AHCA Passes The House, But Can It Pass The Senate?

Earlier this spring, House Republicans punted on the Obamacare repeal-and-replace vote, tabling the American Health Care Act (AHCA) after too many conservatives announced that they would not support the bill. On the second attempt, the AHCA passed muster in the GOP-controlled House of Representatives, winning a tight 217-213 vote that saw 20 Republicans side with a unified Democratic Party. Although President Donald Trump triumphantly declared Obamacare “essentially dead” after successfully getting his proposed reform through the House, the controversial bill must still garner a majority vote in the Senate.

The GOP controls the Senate as well as the House, but the AHCA will face a tougher battle in Congress’ upper chamber. Outside Washington, a public battle is brewing over the bill’s more controversial provisions, especially regarding pre-existing conditions and premiums for older citizens. Despite tremendous liberal dismay in the aftermath of the House vote, some left-wing pundits appear confident that the AHCA bill will crumble once its magnitude sets in, driving many Trump supporters to criticize it. 

Already, Democrats are vowing to hold the AHCA bill, which removes many protections enjoyed by consumers, over the heads of Republican incumbents in 2018. While safe district conservatives may comfortably roll their eyes, many Republicans in swing districts may find it tough to justify the predicted effects of the AHCA to angry voters. Analysis of the original AHCA bill predicted gloom and doom for millions of Americans, with the nonpartisan Congressional Budget Office (CBO) reporting that up to 24 million citizens could lose health insurance coverage.

The revised AHCA that just passed in a squeaker has not been reviewed by the CBO, prompting warnings from political observers. This may be intentional: Republican leadership obviously rushed the vote on the Obamacare repeal to prevent the defections they saw ahead of the vote for AHCA 1.0. Quickly, bill-crafters threw in individual provisions to get hesitant Republicans on board… but did not wait for analysis on whether or not those provisions would cause any real improvement to the CBO’s initial analysis.

Trump and his friends may have been able to rush House Republicans to vote, but there is little they can do on that front in the Senate, which allows unlimited debate on bills. Senate Republicans have already indicated that they are less than thrilled with the House version of the AHCA, and will likely try to significantly alter the bill to avoid a Democratic filibuster. Senate Dems can run out the clock on the bill until more and more moderate Republicans begin to heed the CBO’s warnings.

Republican Senators in swing states will be especially vulnerable if they vote in favor of the AHCA and constituents begin losing healthcare coverage. How many are willing to take that risk in order to appease the most controversial President in modern times? Unlike members of the House, Senators are supposed to take a longer-term view of public policy, including a time when Donald Trump no longer roams the White House. Given that every other industrialized nation currently has universal health care, logic and math indicate that it’s going to be tough for U.S. Senators to explain their support for the AHCA twenty years from today. In terms of Western culture, it is hard to argue that the current version of the AHCA is anything but a step backward.

And you can bet your bottom dollar that Democrats will be engaging in a massive campaign to persuade every voter of that fact. As evidenced by the recent emotional appeal of popular television host Jimmy Kimmel, it looks like the GOP is going to lose the culture war over healthcare reform. Thus far, no conservative appears to have come up with a better argument for repealing Obamacare besides vague accusations that it “kills jobs” and forces people to purchase health insurance against their will.

Saying “I don’t want to pay for your health care” lacks the emotional weight of the countless stories about hardworking Americans, or innocent children, who face illness, permanent injury, or medical bankruptcy. While many Trump supporters, full of populist fervor and indignation, may still claim to favor the Obamacare repeal today, they will likely feel differently tomorrow when they remember that their uncle, cousin, niece, or friend will face sky-high premiums due to their pre-existing conditions.

And while Democrats don’t have the resources to saturate every Republican-controlled House district with political ads pointing out that the AHCA’s human cost will be vast and touch almost everyone, they can do so in every Senate contest with a Republican incumbent. And, with only 1/3 of U.S. Senate seats coming up for a vote every two years, liberals will have more than enough time to raise money to ding the GOP in 2018, 2020, and 2022. Basically, every Republican Senator must vote for the AHCA bill at his or her own peril, knowing that a tough and determined Democratic challenge will await them at re-election time.

If you thought liberals were ready to go to war over Betsy DeVos, you ain’t seen nothing yet!

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