Congressional Republicans failed again to repeal Obamacare last week. To rationalize yet another swing-and-a-miss, President Trump took a novel approach: he invented a hospitalized senator. “We have the votes,” Trump falsely claimed to Fox and Friends, but “we don’t have enough time, because we have one senator who’s a ‘yes’ vote, he’s a great person, but he’s in the hospital.”
This appeared to be an odd spin on the plight of Sen. Thad Cochran, who was forced to publicly clarify that he was not actually hospitalized, but was home recuperating from a “urological issue.” And of course, even with a healthy Cochran, the GOP still lacked 50 votes for its bill, with Sens. John McCain, Rand Paul, and Susan Collins all opposed.
Still, Trump’s fabrication of the hospitalized clinching vote is a fitting coda to the latest GOP healthcare failure. After all, the entire battle against Obamacare has been founded on fantasy.
It was a fantasy that Obamacare was a tyrannical government takeover of the healthcare sector. In reality, it was a modest step to patch up the holes in our ragtag mix of public and private coverage, meant to scoop up most of the people who fell through the cracks and were victimized by the old status quo. Obamacare was such a centrist program that it left the GOP no room to maneuver rightward while still maintaining its popular coverage guarantee for people with pre-existing conditions.
It was a self-delusion that Obamacare was failing or caught in the throes of a death spiral, as Republican leaders like Speaker Paul Ryan like to claim. Every indicator of insurer profitability showed that Obamacare’s marketplaces became a stable, safe place to sell insurance last year. And every government study found that the marketplaces were on firm ground for the foreseeable future. Even Trump’s own Health and Human Services department admitted that the marketplaces were in good shape–but that didn’t stop him from spreading the myth that Obamacare remains on the brink of collapse.
It was masochistic wishful thinking to believe that Obamacare was sowing ruin in the lives of American families. For millions, the law was quite literally a lifesaver. For the first time, people with preexisting conditions were guaranteed a right to affordable healthcare. People who already had insurance could rest easy knowing that a costly illness or injury wouldn’t bankrupt them, thanks to the ban on caps on insurance coverage. The repeal drive in particular revealed the immense popularity of Obamacare’s Medicaid expansion, and how much people had come to depend upon the law’s protections.
Certainly, Obamacare is not a perfect law. But it was absurd to think that the GOP’s proposals would do anything to fix its flaws. Mitch McConnell, Ryan, and other Republican leaders spent years ripping Obamacare for its high premiums and deductibles–and then turned around and embraced a series of bills that would make those problems much, much worse.
The conservative movement’s “alternative facts” problem well predates Trump. But Trump undoubtedly made the problem worse, normalizing the acceptability of outright lies about policy proposals. Trump’s shameless disregard for the truth made it okay for other Republicans to insist that their healthcare bills would cover everyone and lower premiums–when time after time, the exact opposite was true. In the latest Republican run at Obamacare, it’s what made it okay for Bill Cassidy to lie that his bill guaranteed coverage for people with pre-existing conditions, even though it was clear that it left room for states to kick those very people off of their coverage.
It was this unbridgeable chasm between fact and fiction that ultimately doomed the repeal effort. After being fed fantasies for seven years, average Fox News-ingesting conservatives–like Trump himself–came to believe that Obamacare really was a disaster and that their leaders had actual plans to do better. But as Barack Obama warned Trump after the election, “Reality has a way of asserting itself.” And the gap between healthcare reality and fantasy was massive, sucking the GOP’s repeal plans into the vortex in between.
It has long been clear that Republicans would be unable to produce effective healthcare legislation. And it was predictable that this would all end with the GOP scampering away with a contrived excuse to preserve some dignity to fight another day. That the best apparent excuse involved a non-decisive senator’s urological outlook speaks volumes about the shattered state of that dignity.
Republicans won’t soon give up the ghost of Obamacare repeal. Fantasy or not, repeal has been the party’s central policy goal for seven years. It’s much easier to keep taking potshots at universal healthcare and to fire off Hail Mary repeal bills than it is to rethink what it means to be a conservative in a governing party–particularly with a president void of core principles or long-term policy visions. Right on cue, congressional Republicans are still leaving the door open to take yet another run at Obamacare in 2018, undeterred by their latest face-plant.
For the better part of a decade, Republicans have committed themselves to a policy mission premised on a series of fantasies. It’s no surprise that they’d conjure one more to excuse their failure—a way to cling to the illusion that they’ll grab the brass ring next time.
So they beat on, boats against the current, forever one healthy urinary tract away from the promised land.