What the heck is going on with health care reform?

Six months into Trump’s presidency and Congressional Republicans have fumbled the Obamacare repeal ball four times (by my count).

The rundown:

No one liked the House’s first attempt at Obamacare overhaul (AHCA), so the bill was pulled from the floor at the last minute. Congressional Republicans wait, reintroduce the bill with a few tweaks, it barely passes the House. House Republicans cheer and then the Senate scraps the bill to create their own. Senate Budget Committee works behind closed doors to draft a bill which is only slightly better than the House version but still doesn’t have support to make it to floor debate, much less an actual vote. Finally, leadership caves to clean repeal a la a 2015 bill (which isn’t a clean repeal, but the internet is pretending as much), and then a handful of Republican Senators decide maybe they can’t support ‘clean’ repeal after all. Leadership trots out Libertarian Senator Rand Paul to sell their repeal bid, and Senate Majority Leader McConnell says he’s holding a vote anyway. Trump, annoyed, just wants Congress to get it done so he can move on.

And that brings us to today.

So what the heck is going on?

No one seems to know exactly, not even Senate Republicans.

I’m torn between loving a fractured, independent-minded caucus which, in a perfect world would encourage debate and innovation, and desperately wishing Congressional Republicans were more like their Democratic counterparts, willing to sacrifice small asks in favor of a shared goal.

Regardless, watching the Republican health care reform novella unfold makes it hard to understand why Senate GOP leadership hasn’t attempted getting everyone in the same room to hash out what’s possible for passage. At this point, it’s painfully clear that what’s possible for a legislative success is not what voters were sold in 2012, 2014, or 2016.

It’s the same strategic trap Republicans have haplessly stumbled into for some thirty years now — pressing for radical transformation overnight rather than accepting incremental, possible reforms now. Democrats get this, it’s how they’ve successfully transformed policy across the board in their favor for decades. When the tides turned in their favor granting them large majorities (most recently 2008), Democrats spent a year working on Obamacare before unrolling and shoving it through the legislative process. Even then, Democrats presented a united public front with uniform messaging and talking points.

Why can’t the GOP start with the few items the caucus agrees on, pass that, then move on to the next?

In January of 2012, before he was elected, I interviewed then candidate Ted Cruz. We discussed compromise. What he said then is what the Senate should be doing now:

My view on compromise is the same as Ronald Reagan’s. Reagan used to say, “if they offer you half a loaf, what do you do?” And his answer was, “you take half a loaf and then you come back for more.” I’m interested in moving the cause of liberty forward. So if we are advancing in a positive way, if we are shrinking the size of the federal government, if we are moving towards fundamental tax reforms, simplifying the tax code, moving towards a low uniform rate towards everyone, then I’m willing to compromise and accept less than 100% if we are moving forward. Now I intend to come back and keeping getting it, but I want to affirmatively move the ball forward. The problem is some of the Republicans in Washington compromise, moving backwards.

“Repeal and replace” as it has been sold will not happen. If Republicans can’t accomplish that seemingly simple task (one they voted for repeatedly under the shield of presidential veto these past years) with chamber majorities and the White House at their disposal, it’s never going to happen. So why not focus on the possible? Sure, the possible isn’t sexy, but it’s certainly better than whatever is happening now.

Follow Kemberlee on Twitter @kemberleekaye

Tags: Obamacare, Trump Health Care, Trump Health Insurance

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