What’s At Stake in Today’s Health Care Vote

Well. For better or worse, it’s health care day in America. Yesterday, the House leadership announced that they would hold a vote on the American Health Care Act (AHCA) on Thursday and assured reporters that they had the votes needed to pass the bill. What the Senate does with it is a whole other ball game.

We’ve seen a lot of threats from AHCA supporters, big stands from those who oppose and even tangential fallout possibly in part over the AHCA in the last six weeks. But this vote is nothing if not monumental for Republicans as a whole.

Since the Patient Protection and Affordable Care Act — lovingly known as Obamacare — was passed without a single vote from Republicans, repeal became their mainstay and rallying cry since 2010.

Voters first gave them the House immediately following the passage of Obamacare. Republicans subsequently show-voted on repealing Obamacare more than 50 times in the following six years when they knew such a bill would never be enacted while a Democrat was in the White House.

Let us be very clear, while the Republican bill may be a step toward making health care more affordable to most Americans, it is a far cry from the “repeal” Republicans ran on when the interloping Tea Party began to make inroads and win seats and they realized promising something they couldn’t really deliver was better than being realistic.

Because at the end of the day, the AHCA is still a stinker, it just doesn’t stink quite so much.

The AHCA relies on three stages. The passage of the AHCA is simply Stage 1. As Senator Ted Cruz pointed out when the original iteration of the AHCA was being debated, the basket of goodies in the second and third baskets are what voters were promised for over half a decade. The AHCA “basket” changes almost nothing and the subsequent baskets rely on easily changed mandates from the Secretary of Health and Human Services.

If the AHCA is to be heralded at all as a conservative win, it’s that the amendments made were in the direction toward a health care system based on free markets but still not hitting the mark of a “free market solution.” To make the bill palatable to the must-have House Freedom Caucus, two amendments were added. First, waivers for states to opt-out of the pre-existing condition requirement, and second, waivers for states to opt out of the provision regarding “essential health benefits” were included.

However, with one dumb comment from President Trump — throw in a sob story from Jimmy Kimmel while you’re at it — another amendment was added that provides $8 billion over 5 years for the nearly inconsequential issue, but buzzword du jour, of “pre-existing conditions.” A phrase that precious few understand and seemingly fewer Republicans are prepared to defend eloquently.

Rushing the health care vote in March has made Americans, and particularly Republicans, weary. The president and Republican congress only have themselves to blame, but falling short on this vote tomorrow will leave most Americans who voted for Republicans because they promised to repeal Obamacare and later to replace it with something better, with the clear understanding that Republicans never meant what they said.

Even conservative action groups who have their roots in the Tea Party movement but remain unimpressed by the Republican effort are ready to leave the quagmire Republicans have made of health care in the age of Trump and move on to other important things like tax reform.

Republican’s credibility is on the line with the AHCA. While the bill may be far from perfect, a failure to pass the bill will likely set in motion a contagious unconfidence in the party in power. Critical tax reform is next on the agenda, and two more stages in repealing Obamacare are necessary if the AHCA passes. If the health care bill Republicans and the White House have staked their careers on fails, 2018 seems like a sorry uphill battle.

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