|Desperados of Richardson High School in the Texas State Capitol. From The Statesman.|
So Majority Leader McConnell had to abandon his bill, as I expected he would, and send the troops off to their recess, while he and his elves theoretically work to rewrite the thing into a form that can pass after Independence Day, and the pandits aren't expressing much doubt that it can be done, referring to McConnell's "slush fund" of something over $300 billion in money that the bill theoretically saves the government, according to the CBO score, which could be used to pay for the traditional Christmas tree lights and ornaments with which legislation like this is festooned to get votes from the recalcitrant legislators.
I'm not changing my mind, mainly because I think Medicaid expansion is a much bigger deal than is widely understood—according to Times reporting picked up this morning by BooMan, it wasn't those prima donna dramatically wavering Republican Senators like Heller and Collins who really stopped the vote this week, it was Republican governors working a plan they'd been devising since February to preserve Obama's new Medicaid, and there's more to it than this week's defeat; in theory, a plan for some "moderate" group to work out a bipartisan proposal. Yeah, I'll believe that when I see it, but I don't see in the meantime how McConnell comes up with anything that overcomes these obstacles. (In Kansas in April, the utterly Republican legislature almost passed Medicaid expansion over the governor's veto—they were just three votes short of the two thirds they needed.)
The other day, lawrence090469 commented on my predictions of death for the bill:
wish I shared your optimism. Where else are they going to get the spending offsets for the tax cuts?Optimism could be putting it a little too strongly. There's no place else to get the spending cuts from, indeed—in the words of the immortal Willie Sutton, "That's where the money is." And if they give up this plan they're going to have to give up the whole thing for the time being, and that's going to make them very cross in the best of worlds. The moment they've been waiting for for decades, with Republican control of all three branches of government, and they can't get one fucking thing done.
In that sense, the alternative to repeal-and-replacing isn't very cute in the health care scene or anywhere else. It's the anarchy, basically, of courtiers jockeying for position in the Emperor's narrow attention span, Congress totally abdicating its responsibilities, and little public business getting done at all. With foreign and security policy left to the Pentagon, apparently, except for the social events Trump feels like attending, which is in some ways reassuring (at least Mattis and McMaster have a good deal of elementary competence), and in some ways very much not (with no civilian oversight at all, it's a military dictatorship, however benign, and to me at least the increased killing of civilians by US forces in all the theaters of the long war from Syria to Afghanistan has to reflect that).
In health, Trump himself has characterized his Plan B pretty specifically, for once: "Let Obamacare explode." Or in yesterday's gnomic utterance,
This will be greatThat is, to keep sabotaging the operation of the individual marketplace with threats and executive orders that are sort of not carried out but sort of are (tax penalties on individuals without health insurance were going to start getting heavy this year, Trump issued an order that they wouldn't be enforced but the IRS said they would, and I seriously can't figure out from the coverage whether they are or not), hope the death spiral really does begin, and blame everything on the Democrats in 2018.
if we get it done.
And if we don’t
get it done, it’s
just going to be
we’re not going to like.
And that’s okay,
and I understand
that very well.
The Congress could certainly fix much of this, but greed, ideological rigidity, and sheer incompetence stand in the way. Nothing to be optimistic about, really, except the hope that people will finally, after however much unnecessary suffering, start to notice.