NOTE: The post below, the electronic version of my Sunday AJC column, incorporates some portions of posts published earlier on this blog.
It shouldn’t be a surprise that House Republicans found it impossible to pass a health-care “reform” bill that gutted Medicaid by cutting $880 billion, that pushed an estimated 24 million Americans off their health insurance plan with no replacement, that hit poor, elderly and rural Americans hardest and that hands most of an $880 billion tax cut into the hands of wealthiest Americans.
For many Americans, the surprise was why it proved so tough. They watched as Republican leaders failed to corral Republican votes for a Republican bill to keep a Republican promise to the Republican base. And why? Because in the eyes of many of those Republicans, the bill simply was not mean enough. It didn’t cut enough, it didn’t punish enough, it didn’t do more to make the vulnerable and fragile in our society even more vulnerable and fragile.
That’s the part that gets to me. More importantly, I think it now gets to the American people as well.
For seven years, as Republicans repeatedly promised to repeal and replace Obamacare, they intentionally created a broad public expectation that when they finally revealed their replacement, it would be an improvement, that it would somehow cover more people at lower cost with lower deductibles. Out of sheer political calculation, they pretended to accept the principle that in a decent modern society, people should not be denied basic health care because they lacked the money to buy it.
A lot of the time, that promise was explicit.
“You’re going to have such great health care at a fraction of the cost, and it’s going to be so easy,” as Donald Trump put it on the campaign trail. He also promised that “we’re going to have insurance for everybody,” telling voters that while “there was a philosophy in some circles that if you can’t pay for it, you don’t get it, that’s not going to happen with us.”
But the hard truth is that the GOP never had the slightest intention of fulfilling the lofty expectations it created. The truth is, basic GOP ideology says that health care should be treated no differently than any other commodity in a free market system, which means that if you can’t afford it, then you should get a better job so you can. The House GOP plan reflects that philosophy perfectly.
That explains why, in a new Quinnipiac poll released this week, just 17 percent of American voters said they supported the Republican plan, while 56 percent opposed it. Even among Republicans, just 41 percent supported their party’s plan. On another question, just 33 percent said they want to end support for Planned Parenthood, which is another top GOP goal.
Public support for the gutting of Medicaid, a third top GOP goal, is also minimal. Last week, a gleeful House Speaker Paul Ryan celebrated the plan’s dramatic, $880 billion reductions in Medicaid, telling Rich Lowry of National Review that “We’ve been dreaming of this since I’ve been around ― since you and I were drinking at a keg.”
According to Quinnipiac, just 22 percent share Ryan’s dream of gutting Medicaid. Just 39 percent of his fellow Republicans think it’s a good idea.
Overall, an enormous 85 percent of Americans say it is very important to them that “health insurance be affordable for all Americans,” while another 13 percent call it somewhat important. That’s adds up to 98 percent, yet the thrust of the Republican plan has been to move rapidly in the other direction.
The American people can now see that.