Effort to repeal ACA now critically endangered

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The Republican Party’s stunning and humiliating inability to pass the American Healthcare Act (AHCA) on Friday represents a failure to live up to one of Donald Trump’s top campaign promises: the repeal and replacement of the Affordable Care Act (ACA). The Republican leadership’s failure to whip up enough support in the House of Representatives to pass the AHCA and the subsequent pulling of the legislation without a vote leaves us wondering just how the Republican Party could bungle this so completely and who is to blame for the monumental scope of this political incompetence.

Republicans have spent seven years spewing negative rhetoric about the ACA and have passed over 60 symbolic bills in the House to repeal it during that time. That’s seven full years for Republicans to craft a new healthcare bill and rally its politicians and voters behind it. They failed to do so, and the ACA remains the law of the land for the time being.

The Trump administration badly misread the Republican Congress when pushing to get the bill passed only 15 days after it was revealed. They apparently thought that because Republicans so strongly wanted Obamacare repealed, just any bill would do. They expected Republican lawmakers to fall in line even though the AHCA left significant parts of the ACA in place and was projected to raise costs and kick millions of Americans off their health insurance plans. Trump, the fake Republican that he is, is ignorant of the basic ideological makeup of the modern Republican Party. Therefore, he missed the completely predictable opposition that the House Freedom Caucus would put up to anything less than complete repeal of the ACA.

It’s baffling that they could have screwed this up so badly. The flagship promise of the Trump candidacy, the biggest fundraising issue for Republican politicians over the last seven years, the most contentious issue that Republican voters had with the Obama administration, and Republicans couldn’t get a bill passed. Instead, a president with historically low approval ratings and no mandate rushed the drafting of a badly constructed bill which ended up having a 17 percent approval rating. Moderate Republicans in Congress didn’t want to see their constituents price-gouged or left without coverage, and I guess their libertarian wing didn’t think the bill raised our infant mortality and senior poverty rates high enough. The AHCA was so unpalatable to enough House Republicans that it had to be pulled to either be revised or abandoned completely.

The coverage of the House Republican leadership’s scramble to whip up the votes for passage of the AHCA on Friday almost gave the impression that the White House knew the bill would be voted down. It was reported that House Speaker Paul Ryan told Trump that he didn’t have the votes around midday and that Ryan had to plead with Trump to pull the bill rather than force a vote. It seems that Trump realized how difficult crafting and passing a healthcare bill would be, and ultimately, Ryan had to talk him down from deliberately letting the bill fail just get it over with and move on to some easier issue. Trump himself has admitted on the record to not understanding how complex our national healthcare situation was before tackling it head-on.

Speaker Ryan’s failure to corral his party in the House is astonishing. Many excuse-makers are already pointing to the conflicts within the Republican Party as leading to Ryan’s inability to gather enough votes for passage of the AHCA. This is really just a way of saying that Paul Ryan is bad at his job. As soon as Trump won the presidency, Ryan’s top priority should have been gathering the support to craft and pass a healthcare bill that the entire party could get behind. His failure to do so means that the Republicans’ control over the Executive and Legislative branches means little in the face of their sectarian divisions.

There is something of a parallel between the Republicans’ failure to pass the AHCA and the Obama administration’s inability to fulfill its promise of passing a truly universal healthcare bill even with a Democratic majority in Congress. However, the Obama administration passed and implemented the ACA, and many of its reforms are still favorably viewed by most Americans. The Obama administration went on to achieve several legislative, military, economic and symbolic victories over its two terms. It remains to be seen if the Trump administration will be able to pull off a similar about-face.

Rather than achieving some sort of compromise between the moderate and hardliner wings of the Republican party as Barack Obama did with the Democrats and the passage of the ACA, Trump’s healthcare fight has crashed and burned more quickly and utterly than any political observer had predicted. Friday, Trump and Ryan claimed they would return to the healthcare fight at some point in the future. If the Trump administration and Congressional Republicans can’t find a way to come back from this and pass some meaningful conservative legislation within Trump’s first term, their failure will go down as possibly the worst squandering of a complete electoral victory in American history.