger voters and the party’s donor class are quite far to the left on identity issues. If so, American politics would become further polarized along questions of culture and identity.
.. Since Republicans have picked up more economically liberal voters (and may continue to do so since there are still some populists who vote for Democrats), it may be harder for Republicans to continue to push a traditional conservative free-market agenda. If so, this would leave conservatives with little place to go. Democrats might move right a little bit on economic issues, but they are limited by where their voters are on the issue. In addition, a move rightward might activate more of the anti-establishment sentiment that could potentially cause a rift in the Democratic Party.