Thursday, May 11, 2017

Trumpcare Obscenity

Last week occurred one of the most shameful episodes in US politics. Even more troubling than the precipitous firing of an FBI director in the midst of an investigation of people close to the president.

For seven years, Republicans have fumed and ranted over Obamacare, campaigning endlessly with the promise of repealing the groundbreaking health care law. The House of Representatives held some 60 meaningless votes to do just that (meaningless, since they knew that none of those attempts at repeal could survive a veto by President Obama).

Then, with a Republican president (so-called*) finally installed in the White House, GOP lawmakers had their chance. And they blew it. 

First of all, the GOP didn’t have a coherent plan of its own ready to go, even after seven years. At least not one they all agreed on. It’s understandable, of course. They were taken by surprise in November. No one expected Trump to win, and consequently no one expected the Republicans to be forced out of their comfortable role of the opposition party. They didn’t expect to have to step up and actually govern.

Secondly, the plan Paul Ryan, the GOP leader in the House, did slap together after Trump’s surprise win was rushed toward a vote only a month after Trump took office (and just over two weeks after the plan was unveiled). The aim was to pass the bill on the seventh anniversary of Obamacare’s launch. It was a schedule dictated by optics and symbolism, but it meant the plan was only half-baked.

(And compare this to the torturous process of passing Obamacare, which took a full year, dozens of public hearings and much political wrangling. It was a process that conservatives never tire of characterizing as “ramming” a rushed law down the throats of the American people. A year, compared to two weeks.)

Thirdly, the Trumpcare plan was instantly unpopular. A poll showed only 17% of Americans supported it. And for good reason. According the analysis by the Congressional Budget Office, the GOP’s “reform” would force some 24 million Americans off insurance. The White House’s own estimates pointed to even higher numbers of people losing their coverage.

No wonder not even House Republicans could agree on the Trumpcare plan, leaving severe doubts that it would pass, even in a House made up of a 44-seat majority of Republicans. Trump tried to force the issue by instructing a now-doubtful Paul Ryan to proceed with the vote regardless. In the end, Trump had to back down and seemingly stopped caring about the bill.

Win one for the Democrats! No vote was taken. The bill died. Except, Trump and the GOP couldn’t bear the publicity that came with the lost. And, needless to say, the bill hadn’t really died. It was only in a coma, an induced coma.

I suspect that Trumpcare was brought out of this coma because Trump started to chafe under the perception, happily foisted by the media, that things weren’t going well for him. The operation of his White House continued to be a farce, and his first 100 days had passed without any significant legislative accomplishments.

Sure, he has signed lots of documents, executive orders, some of which have real effects (for example, allowing the completion of the Dakota Access oil pipeline to proceed), while many of which just stated Trump’s intention of doing something (like repealing Obamacare or building a border wall) but didn't result in any real-world actions by themselves. And sure, he got a conservative added to the Supreme Court after the Republicans had kept the seat open for a full year.

But in terms of actual laws that move forward on some key campaign promises, such as actually building a border wall, the symbolic first 100 days surely had to be a big disappointment for Trump supporters -- if they were honest about it.

To make matters worse, the recent budget passed by the GOP-dominated house lacked many clear-cut victories for Trump, and yet was filled with concessions to Democrats, over which the Dems couldn’t help publicly gloating.

The Democratic gloating was so bad that Trump and the Republicans -- snowflakes that they are -- complained bitterly that the Democrats were “spiking the ball”. And this from the man who celebrated his narrow win in November with an endless series of victory rallies where he did nothing but gloat. What is good for the GOP goose is, apparently, not good for the Democratic gander.

So, perhaps to soothe Trump’s feelings over his lackluster first 100 days and the humiliation of his failed budget, the GOP took another stab at killing Obamacare.

By injecting some amendments to the comatose Trumpcare bill, Paul Ryan and company were able to win over the ultra-conservative “Freedom Caucus” of Republicans who had formed the biggest obstacle to the bill’s first incarnation.

It seems the Freedom Caucus’ biggest objection had been the fact that Trumpcare didn’t remove Obamacare’s requirement to cover certain “essential health benefits”. This has often been a talking point in conservative media, which argues, for example, that middle-age men, in no danger of getting pregnant themselves, shouldn’t have to pay the additional cost for maternity-care coverage. 

The new amendments essentially allow individual states to opt out of this and other provisions of Obamacare, thereby placating the Freedom Caucus, which apparently won’t rest until every person dying without health insurance can die happy in the sweet knowledge that at least they died free. And not a burden to their fellow, freedom-loving, more prosperous Americans. Amen.

With this sweetener added for the Freedom Caucus, the bill passed, but by only four votes. No Democrats voted for it, which makes me wonder about those fashionably cynical folks who love to claim that there are absolutely no differences between the two parties.

This second try at passage was also rushed, this time apparently in order to hold the vote before the House left town for a “spring break” vacation. It’s often claimed these “recesses” are an important chance for the hard-working legislators to spend time in their home districts getting in touch with “the people” and hearing their concerns. Oh boy, do I ever hope they are actually doing that this time. I’m sure those brave enough to hold town hall meetings are getting an earful. We already know that Congressman Raúl Labrador,  a Freedom Caucus member from Idaho, got lambasted by the people in one such town hall after he foolishly claimed "Nobody dies because they don't have access to health care". Obviously, he inhabits a different world than the rest of us. 

So, the House Republicans wasted no time. Pushing the vote through so quickly had the added benefit of not having to hold hearings or giving the CBO time to score the new version. It's much easier to ignore how much worse the bill will be for poor people if you conveniently vote before you find out something unpleasant like that.

And in some sense, it doesn’t matter. Every House Republican can take solace in the fact that the Senate will radically change the law. In fact, some key senators have already said they will write their own bill from scratch, potentially making the horrible House plan marginally less horrible. Even then, it’s far from certain that a kinder, gentler Trumpcare will be able to pass the Senate.

I doubt the House Republicans even care. It seems the important thing was to pass something, anything, giving voters the impression the House had finally done something, not to mention giving so-called* President Trump the appearance of a win. And he grabbed onto that appearance of a win with all the desperation and gusto that he might normally reserve for some random woman’s genitals.

After the vote, the entire GOP caucus was bused over to the White House to celebrate in the Rose Garden like a jubilant fraternity at a keg party. In light of the travesty they had just committed, putting the future of millions of sick Americans in doubt, that display of heartless self-congratulation was simply obscene. There is no other word for it. 



* A "so-called" president in my mind, since Trump applied that label to a sitting federal judge who should be granted at least as much legitimacy for the office he holds as any president who loses the popular vote by some three million.