The status of the Senate healthcare repeal bill is … dead on arrival.
Senate Leader Mitch McConnell huddled with his henchmen late yesterday in a last-ditch effort to persuade conservative, moderate and libertarian Republicans to all vote in favor of the single biggest issue of Donald Trump’s election campaign. That’s like mixing oil and water and expecting instant salad dressing.
Enamored with his own reflection, Trump never had a plan to deliver the easier, cheaper and improved health care plan he promised at every rally. Overly confident in his position as leader, McConnell’s promises of secret concessions didn’t impress senators who were certain they would be voted out of office if they folded to the party agenda and took back health care from 20-30 million Americans.
It was over, ironically, when Sen. John McCain went into the hospital. For health care.
It’s worth noting that McConnell first attempted to delay the Senate vote until McCain returned to work to vote yes for repeal. And it should not be forgotten by the voters in Kentucky and Arizona, respectively, who rely heavily on Medicaid and yet had senators willing to toss their constituents’ health care away.
All Americans should take note that McConnell was quite willing to undermine the United States Constitution to get a winning vote. The Founding Fathers had an amazingly forward-thinking plan when they specified two votes from each state would make up a legislative body that ruled by majority agreement. There is no asterisk that says the majority vote rules *except when a deciding yea or nay holds the same position as the Senate leader.
But holding out for McCain’s yes vote was just one card in McConnell’s bag of tricks. Those secret meetings where the Senate bill was brewed included some “inducements” for select senators who had indicated they may not vote for the bill. Alaska’s Sen. Lisa Murkowski met with McConnell behind closed doors and walked out with a $1.8 billion earmark for that state’s excessively high insurance costs.
Sen. Bill Cassidy of Louisiana and Sen. Steve Daines of Montana would get to take advantage of a “late Medicaid expanding state” clause that would make them eligible for more federal dollars. And states with Native American Indian reservations — cue to South Dakota Sens. John Thune and Mike Rounds — could add Indian Health Service enrollees with a 100 percent Medicaid federal match.
At the very least, McConnell is a low-down, dirty card player. The ethics of the Senate leader to win at any cost should be a crime. Health care has gone well beyond political intrigue and straight into a life-or-death reality. Republicans have redefined patriotism as loyalty to the highest bidder, and no doubt Abraham Lincoln is rolling over in his grave.
It seems odd for a nation with a popular Social Security program not to have a comparable plan for health care, but ever since Medicare and Medicaid were signed into law by President Lyndon B. Johnson in 1965 Republicans have been trying to kill anything resembling a national health care program. In 1961 then-actor Ronald Reagan dramatically predicted “One of these days, you and I are going to spend our sunset years telling our children, and our children’s children, what is once was like in America when men were free.” Yes, we later elected this man president and that paved the way for small screen celebrities like Trump to potty mouth his way into the Oval Office.
About 30 nations have free, or universal health care. Even tiny Moldova has free health care. The U.S. has long claimed it has a free-market health care system, but that’s fake news. Here’s something “you probably didn’t know,” as Donald is fond of saying when he discovers something new to him as he reads it from a teleprompter: The federal and state tax exclusions for private health insurance provide a subsidy worth several thousand dollars a year to everyone with employer-sponsored insurance.
Kaiser Family Foundation studies show the exclusion from income and payroll taxes of employer and employee contributions for employer sponsored insurance totaled $250 billion in 2013 in lost federal tax revenue. Compare that with premium tax credits under the Affordable Care Act of about $140 billion. And there’s another deficit of $12.5 billion in lost tax revenue from certain health expenses. Massive tax subsidies are definitely not free market forces.
The Senate bill is dead in its current form. Trump last night tweeted a suggestion that the Senate start all over from scratch and create a new plan. But that would involve working with Democrats, something McConnell is loath to do. This latest Republican debacle is not a confidence-builder for any meaningful tax reform, national infrastructure repair program, or even Trump’s big beautiful wall.