Let’s start with the obvious fact: Just like in the House, Senate Republicans will fall in line and vote to pass the atrocious healthcare bill that will cost more than 20 million Americans their insurance, gut Medicaid, and give an enormous tax break to the richest people in the country. This is what they do, and any drama around the so-called dissenters is just noise—Mitch McConnell will make a few cosmetic changes, and they’ll fall in line.
Case in point: Ted Cruz was a “no” because there was no provision for allowing insurance companies to offer policies that don’t comply with certain ACA requirements like “mandated coverage of preventive care” and “mental and substance abuse treatment.” Of course, Cruz spun this as offering insurance to more people at lower premiums, which is cynical because what it actually does is “save” money by letting people buy shittier insurance, which in turn leads to more problems, and more expenses, when things go wrong. It’s more “austerity” nonsense designed to benefit the insurance companies. And, of course, it would inevitably lead to a death spiral that makes healthcare exponentially more expensive if you’re actually sick.
It’s a bad idea, and it makes a bad plan worse, but what did McConnell do? He added it in, and now Cruz is a “yes.”
We saw the same farce play out between House moderates and the Freedom Caucus—a conflict that was resolved by making the bill even worse by removing protections for those with pre-existing conditions—and it ended with the moderates getting squeezed because they have no backbone.
And now we’re seeing the same thing happen again. Certain Senators are clucking their tongues, and threatening to stop the bill from coming to the floor. It will end the same way, but what the hell, let’s indulge them and their fake concerns!
So—who’s left? At the moment, we have a handful who are uncertain:
1. Rob Portman, Ohio
Portman got a small token from McConnell with $45 billion to fight the opioid epidemic, which sounds like a lot but is actually like throwing a deck chair off a cruise liner in order to cut weight. In the exchange below, you have to laugh at “we’ll see.”
2. Susan Collins, Maine
She actually seems to care about Medicaid:
3. Shelley Moore Capito, West Virginia
Wants to review the CBO score, again:
4. Jeff Flake, Arizona
Supported the Cruz amendment, but as far as going forward? Stillllll digestin':
5. Rand Paul, Kentucky
Calls it crony capitalism, and may be the one guy who actually sticks to his guns:
The Kentucky lawmaker said the bill hands an additional $2 billion to insurance companies. Paul says he's all for “injecting more capitalism” to save the health care industry, but he won't support “crony capitalism.”
“I'm not willing to subsidize insurance companies. I think that's a terrible thing to do,” he said. “It's crony capitalism and there has to be somebody left in Washington who doesn't believe in crony capitalism.”
6. Dean Heller, Nevada
Originally said he wouldn't support the bill because of Medicaid cuts, and that “it will be very hard to get me to a yes.” This is what a GOP Senator sounds like in a purple state. Today, it's been radio silence from him after the revised version introduced by McConnell.
7. Lisa Murkowski, Alaska
No word from her yet, either, despite McConnell implementing the “Polar Payoff”:
These two grafs are amazing, and show that it’s basically a one-off bribe for a vote.
Changes made to the Republican legislation to repeal large parts of Obamacare would send hundreds of millions of extra federal dollars to Alaska, whose Republican Senator Lisa Murkowski has been holding off from giving her much-needed vote to the bill. Under formulas in the revised legislation, only Alaska appears to qualify for the extra money.
The money comes from the legislation’s $182 billion in funding meant to help stabilize insurance markets and help states provide coverage. Under the formulas, states — in this case just Alaska — with disproportionately higher premiums would get extra funds from that account.
In June, Murkowski said she wasn’t interested in exactly the kind of Alaska payoff McConnell is attempting, but today she said she needs to read and digest the bill before commenting.
8. Lindsey Graham, South Carolina, and Bill Cassidy, Louisiana
I’m grouping these two together because they unveiled their own plan on CNN just minutes before McConnell came through with the revision.
To their credit, it’s less of a tax cut, and saves some protections for people with pre-existing conditions. It does away with mandates, and it gives a lot of money to states at the expense of federal oversight, and it supports Cruz’s “health saving accounts.” But make no mistake: It’s still horrible, even in theoretical form, compared to our current system.
So those are the hold-outs. This post will be updated as they inevitably step in line. Keep in mind that only 50 votes are needed, so there’s still room for two defectors—likely Paul and Collins. But make no mistake—this will end with at least 50 Senators passing the worst legislation of our lifetimes. There is no such thing as courage on the right side of the aisle.