Senate Once Again Fails On Health Care Reform

Seven years of rhetoric on health care reform ended early this morning with a narrow vote on a bill that even Republicans didn't really support.

congress-healthcare

Just over a month ago, in the wake of a razor thin vote in the House of Representatives in favor of the American Health Care Act, the Senate proposed the so-called Better Care Reconciliation Act, its own version of a bill to repeal and replace the Affordable Care Act. As with the House bill, this bill was created behind closed doors with no committee hearings or public debate of any kind, and no input whatsoever from the opposition party, and, just like its House cousin, it quickly ran into road blocks. Plans to hold a vote on the original bill before the July 4th recess, and thus avoid the possibility of Senators being influenced by angry constituents at town halls back home, fell apart when the Congressional Budget Office released a devasting score for the bill. After that, the bill quickly lost support and was pulled from the floor before the voting process could begin. When the Senate GOP put forward a revised plan that also received a bad CBO score and quickly came under fire. When it became apparent that this revised bill would also fail to get even the fifty votes that the GOP would need to pass under the Senate’s reconciliation rules, Senate Majority leader Mitch McConnell proposed yet another plan that would repeal the Affordable Care Act without actually replacing it with anything, but that plan ended up falling apart after only eighteen hours. Undaunted, the Senate still refused to give up and decided to go forward even though it was unclear which direction they were heading.

All of this led to the absurdity that occurred on Tuesday when the Senate voted to proceed to debate on a bill even though they had no idea what they were voting on. Since then, the Senate voted on proposals that included the original House bill with only a few cosmetic changes, the revised version of the BCRA, and the full repeal-only bill proposed by Texas Senator Ted Cruz. Each of these bills failed to garner even the fifty votes that would allow the Vice-President to break a tie and send something to the House. By that point, the only idea left on the floor was so-called “Skinny Repeal,” under which only certain provisions of the Affordable Care Act would be repealed. In what can only be described as a stunning admission, several Republican Senators admitted that this proposal was not a serious idea and that it would be a “disaster” if it became law. The intention, apparently, was to get the matter to a House-Senate Conference Committee where the two bodies and both parties would try to come up with something that could pass both chambers.

With all of that history, the Senate headed into an all night voting session last night that ended rather dramatically with the defeat of “skinny repeal” and the past three months or so of legislative effort lying in ruins thanks in no small part to Senator John McCain:

WASHINGTON — The Senate in the early hours of Friday morning rejected a new, scaled-down Republican plan to repeal parts of the Affordable Care Act, derailing the Republicans’ seven-year campaign to dismantle President Barack Obama’s signature health care law and dealing a huge political setback to President Trump.

Senator John McCain of Arizona, who just this week returned to the Senate after receiving a diagnosis of brain cancer, cast the decisive vote to defeat the proposal, joining two other Republicans, Susan Collins of Maine and Lisa Murkowski of Alaska, in opposing it.

The 49-to-51 vote was also a humiliating setback for the Senate majority leader, Mitch McConnell of Kentucky, who has nurtured his reputation as a master tactician and spent the last three months trying to devise a repeal bill that could win support from members of his caucus.

As the clock ticked toward the final vote, which took place around 1:30 a.m., suspense built on the Senate floor. Mr. McCain was engaged in a lengthy, animated conversation with Vice President Mike Pence, who had come to the Capitol expecting to cast the tiebreaking vote for the bill. A few minutes later, when Mr. McCain ambled over to the Democratic side of the chamber, he was embraced by Senator Dianne Feinstein, Democrat of California. A little later Senator Amy Klobuchar, Democrat of Minnesota, put her arm around Mr. McCain.

The roll had yet to be called, but the body language suggested that the Trump administration had failed in its effort to flip the Arizona senator whom President Trump hailed on Tuesday as an “American hero.”

Many senators announced their votes in booming voices. Mr. McCain quietly signaled his vote with a thumbs-down gesture.

(…)

The truncated Republican plan that ultimately fell was far less than what Republicans once envisioned. Republican leaders, unable to overcome complaints from both moderate and conservative members of their caucus, said the skeletal plan was just a vehicle to permit negotiations with the House, which passed a much more ambitious repeal bill in early May.

The “skinny repeal” bill, as it became known at the Capitol this week, would still have had broad effects on health care. The bill would have increased the number of people who are uninsured by 15 million next year compared with current law, according to the nonpartisan Congressional Budget Office. Premiums for people buying insurance on their own would have increased roughly 20 percent, the budget office said.

Unlike previous setbacks, Friday morning’s health care defeat had the ring of finality. After the result was announced, the Senate quickly moved on to routine business. Mr. McConnell canceled a session scheduled for Friday and announced that the Senate would take up the nomination of a federal circuit judge on Monday afternoon.

With so many senators in both parties railing against the fast-track procedures that Republican leaders used, a return to health care seemed certain to go through the committees, where bipartisanship and deliberation are more likely.

“We are not celebrating,” said the Senate Democratic leader, Chuck Schumer of New York. “We are relieved that millions and millions of people who would have been so drastically hurt by the three proposals put forward will at least retain their health care, be able to deal with pre-existing conditions.”

Mr. McConnell said he was proud of his vote to start unwinding the Affordable Care Act. “What we tried to accomplish for the American people was the right thing for the country,” Mr. McConnell said. “And our only regret tonight, our only regret, is that we didn’t achieve what we had hoped to accomplish.”

The new, eight-page Senate bill, called the Health Care Freedom Act, was unveiled just hours before the vote. It would have ended the requirement that most people have health coverage, known as the individual mandate. But it would not have put in place other incentives for people to obtain coverage — a situation that insurers say would leave them with a pool of sicker, costlier customers. It would also have ended the requirement that large employers offer coverage to their workers.

The “skinny repeal” would have delayed a tax on medical devices. It would also have cut off federal funds for Planned Parenthood for one year and increased federal grants to community health centers. And it would have increased the limit on contributions to tax-favored health savings accounts.

In addition, the bill would have made it much easier for states to waive federal requirements that health insurance plans provide consumers with a minimum set of benefits like maternity care and prescription drugs. It would have eliminated funds provided by the Affordable Care Act for a wide range of prevention and public health programs.

Before rolling out the new legislation, Senate leaders had to deal with a rebellion from Republican senators who demanded ironclad assurances that the legislation would never become law.

Mr. McCain and Senators Lindsey Graham of South Carolina and Ron Johnson of Wisconsin insisted that House leaders promise that the bill would not be enacted.

“I’m not going to vote for a bill that is terrible policy and horrible politics just because we have to get something done,” Mr. Graham said at a news conference, calling the stripped-down bill a “disaster” and a “fraud” as a replacement for the health law.

Mr. Graham eventually voted for the bill after receiving an assurance from the House speaker, Paul D. Ryan, that the two chambers would negotiate their differences if the Senate passed the legislation.

“If moving forward requires a conference committee, that is something the House is willing to do,” Mr. Ryan said in a statement. “The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan.”

But Mr. Ryan left open the possibility that if a compromise measure had failed in the Senate, the House could still pass the stripped-down Senate health bill. That helped push Mr. McCain to “no.”

Republican senators found themselves in the strange position of hoping their bill would never be approved by the House.

Here’s video of Senator McCain’s vote:

Shortly after the vote, McCain tweeted:

And issued a press statement as well:

“From the beginning, I have believed that Obamacare should be repealed and replaced with a solution that increases competition, lowers costs, and improves care for the American people. The so-called ‘skinny repeal’ amendment the Senate voted on today would not accomplish those goals. While the amendment would have repealed some of Obamacare’s most burdensome regulations, it offered no replacement to actually reform our health care system and deliver affordable, quality health care to our citizens. The Speaker’s statement that the House would be ‘willing’ to go to conference does not ease my concern that this shell of a bill could be taken up and passed at any time.

 

“I’ve stated time and time again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict-party line basis without a single Republican vote. We should not make the mistakes of the past that has led to Obamacare’s collapse, including in my home state of Arizona where premiums are skyrocketing and health care providers are fleeing the marketplace. We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people. We must do the hard work our citizens expect of us and deserve.”

On multiple levels, the circus that came to an end early this morning brought to light several truths that have been apparent for seven years at least. For years, the GOP and the organizations that support it have run on the promise of repealing and replacing the Affordable Care Act, and it proved to be an unqualified success. In 2010, Republicans rode the issue to a historic victory that returned control of the House to the GOP after four years of Democrats being in charge and significantly undercut the Democratic advantage in the Senate. Over the next several years, Republicans in the House passed party-line votes to repeal the PPACA more than five dozen times, all of which died an expected death in the Senate as long as it remained in Democratic hands. While many people mocked these votes from the sidelines, they served the primary purpose of keeping the base, which had been taken over by the so-called Tea Party movement, mollified and making sure that their anger against the Obama Administration, the media, and the so-called “Establishment” GOP was stoked and on maximum. At one point, they even engaged in an utterly pointless and futile government shutdown in what was claimed to be a last-minute attempt to prevent the PPACA from going into effect. While the party was not successful in using the issue to unseat the President in 2012, they did manage to grab control of the Senate in 2014. That led to a 2015 effort to repeal the PPACA yet again, only this time it managed to make it to the President’s desk. The important fact, of course, is that Republicans in both the House and Senate knew that their vote on repeal was meaningless because they did not have the votes necessary to override the inevitable Presidential veto.

At no point during this whole seven-year process did we see any serious proposals from Republicans when it came to the ‘replace’ part of ‘repeal and replace.’ Instead, what we usually saw were vague talking points that hit on themes that have been part of GOP rhetoric on this issues for awhile now, such as allowing health insurance plans to be sold across state lines, tort reform, and the incredibly vague, and largely without specifics, idea of returning to a “free market” health care system that ignored the fact that what existed prior to the PPACA was hardly a free market of any kind. This meant that the GOP was largely caught with its pants down when, to everyone’s surprise including their own, they managed to win control of the White House last November.

Much of this goes a long way toward explaining why the health care “reform” efforts in both the House and the Senate proved to be such utter failures. In both cases, Republicans were confronted with the realization that, this time, they couldn’t just pass a meaningless symbolic bill meant to keep the base happy. This time, all of the responsibility would be on them to actually pass something that would make a system that everyone admits is flawed better while decreasing costs of health care providers, insurers, and most importantly patients while ensuring continued access to high-quality medical care when necessary. Neither the House bill nor the multiple versions of reform proposed by the Senate came close to achieving that goal, and none of them came close to addressing any of the numerous flaws that remain in the PPACA, Medicare, or Medicaid. That led to the desperation of last night, and the absolutely absurd idea of “Skinny Repeal.” In the end, this final proposal was a joke, a fact that was made clear when it became apparent that most of the Senators voting for it were doing so despite the fact that they didn’t actually want it to become law. At the end of the day, Republicans finally revealed that seven years of rhetoric on repealing and replacing the PPACA was nothing more than a way to separate gullible fools from their money and line the pockets of the political professionals behind the so-called “grassroots” Tea Party and the politicians it supported.

Where we go from here is hard to say. For the moment at least, it does appear that the ‘repeal and replace’ effort is dead in the water, but that whole idea has proven to be so central to conservative rhetoric over the past seven years that it’s hard to believe that they’ll abandon it entirely. The only question is whether we see an immediate effort to revive the debate, or whether it’s delayed in favor of concentrating on other issues. As things stand, the current effort can only really survive until the end of September due to the way that reconciliation works in the Senate. Given that, it’s possible that there may be some effort to tie ‘repeal and replace’ to the budget for the new Fiscal Year that could force the Federal Government into a shutdown in October. If that doesn’t happen, then the entire process has to start over again, and who knows how long it might take to pull something workable together again, especially given the fact that we’re closing in on the time when Congress will begin focusing on the 2018 midterms and any deal on health care, or any other issue, will become increasingly unlikely. With all that being said, it’s more likely than not the PPACA will be around for some time to come and that Congress will continue to twiddle its thumbs while the problems with the health care system continue to fester.

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Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. teve tory says:

    A friend who is self-employed was diagnosed with Sarcoidosis 5 years ago. Here’s what he wrote on FB this morning:

    The Affordable Care Act lives. As a result, so do I. And you know what I don’t ever want to hear again? How the two parties are the same. Every single Democrat voted to keep it, all but three Republicans voted to repeal it, with no replacement. I am alive because of the ACA. Without it, I would be uninsurable. So if you actually think there’s no difference, fuck you.

  2. KM says:

    Republicans keep driving the point home: money over lives. The whole point of Repeal Now, Replace Later is to get that sweet, sweet tax cut in for the fiscal year. Spouting lips service about how expensive it is it, they do NOTHING to fix the problem and instead are gonna make it worse.

    The rebelling GOP members has been made aware of the fact that their constituents are kinda pissed. They’d like to keep their jobs and so are willing to work with what they’ve got. The stupider ones are going to be in a for a world of hurt if ACA goes away and those premiums don’t drop (hint: they won’t just like gas prices and airline fees haven’t). A primary challenge is all but assured if they can’t deliver.

  3. Facebones says:

    Hey, maybe it wasn’t such a great idea for Trump to insult McCain repeatedly!

    Maybe the WORLD’S GREATEST DEALMAKER shouldn’t have antagonized McCain’s senate buddy, Jeff Sessions!

    Maybe it wasn’t a great idea to give a drama queen like John McCain an opportunity to get a bushelful of glowing press coverage!

  4. Daryl's other brother Darryl says:

    in·com·pe·tent
    inˈkämpədənt/
    adjective
    1. not having or showing the necessary skills to do something successfully.

  5. Facebones says:

    I’ve stated time and time again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict-party line basis without a single Republican vote.

    This is utter nonsense by McCain. There is absolutely no comparison between the 18 months of hearings and debates Democrats held on this bill, the dozens of amendments that republicans got to add, and the outright begging that Obama did to try and get republicans on board and this travesty of a legislative process, where senators only got to see the bill a few hours before voting on it.

  6. Pete S says:

    I don’t understand Heller voting yes, unless McCain hid his intentions in a “Screw you” moment to his party. I figured Heller being too afraid to stand up to his party and good for a yes and the vote would be 50-50. But being the 49th yes vote makes no sense at all.

  7. Scott says:

    A couple of things I know:

    This is not the end. This is zombie legislation.

    Democrats better be fast with draft legislation to repair and improve the ACA.

    Insist on holding hearings starting immediately (actually after break)

    Democrats better be better at defending the ACA.

  8. Moosebreath says:

    When I heard McCain was the 51st vote to oppose the skinny repeal, my jaw hit the floor. The differences between his fine speech earlier this week and all of the other votes he cast this week were so enormous, that I cannot imagine why he did that (not that I am complaining).

    Perhaps he felt that Ryan’s assurance that the skinny repeal would not be voted on meant nothing, and Ryan’s hand was going to be forced by the Freedom Caucus.

  9. Kylopod says:

    McCain said:

    “I’ve stated time and time again that one of the major failures of Obamacare was that it was rammed through Congress by Democrats on a strict-party line basis without a single Republican vote.”

    This is such nonsense. Dems spent months trying to woo Olympia Snowe. They accepted hundreds of Republican amendments. The reason the law got no Republican votes is that the GOP refused to work with the Dems, not the other way around. Mitch McConnell all but admitted the strategy outright in 2011:

    We worked very hard to keep our fingerprints off of these proposals. Because we thought–correctly, I think–that the only way the American people would know that a great debate was going on was if the measures were not bipartisan. When you hang the ‘bipartisan’ tag on something, the perception is that differences have been worked out, and there’s a broad agreement that that’s the way forward.

    In other words, the failure to get Republican votes was entirely the GOP’s doing. To place the blame on Democrats is like criticizing someone for being wet when you were the one who pushed them in the water.

    McCain did the right thing in the end, but I have a hard time taking his criticisms seriously after he voted for the full repeal-and-replace bill just a couple of days ago, which would have done far more damage than the “skinny” bill he torpedoed. His understanding of the issue doesn’t seem to extend much further than his odes to bipartisanship, as if that lies at the heart of the bill’s problems and not, say, the party’s bankruptcy of ideas. It reminds me a little of that moment in 2008 when the debate moderator asked McCain what he’d do to help bring the nation out of the financial crisis, and he immediately started talking about cutting down on earmarks. He has a remarkable habit of getting so invested in his own obsessions he fails to see the forest for the trees.

  10. michael reynolds says:

    @Pete S:
    Steve Wynn (Casino owner) threatened him and Heller caved.

  11. Facebones says:

    @Pete S: He’s more afraid of a primary challenge from a wingnut. Remember, he’s from the state where they though Sharron “barter chickens for medical services” Angle was a legit senate candidate.

  12. michael reynolds says:

    My position from the start of Obamacare has been:

    1) It’s a bit of a hot mess, but it was the best anyone could accomplish at that point.

    2) Once health insurance came to be seen as a right, and landed in the government’s in-box, they’d never be able to get rid of it.

    Even allowing for a Republican Congress on some kind of bizarre suicide mission, Obamacare remains the law of the land. It was the best anyone could accomplish at that point, and healthcare is now seen as a right.

  13. James Pearce says:

    At the end of the day, Republicans finally revealed that seven years of rhetoric on repealing and replacing the PPACA was nothing more than a way to separate gullible fools from their money and line the pockets of the political professionals behind the so-called “grassroots” Tea Party and the politicians it supported.

    This whole endeavor reminds me of the movie Leaving Las Vegas. Republicans are determined to drink themselves to death, and when challenged on why, they can only offer a weak, “I don’t remember.”

  14. Facebones says:

    @michael reynolds: I completely agree. I would rather have Canadian style health care, but there is no way that passes a senate where you need Joe Lieberman or Max Bacchus to break a filibuster. Obamacare has done a great job of getting people coverage. It would be doing even better if Republican governors were more interested in helping their citizens than sticking it to the black guy by turning down the Medicare expansion money.

  15. Scott says:

    Once health insurance came to be seen as a right

    Healthcare is a right is still a tentative concept. That’s another rock that has to be pounded until it is not longer a topic to be debated.

  16. Kylopod says:

    @Scott:

    Healthcare is a right is still a tentative concept. That’s another rock that has to be pounded until it is not longer a topic to be debated.

    I imagine that if you did a poll asking “Is health care a right?” you’d get a lot fewer respondents saying yes than if the question were “Should the government guarantee that everyone has health care?” Both assertions lead to basically the same outcome, but they come from a different philosophical vantage point, and the fact that people are reluctant to include health care in the same category as the right to free speech or due process doesn’t bother me too much. That’s a level of abstraction that, at least for present purposes, I don’t think makes a huge difference.

  17. Gustopher says:

    About the title… the Senate didn’t fail. McConnell failed.

    You could argue that the Republicans failed, if you wish to view them as a single entity without different needs and agendas (which is, honestly, mostly true). The Republican leadership certainly failed.

    But, holding a vote, and ceding to the majority of the votes — that’s what the Senate does, and it did so again, successfully.

    The Senate as a whole did fail to follow any of the norms and procedures that have been built up over hundreds of years. Writing a bill over lunch and voting on it that day is the type of thing we expect from the House, not from the World’s Greatest Deliberative Body (TM), and a majority did put up with that.

  18. DrDaveT says:

    Senate Once Again Fails On Health Care Reform

    I’m sorry, but it is shoddy journalism to use the phrase “Health Care Reform” in association with this bill, or anything else the GOP has attempted lately. “Repeal and Replace” is similarly inaccurate. If you’re just going to parrot propaganda, what’s the point of blogging?

    The Senate once again failed to take away health benefits for millions of Americans in order to fund a tax break for the already-wealthy. Calling that “health care reform” puts Newspeak to shame. Using the phrase “repeal and replace” when there is — by GOP admission! — no intent to replace, is also a lie. Why are you quoting lies uncritically?

  19. michael reynolds says:

    @DrDaveT:
    I agree. This effort had absolutely nothing to do with improving health care. It didn’t even try, as evidenced by the fact that Republicans wouldn’t let anyone read it.

    This was an effort based on ideology, a desire to toady Trump, and most basically racist spite.

  20. Scott says:

    @Kylopod: I kind of disagree. I find “is healthcare a right?” to be a foundational question from which all others flow. After acceptance of the right, then the discussion is how to satisfy that right.

    I find it funny interesting that such a direct question is seldom asked by pollsters.

  21. James in Bremerton says:

    Do forgive me, but bless John McCain.

  22. Kylopod says:

    @Scott:

    I find it funny interesting that such a direct question is seldom asked by pollsters.

    A bit OT, but my absolute favorite example of how words can affect poll results came in 2010 when there was one poll in which some of the respondents were given the question “Do you favor or oppose gay men and lesbians serving in the military?” while others were asked “Do you favor or oppose homosexuals serving in the military?” Of those who received the first question, nearly 20% more responded favorably than among those who received the second question. I’m still scratching my head about that one.

  23. Daryl's other brother Darryl says:

    @James in Bremerton:
    Murkowski and Collins showed much bigger balls than McCain did.

  24. James Pearce says:

    @michael reynolds:

    racist spite

    It’s not the 7 years of backing themselves into a corner? It’s just the old standby?

  25. Flat Earth Luddite says:

    @Daryl’s other brother Darryl:
    Agreed. Big brass ovaries… thank you to both of them. Wonder if Sen. McCain would have voted the way he did without their pathfinding

  26. DrDaveT says:

    @Scott:

    I kind of disagree. I find “is healthcare a right?” to be a foundational question from which all others flow.

    I don’t think that’s a productive way of approaching the policy question. There are lots of things that are not rights but that government can and should ensure. Public highways and streets are not a right; sewer and sanitation systems are not a right; public education is not a right — not in the way that life, liberty, and equal treatment under the law are deemed to be rights.

    And yet, it is to the benefit of all in the long run to provide free public education, and free public roads, and highly-subsidized clean water to everyone. I consider healthcare to be in this category — something that a sensible society will of course want to provide to all, because everyone benefits in the long run and it’s the humane thing to do in the short run.

  27. Kylopod says:

    @Daryl’s other brother Darryl:

    Murkowski and Collins showed much bigger balls than McCain did.

    I don’t think any of them showed balls. I think from the start McConnell absolutely intended to get exactly 50 votes, no more, no less, and they all understood that. Several Republican senators would have liked to get into that cherished “no” group, but there was only room for two, and I’m sure a major part of the negotiations involved deciding which two senators would ultimately get that privilege. There was previously no indication that McCain was one of the senators fighting for a spot. Murkowski and Collins were always obvious choices, as they’re among the most relatively moderate of current GOP senators. So I get the feeling McCain’s defection was a stunt pulled at the last minute.

    Exactly 69 years before this Wednesday, President Harry Truman issued the order desegregating the army. Now that‘s what I call ballsy, especially since it nearly cost him the presidency.

    None of these current senators have balls. They’re politicians, and they don’t all have the same incentives, but that shouldn’t be confused with courage.

  28. Not the IT Dept. says:

    I think it came down to McCain seeing how quick the POW-hero-gets-brain-cancer feel-good news coverage flipped to hypocritical-politician-votes-to-kill-medical-coverage-for-other-brain-cancer-patients coverage and decided if he died tomorrow he’d rather be remembered for the former rather than the latter.

  29. michael reynolds says:

    @James Pearce:

    You’re confusing cause and effect. The racist spite of the base is the reason for the seven years of lies. The GOP made absolutely zero attempt to fix anything to do with health care and yet proceeded with a burning passion to attack Obamacare – a policy which had its roots in the Heritage Foundation and Mitt Romney’s Massachusetts care.

    If this were not about racist spite we’d have seen an actual bill. If this were about healthcare we’d have seen an actual bill. If this were about anything other than idiot libertarian ideology and contempt for that negro named Obama, they’d have produced an actual bill.

    You will never understand politics in this country without understanding motive.

  30. Daryl's other brother Darryl says:

    @Kylopod:

    Now that‘s what I call ballsy

    Well, yeah.
    But everything is relative. Compared to their male counterparts in today’s Senate…they showed they have bigger balls.

  31. Monala says:

    @Kylopod: “gay people” describes them as people who happen to be gay but still deserve respect. “Homosexuals” reminds a lot of folks of the sex lives of gay people, which they might find icky.

  32. Just 'nutha ig'nint cracker says:

    @Kylopod:

    So I get the feeling McCain’s defection was a stunt pulled at the last minute.

    I suspect you’re right, but I’m responding to the calls of my better angels at this moment and so I thank the Senator for finding his soul and principles–even if it probably is only a one time thing.

  33. teve tory says:

    @DrDaveT: I agree. “Senate narrowly fails to throw millions off health care, kill thousands.” would have been objectively accurate. In no sense was this a ‘reform’.

  34. teve tory says:

    @DrDaveT:

    I don’t think that’s a productive way of approaching the policy question. There are lots of things that are not rights but that government can and should ensure. Public highways and streets are not a right; sewer and sanitation systems are not a right; public education is not a right — not in the way that life, liberty, and equal treatment under the law are deemed to be rights.

    And yet, it is to the benefit of all in the long run to provide free public education, and free public roads, and highly-subsidized clean water to everyone. I consider healthcare to be in this category — something that a sensible society will of course want to provide to all, because everyone benefits in the long run and it’s the humane thing to do in the short run.

    Well said. I wouldn’t say it’s so much a “right”, as “the richest society in history shouldn’t let citizens who are born poor die in the street so that Charles Koch’s grandkids can inherit 45 billion dollars instead of 42 billion dollars.”

  35. al-Ameda says:

    Only 3 Republicans deigned to vote ‘no.’
    Republican ‘moderates’ like Senators Heller and Graham were an inspirational profile in courage. Basically, this was how it went down for them:

    ‘moderate’ GOP senator: “This bill is terrible”
    Normal observer: “So, you’re vote will be ‘no’ then.
    ‘moderate’ GOP senator: “I’m voting ‘yes’ and I’m hoping that the The House does not pass it, that it won’t become law.”
    Normal observer: “ummmm …. okay”

  36. James Pearce says:

    @michael reynolds:

    If this were not about racist spite we’d have seen an actual bill.

    Right, and if aliens hadn’t given our ancestors advance technology, we couldn’t have built the pyramids.

    Point being, you’re looking at this to see how it fits in with your theory.

    This is closer:

    If this were about healthcare we’d have seen an actual bill.

    This is about the GOP having no vision other than generating content for the right-wing entertainment complex.

    If this was about race, why did 3 Republicans from the whitest of our states kill the bill?

  37. Blue Galangal says:

    @Just ‘nutha ig’nint cracker: John McCain has often and frequently disappointed me, most recently with the MTP vote. But now I wonder – especially given that he clearly doesn’t give two crackers for Ryan’s assurances and Lindsey Graham was right up there with him (and I think would have voted no if McCain hadn’t been all, hey, let me take the bullet for you) – if he voted for the MTP and then fired his shot across the bow with the follow up speech. That might have signaled his intention to not vote for the actual bill, only the “Senate order” to allow debate.

    Then again, maybe the bad press got to him. Who knows.

  38. teve tory says:

    If this were not about racist spite we’d have seen an actual bill. If this were about healthcare we’d have seen an actual bill. If this were about anything other than idiot libertarian ideology and contempt for that negro named Obama, they’d have produced an actual bill.

    You will never understand politics in this country without understanding motive.

    I live (again, sadly) in the Deep South. I’ve lived in Florida, Georgia, Texas, and North Carolina. If you don’t understand the deep fear and loathing white people have for black people, half the things that happen in politics won’t make sense to you.

  39. teve tory says:

    @al-Ameda: “Only 3 Republicans deigned to vote ‘no.’
    Republican ‘moderates’ like Senators Heller and Graham were an inspirational profile in courage. Basically, this was how it went down for them:”

    Heller’s opponent is already putting out statements explaining that Heller voted to throw thousands of Nevadans off their health care.

    This bill, this process, this vote, was truly one of the stupidest sequences I’ve ever seen in American politics. McConnell and Ryan done fucked up.

  40. 1 says:

    @Kylopod: For months you’ve been saying that these votes would come down exactly 50/50, with only two Republicans voting nay. None of these votes have been 50/50, and more than 2 Republicans have voiced opposition to the different proposals. Different numbers have opposed bills for different reasons. You need a new theory.

  41. teve tory says:

    If this was about race, why did 3 Republicans from the whitest of our states kill the bill?

    Because the more black people are around, the more racist the white people act. This is really basic stuff.

    There are like 11 black people in Washington State. People aren’t very racist there. The states with the highest African American populations are Mississippi, Louisiana, and Georgia, and white people there are racist as all hell.

  42. Kylopod says:

    @Monala:

    “gay people” describes them as people who happen to be gay but still deserve respect. “Homosexuals” reminds a lot of folks of the sex lives of gay people, which they might find icky.

    I tend to look at it in terms of the histories of these terms. “Homosexual” goes back to the 19th century when the condition was widely believed to be a mental illness. The word still has a distinctly clinical ring about it. “Gay” and “lesbian” were terms popularized in the 1960s (they’d existed as underground slang for a while before) as part of the original gay rights movement, which was first known as gay lib. So it makes sense why they’d have more positive connotations than “homosexual” (especially given the use of homo as a slur). I don’t know if you remember Superdestroyer when he commented here, but he was always talking about “homosexuals,” never gays or lesbians. The word is not a slur per se, but it seems to have largely fallen out of fashion, supplanted by “gay” and even “queer,” which actually was once a slur but is now the preferred term in academia.

    A few years ago I was reading Elizabeth Drew’s Showdown, a book written in the 1990s about the Clinton-Gingrich battles from that era. Drew is one of these thoroughly mainstream Beltway journalists. So it took me a little aback when the book refers to Barney Frank as an “avowed homosexual” and later Gingrich’s sister as an “avowed lesbian.” It struck me as odd phrasing, since “avowed” is an adjective you normally put next to a controversial or taboo belief system, as in “avowed communist.” Apparently this was considered a normal, professional way of describing these things just 20 years ago.

    Despite all this, it never occurred to me until I saw this poll that “homosexual” and “gay” could elicit such widely differing reactions.

  43. James Pearce says:

    @teve tory:

    Because the more black people are around, the more racist the white people act.

    This strikes me as….forgive me…bullshit.

    The whitest places are also the least racist? Really?

    Black people know better, man.

  44. Kylopod says:

    @1:

    For months you’ve been saying that these votes would come down exactly 50/50, with only two Republicans voting nay.

    Huh? First of all, I don’t recall ever opining on this matter at all until now. (Do you have me confused with someone else?) Second, I was describing what I believe to be McConnell’s strategy or goal for passing the bill. In other words, he wanted to get just enough votes to get it to pass, but not a single vote more, because he recognized how risky a vote it was. Actually, this is about the least abnormal aspect of the whole process. It’s standard procedure in Congress to have individual members vying for a “nay” spot on closely fought items (where once the leaders get the number of votes they need, they let remaining members of their caucus off the hook). This is not complicated.

    Nowhere did I suggest that McConnell would inevitably succeed in getting 50 votes. All I said was that was his goal. This is utterly obvious from what I wrote, to anyone with even minimal reading comprehension skills. Are you on crack?

  45. Jen says:

    @michael reynolds:

    If this were not about racist spite we’d have seen an actual bill. If this were about healthcare we’d have seen an actual bill.

    I’m not so sure about this. The first part of your statement about the base is spot-on. The problem is that Republicans never thought they would have to square that with actual policy.

    Healthcare policy is extremely complex, and Obamacare actually worked off of what could, in the context of healthcare reform, be considered the low-hanging fruit.

    Any changes from this point forward are going to be excruciating. What one group will propose as a fix will hit another group in the wallet. Any Republican–or Democrat, for that matter–who is serious about reforming healthcare knows this. Real cost-cutting measures, like getting pharma costs under control or making costs transparent, or moving away from fee for service, means pain in the form of lost revenue.

    These are reforms worth fighting for. That does not mean they will be easy, and any legislation proposed to fix these issues is going to piss off a number of advocacy groups, mightily.

  46. michael reynolds says:

    @James Pearce:
    No, James, I’m looking at it as a guy who creates characters all the live-long day. Absolutely no one who deals with character on a professional level – psychiatrists, fiction writers, actors – doubts that Trump is guilty and nuts besides.

    People don’t do things for ‘policy’ they do things because of emotional need. Humans are not policy algorithms, they are people who act in keeping with their self-definition, their character (in the fiction not moral sense.) And that, my friend, is why I’ve been right about Trump from the start. He is a character, who acts in-character. A snake eats mice – it’s not about policy, it’s about being a snake.

  47. Barry says:

    Doug, I’m seconding and thirding the commenters who pointed out that ‘Senate Once Again Fails On Health Care Reform’ is wrong. It’s more like ‘Senate once again fails to f*ck over millions for tax cuts for the rich’.

  48. michael reynolds says:

    @James Pearce:

    Here’s what @teve tory wrote: “…the more racist the white people act.”

    Here’s your unsubtle shifting of the goalposts: “The whitest places are also the least racist?”

    Act ≠ Are.

  49. Kylopod says:

    @James Pearce:

    This strikes me as….forgive me…bullshit.

    The whitest places are also the least racist? Really?

    Um…

    Do you know anything about American history?

  50. James Pearce says:

    @michael reynolds:

    And that, my friend, is why I’ve been right about Trump from the start.

    Because you’re a successful fiction writer? I respect and appreciate that, but…

    Also, for what it’s worth…I’m not a Trump supporter. But I recognize his election not as an endorsement of his nonsense, but a rejection of ours. Hence my contrarianism…

    @Kylopod:

    Do you know anything about American history?

    Do you? No doubt you’ve heard of the Great Migration and White Flight.

    Have you heard of the New Great Migration?

    (Hint….black people are not moving to Washington state….)

  51. OzarkHillbilly says:

    @James Pearce:

    This is about the GOP having no vision other than generating content for the right-wing entertainment complex.

    If this was about race, why did 3 Republicans from the whitest of our states kill the bill?

    Exactly what content do you think the right-wing entertainment complex wants??? James, you’re not that Pence…. I mean dense.

  52. michael reynolds says:

    @James Pearce:
    You’re being dense, so let me be less diplomatic: you don’t understand humans, I do. It’s the difference between a phrenologist and a geneticist. You’re looking at skull bumps, I know the DNA of character.

    Trump has never surprised me once because Trump acts entirely in character. He is consistent and predictable. Captain James Tiberius Kirk was a great character because he was so well-drawn and always acted in character. Random Viewer might wonder if Kirk would bone the hot green alien, anyone who understood the character knew that of course he’d bone the hot green alien. It’s not rocket science.

    Reverse engineer that: someone boned the hot green alien. Was it Bones, Spock, Scotty or Kirk? How do we know the answer? By knowing the mind and personality of the characters.

    Very much the same with the more amorphous character of the Trump voter. Survey after survey has pinpointed cultural panic as the largest driver. His voters are not particularly poor, they are particularly right-wing evangelicals, white southerners, older and more rural. Make that a single person – an older, rustic white evangelical in Texas. You don’t think that guy is very likely to be on the racist end of the spectrum? Reverse-engineer a typical American racist and guess what you’ll find: an older, rural white evangelical from the south.

    It’s not policy, it’s not logic, it’s not always even self-interest that motivates people – that’s a more reliable measure in more successful folks – it’s people acting as what they are. That’s what people do.

  53. DrDaveT says:

    @James Pearce:

    But I recognize his election not as an endorsement of his nonsense, but a rejection of ours.

    That’s one hypothesis, certainly.

    Another is that his election is the result of one of the most successful propaganda campaigns in history, going back perhaps to Nixon but certainly to Reagan. I can see failure to counter that as a Democratic failure, but I wouldn’t characterize it as “our nonsense”.

    Of course, it could be some of both. What particular part of “our nonsense” do you think was comparably important to the Limbaugh / Fox News / Breitbart brainwashing of America?

  54. teve tory says:

    When it comes to race, James is in some pretty heavy denial.

  55. Hal_10000 says:

    The dirty little secret is that everyone in the GOP is grateful that McCain killed this awful bill. It would have been a political and legislative nightmare for them. They wanted to vote for it but not have it pass. I’m somewhat reminded of the bailout bill, which the GOP and Dems carefully negotiated so that politicians in swing districts could safely vote against it (only to have Pelosi screw it up on the first pass).

  56. James Pearce says:

    @OzarkHillbilly:

    Exactly what content do you think the right-wing entertainment complex wants???

    Nationalistic, jingoistic ‘Murica dammit BS. That’s what they want.

    Trump’s comments about cops banging heads today taps right into that. Or maybe he’s just prepping for the RaHoWa.

    @michael reynolds:

    You’re being dense, so let me be less diplomatic: you don’t understand humans, I do.

    I understand the difference between fiction and real life. I’m sure you do too.

    And while I take your point, his voters are primarily motivated by opposing us. They don’t have some great agenda, some big idea of how America should evolve in the 21st Century. It’s all trolling middle fingers.

    As for this:

    Reverse-engineer a typical American racist and guess what you’ll find: an older, rural white evangelical from the south.

    I’m not sure anymore. Might be some young millennial who grew up in the Obama era, either sick of social justice rhetoric or steeped in it. I imagine older people have been humbled for decades or they’ve embrace MLK’s dream wholeheartedly.

  57. DrDaveT says:

    @James Pearce:

    And while I take your point, his voters are primarily motivated by opposing us.

    Perhaps. My take is that his voters are primarily motivated by either (1) opposing the caricature of ‘us’ they have absorbed from their preferred media, (2) believing Trump will bring back the mining and manufacturing semi-skilled jobs in their town, or (3) genuine racism, sexism, and/or nihilism. There are the Trumpists who are eager to raid the pizza parlor where Hillary is abusing children, the Trumpists who will believe any promise that means they don’t have to change, and the Trumpists who are eager to regain their privilege.

    Oh, and Trumpists who hate Trump but think they can use him to get their oligarchist agenda through on his watch. I’ve met those too.

    I have not yet met any Trumpists who have even heard of “social justice rhetoric”.

  58. Jim Brown 32 says:

    @James Pearce: My experience? The flavor of racism is different in large vs small black population states. In states with large populations of us–white people are very polite–especially the deep south states of Mississippi, Alabama, and Georgia. In states with fewer of us the white people are more standoffish and not as friendly–you’re far more likely to get double takes if you’re in a white neighborhood in Rhode Island than you’d get in Texas.

    My granddaddy used to describe it this way: “In the North, the whites don’t care how rich you get as long as you dont get too close. In the south, you can get as close as you want but just don’t get to rich.”

    In the civil rights movement of the 60s, some of the most violent riots were in the north and midwest around housing desegregation. The Jim Crow laws of the south were about keeping us as a permanent class of dirt farmers.

  59. Matt says:

    @Jim Brown 32: Well I’m white and I was born/raised in a rural area in the north that had basically one family of blacks and a good number of migrant workers. I ended up moving into the south in my later years. Some years ago home town saw an influx of blacks from Chicago due to the closing of several housing projects. Prior to the influx some people were openly racist but most of it was kept behind closed doors. After the influx people who weren’t really racist began using racist terms to describe the “outsiders” who were nothing but criminals in their mind. I saw people who were fairly open minded make a pretty dramatic swing due to encounters with the criminal element that moved down (which was a tiny fraction of the people). On the flip side I worked with a white dude down here who was absolutely racist. He hated both blacks and hispanics and would rant about them. He moved up to Ohio and no longer has racists rants. He even has a black friend on facebook now. The job was in the service industry and most of the people we served were hispanic or black. Instead of getting angry at the individual he just saw them as a group and that’s how his hatred grew.

    My point? Racism is some complex stuff and there are MANY factors that feed into it. Personally I believe everyone is racist it’s just some of us are better at keeping those tendencies in check. As a species we seem to have a tendency to fall into tribes and skin color is the easiest way to classify tribes.

    EDIT : Your granddaddy was right. Long ago one of my family members was banned from family events until she stopped dating a black man…

  60. James Pearce says:

    @DrDaveT:

    the caricature of ‘us’ they have absorbed from their preferred media

    A lot of times it’s a caricature, yes, but sometimes…it’s not. There are lefties who think white people are soooo privileged they never get shot by police, and then when a blonde white lady gets shot, they get mad that the privileged white lady who was unjustly killed gets all the media attention. These people claim to be proponents of social justice and yet they wouldn’t know social justice if it sat on their shoulder and whispered in their ear.

    believing Trump will bring back the mining and manufacturing semi-skilled jobs in their town

    Pity those people. Seriously. These are the people we should be helping, regardless of skin color or which side of the rural/urban divide they live on. There is this calcified idea that these people will never vote for us, so screw em. They just voted for a philandering, vulgar liar who is actively conning them, but they won’t vote for us?

    My, how little confidence do we have in ourselves….

    genuine racism, sexism, and/or nihilism.

    I’ll not deny that genuine racism and sexism exists and that Trump appeals to racists/sexists. But the left’s credibility on both racism and sexism has taken a tremendous hit in these Obama/Hillary years. Apparently, the got the idea that the left’s agenda is self-evidently perfect and cannot be legitimately criticized or opposed except by sexists and racists, and that’s such ridiculous bunk.

    And yes, we’ve had a resurgence of “genuine” racism/sexism, not in good ole boy hillbillies down south, but in young people, many of them on the left.. I mean, lefties of good intention should be embarrassed when they proclaim they’re only reading women authors this summer, but they’re proud. Do they not know they’re being sexist? Does coming up with spurious reasons to justify your prejudice actually ennoble your prejudice? Does the left really need their own “Lost Cause” mythology?

    Count me out.

    @Jim Brown 32:

    My experience? The flavor of racism is different in large vs small black population states. In states with large populations of us–white people are very polite–especially the deep south states of Mississippi, Alabama, and Georgia. In states with fewer of us the white people are more standoffish and not as friendly–you’re far more likely to get double takes if you’re in a white neighborhood in Rhode Island than you’d get in Texas.

    This roughly comports with accounts I’ve heard of other people’s experiences –that is, people who are not white liberals living in white neighborhoods.

    I mean, there’s something to be said for the wisdom of crowds. A busy restaurant, despite the wait, may have better food than the empty one. The fact that there are almost 10 million black people living in GA and less than a quarter million living in WA says something. It says “the food is better,” so to speak, in GA.

  61. SC_Birdflyte says:

    @teve tory: Thank you for including me (cousin of Jimmy Carter and Berry Gordy, Jr.) in your broadside. My wife also sends her thanks.

  62. Kylopod says:

    @Jim Brown 32:

    My experience? The flavor of racism is different in large vs small black population states.

    Agreed. I’m a white guy who grew up in a largely black neighborhood in Baltimore, and I traveled heavily around the country as a kid and teenager. I’ve visited every major region, and I’ve probably been in the majority of states. (My dad, partly through business trips we used to hitch onto, has been to all 48 contiguous states.) If you’re a white guy from Montana who seldom sees black people in your regular life, it may predispose you to view them as an alien species, but it’s a different variety of racism from a white guy in Mississippi whose grandparents use the N-word and who regularly sees the Confederate Flag.