The Perils of Obamacare

Pearl White in an installment of The Perils of Paulline (1914), via The Hooded Utilitarian.

If you're counting how many lives or near-death experiences the Affordable Care Act has, like a cat's, I think you can say the current one is over, judging from the response of our distinguished Senators, like Jerry Moran of Kansas:

“What I would say is it doesn’t matter that much in the Senate, because we’re going to start from scratch,” Moran, a Kansas Republican, said Friday after he briefed University of Kansas Medical Center researchers on National Institutes of Health funding increases. (Kansas City Star)

I love that little touch of noting that what Moran was in Kansas City KS for was the very opposite of trying to take away everybody's health care—he was taking credit for bringing home some pork. And I mean that in the most positive sense; the kind of pork that can be openly proclaimed, like research funding in a local institution, is a cornerstone of good politics, and the holier-than-thou Republicans who got rid of earmarks in 2010 were attacking democracy (some Republicans understand that, and tried to reinstate earmarks in November, but Ryan shut them down—maybe the idea will be revived this summer). Having nothing to apologize for, he was in better shape than his House Republican colleagues, who mostly seemed to hope that nobody would talk about the tax cut health care bill passed yesterday.

Not one of the 217 House Republicans who voted for the bill was willing to go on Joy Reid's MSNBC show to defend themselves, and Greg Gianforte, the Republican candidate to replace Ryan Zinke, the new Interior Secretary, as Montana's single representative, has been caught in flagrante trying to conceal from Montana voters the fact that he expressed support for it, in a meeting with some of them Washington DC lobbyists. I hear there are not going to be many town halls for Republican House members this recess, and today's with Raul Labrador (R-ID) demonstrates why:

"You are making a mandate that will kill people," said a woman who stood up and challenged the Idaho representative over the newly passed bill.

Labrador responded bluntly saying, "That line is so indefensible...Nobody dies because they don't have access to health care."

Because out in the rugged West folks usually do their own surgery—it's not that different from dressing an elk—and grow their own drugs.

Tennessee Senator Lamar Alexander, who chairs the committee (Health, Education, Labor, and Pensions) that will do the drafting, confirms that the Senate will never vote on the House bill:

We will write it, find out what it costs, vote on it, and then we’ll compare our bill to the House. And then they’ll pass our bill or we’re going to go to a conference committee. (Tennesseean)

And the White House deputy chief of staff, John Dearborn, came out this afternoon to say that the Senate will not draft its own bill—

I don't think there's a start from scratch. Will there be some changes? Of course, the Senate is a different animal than the House. But I think we feel really good where we are. There's a proposal that will now go the Senate. (ABC News)

—which, given that this is the Trump White House, is virtually proof that the Senate will.

I think it's pretty clear what yesterday's vote on the so-called American Health Care Act was about, and it wasn't, at least not directly, about repealing and replacing the ACA at all; it was about getting a 100th Day present for Donald J. Trump.

The Emperor being pissed off and distressed, obviously, by the publicity according to which he hasn't accomplished anything in his 100 days, the executive orders being basically theater, as is now increasingly recognized, as David Waldman says:

 Over and over, the White House takes some issue that Trump has promised to aggressively act on, and then issues an executive order that studies it, examines it or investigates it but doesn’t actually do anything about it

—except when it actually does do something and then the courts have to shut it down because it's something presidents aren't permitted to do. And the only legislative action being that budget stopgap resolution to prevent a shutdown that seemingly neglects every one of his "issues",  not funding the Greatness Wall or punishing the "sanctuary cities", but providing funds for the NEH. NEA, and cost-sharing subsidies for the Affordable Care Act/, etc. Which have made him feel like he worst thing of all, a loser.

What he wanted is some way of saying he was a winner before he went off for his long weekend and before the hundred-days moment was over, and people who work with him understand that at that level of psychopathy, the patient doesn't necessarily have to get what he wants but will be satisfied if everybody's willing to pretend he got what he wanted. This is why it was such a terrible bill in the first place, as Steve was explaining yesterday, because it didn't really matter (only the fool members of the Freedom Caucus didn't understand this, so they had to be placated by the worst provisions).

He had no idea what was in bill in any case, as he demonstrated in the interview with John Dickerson, and later when he praised Australia's health care system  (Australia provides universal and extremely high-quality health care at about half the cost per person of the US system in what's not a single-payer system—government pays most of the costs out of general revenue, but there is a designated Medicare levy in the income tax and a pretty high cost sharing requirement for patients, 17% of the total bill. Bernie Sanders is wrong to call it a single-payer system, but he's right to suggest that yes, it's better than ours and completely different from anything Trump and/or the Republicans have to offer.) The responsible parties knew there would be no need to literally pass a health care bill that would do any sort of job for the American people, because that's not what the Emperor needed. What he really wanted was the triumphal party he got yesterday.

Which is why it was held (it was noticeable that the Republican caucus needed to down a few beers in the Capitol—Bud Lite, we're told—before taking the bas over to the White House).

This is not to say the ACA is preserved—the Senate bill will be out in a few months, perhaps, and it won't be the Australian plan—but what happened yesterday was literally nothing. It was just another cliffhanger ending, maintaining the reality-show suspense, and most importantly keeping the host of the show stable for the time being.

Cross-posted at The Rectification of Names.