Here is the core problem with the Senate Republican health care plan: it is all about politics, not health care.
The bill exists primarily to deliver on a promise Republicans campaigned upon continuously since 2010: "We will repeal and replace Obamacare!" Arguably, the GOP now controls both houses of Congress because they successfully scared voters by demonizing the Democrats' Affordable Care Act. The irony was that the ACA was based on a Republican health care model developed by a conservative think tank in the 1990s and implemented in Massachusetts by Republican Gov. Mitt Romney.
Having won the White House in 2016, Republicans felt duty-bound to follow through on their promise to axe Obamacare. Since, in all their years of complaining, they failed to develop a comprehensive alternative plan, they quickly threw together an incoherent legislative mess that is not only deeply unpopular with voters, but is unacceptable both to moderate Republican senators who think it is far too harsh and hardline conservatives who want it to be even more miserly.
They find themselves in this untenable position because, in recent decades, the Republican Party has become tightly harnessed to a militant anti-government ideology that defines compromise with liberals as traitorous and that punishes GOP elected officials who stray too far from the dogma that government can never do good. As a result, there are only a few brave men and women in the party who remember that "Republican" has not always been synonymous with belligerent, anarchic libertarianism.
One reason the Senate health care bill failed to come to a vote this week was because several traditional Republicans — both senators and governors — refused to give their support to a terrible package that would cause 22 million Americans to lose health coverage, spike deductibles and insurance premiums for millions of middle class folks and do nothing to control the growing distortions and inequities in the insurance market.
One of those honorable Republicans, Ohio's Gov. John Kasich, went to Washington to personally lobby against the legislation. He called it "unacceptable," an awful scheme that would victimize poor and mentally ill Americans while giving huge tax breaks "to people who are already very wealthy." His concerns were echoed by Nevada Gov. Brian Sandoval, Massachusetts Gov. Charlie Baker, Alaska Sen. Lisa Murkowski, Maine Sen. Susan Collins and a handful of other principled Republicans.
In stark contrast, there is Mitch McConnell's politically expedient hypocrisy. Seven years ago, the Kentucky senator excoriated Democrats and the Obama administration for the bare-knuckled way they pushed the ACA to final passage. However, now that he is majority leader, Mr. McConnell's secretive, rushed, take-it-or-leave-it approach to writing the Senate health care bill makes President Obama and congressional Democrats look, in comparison, like polite Cub Scouts.
Especially galling is the contrast between Mr. McConnell's cynical, heartless health care proposal and the pitch on the same issue that he made to voters early in his career. In a 1990 campaign ad, a much younger Mr. McConnell tugged at the heartstrings of voters by describing how, as a boy, he had been stricken with polio and how his parents "almost went broke" paying for the costs of his treatment. Back then, Mr. McConnell pledged that he would work to get "decent, affordable health care" for his constituents, because "you don't have to be a doctor to deliver health care to Kentucky."
Today, Mr. McConnell is doing all he can to take away decent, affordable health care from working class folks like his parents, not just in Kentucky, but all over the country. Fortunately, there is still a small but politically potent cadre of Republicans with generous hearts and a sense of decency. It is they who will make it difficult for Mr. McConnell to play politics with the lives of millions.