This was supposed to be the week the fight over the Republican health care overhaul reached its endpoint. One way or the other, the Senate GOP leadership planned to bring their regressive plan to the floor, and it'd either pass and get rubber-stamp approval from the Republican-led House, or it'd fail.
At least, that was the plan. Sen. John McCain (R-Ariz.) had surgery for a blood clot the other day, and while the procedure reportedly went well, he'll be home in Arizona this week, recovering. Senate Majority Leader Mitch McConnell (R-Ky.), pushing a bill that was already facing tough odds, said McCain's absence would delay the vote for at least a week.
In theory, this could help GOP leaders, giving them more time to twist arms and buy off on-the-fence members with special goodies and giveaways. (I've heard the phrase "Christmas in July" used more than once from Capitol Hill contacts in recent days.) But in practice, the more the Republican health care is exposed to sunlight, the worse it appears.
McConnell is well aware of this, which is precisely why he's been in such a rush to pass it. More time means more scrutiny, and more scrutiny means more exposure of the bill's many flaws.
So, where does that leave the state of the debate? For Republican officials, in a less-than-ideal place. The Wall Street Journal had this report over the weekend, for example, on major insurers balking -- in rather blunt terms -- at the revised details of the current GOP blueprint.
The provision, backed by Texas Sen. Ted Cruz, would authorize insurers to sell coverage that wouldn't meet ACA standards on the condition that they also sell at least some plans that did. While this setup could offer healthy people less expensive policies, insurers and actuaries say it would likely prove dysfunctional over time, pushing up rates and reducing offerings for people buying the compliant plans.In a letter sent Friday night to the Senate Republican and Democratic leadership, the two major associations representing health insurers, which don't typically send such missives jointly, said the amendment "is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people currently enrolled in the individual market."
"Simply unworkable in any form" isn't an especially subtle phrase.
The insurers' statement follows opposition to the Republican legislation from practically every major stakeholder in the health care industry, including organizations representing doctors, nurses, hospitals, patients, and seniors. It's difficult to think of any recent policy measure that's united every possible faction of the industry, including insurers, but the GOP bill has managed to pull it off.
Giving these groups another week to register their concerns likely won't do the ant-health-care forces any good.
There's also public opinion to consider. The latest Washington Post/ABC News poll asked respondents, "What do you prefer: the current federal health care law, known as Obamacare, or the Republican plan to replace it?" By a two-to-one margin, Americans prefer the Affordable Care Act: 50% backed the ACA, while only 24% said they support the GOP alternative.
There is no American constituency that wants this plan imposed on the nation.
And finally, there's the Congressional Budget Office, which has not yet released its analysis (a.ka., the "score") of the current iteration of the Republican plan, but which is expected to do so tomorrow. If the report paints an ugly picture, as every previous CBO analysis from previous months has done, it will be that much more difficult for McConnell and his lieutenants to persuade his members to pass the regressive and unpopular plan.
After having to pull his health care bill three weeks ago, the Majority Leader reportedly joked, "It's not easy making America great again, is it?" Neither, evidently, is making America less healthy again.