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The Mitch McConnell Health Care Follies…Continued

Jul 12, 2017

Back in June, just after Senate leaders released their version of Trumpcare, I asked: “Did Senate Republicans Knowingly Craft Their Health Care Bill to Fail?” My answer to that question then was that, despite seven year’s worth of rancorous rhetoric over Obamacare, a substantial core of GOP senators didn’t truly want to be saddled with owning its replacement—particularly, an unpopular and inadequate one. And rather than continue to waste their dwindling political capital ramming through a massive cut in health coverage that an equally massive chunk of the country says it doesn’t want, they would effectively stage a vote on an unpassable bill, blame everyone (but themselves), and then move on to what they really care about: corporate tax reform.

I still believe that. But Mitch McConnell, the Senate Majority Leader, has introduced a new wrinkle that might appear to undercut the theory. The chamber’s principal has canceled recess—or at least postponed it. Instead of taking the month of August off like the rest of the American workforce (hey, wait a minute…), senators will now have to stay on the job and focus on passing an apparently-revised-but-still-mysterious healthcare reform bill, like it or not.

In short, it’s harder for senators to back away now.

But then, maybe not. In theory, McConnell could achieve the same end by offering up two new versions of the ACA replacement bill Republicans introduced in June, the awkwardly named “Better Care Reconciliation Act.” BCRA-A would satisfy hard-line conservatives by all-but-eliminating a health coverage entitlement; BCRA-B would be a kindler, gentler version that would keep some widely liked Obamacare provisions (such as ensuring affordable coverage for those with pre-existing conditions), trim Medicaid more gradually, and win the support of teetering moderates.

Neither bill, in the end, would likely secure the 50 votes necessary for passage, but the process might give the 52 nervous GOPers in the senate a face-saving way out of this mess.

The idea seems to have gotten enough traction to be whispered about. Whether it will happen depends on how eager Republicans are for a legislative win on taxes by year’s end—and, of course, how badly McConnell’s charges want to go on recess this summer.

This essay appears in today's edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.

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