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Did Senate Republicans Knowingly Craft Their Health Care Bill to Fail?

President Trump Meets With Senate And House Leadership At The White HousePresident Trump Meets With Senate And House Leadership At The White House
Tax reform is hard.Pool/Olivier Douliery/Bloomberg—Getty Images

Senate Republicans finally revealed their super-secret healthcare bill yesterday. And while it’s too early to count votes, I’m guessing that it won’t get to 50. To me, though, the more provocative question isn’t whether it will pass the chamber, but rather whether GOP leaders intentionally crafted a bill to fail.

Let me start by saying that this is unadulterated Friday-morning musing—pure Colonel-Mustard-in-the-library-with-the-candlestick conjecture.

That said, here’s the primary motive: Republicans are learning the hard way that “owning” healthcare legislation isn’t fun. Generally, in politics, when someone attaches your name to something, it’s not in a complimentary way: See, for example, “Hoovervilles”—and for the first few years anyway—“Obamacare.” Even President Trump, a man who likes seeing his name on anything, can probably tell that the word “Trumpcare” isn’t often uttered with a smile.

Senator Mitch McConnell, the majority leader, understands this. McConnell is a savvy political wrangler and survivor (see Tory Newmeyer’s great 2014 profile of the fellow in Fortune). And he can masterfully parse the polls, which show that many in his own party, across a big red swath of America, hate this bill and the House bill before it. He can see how poorly it looks on national TV to have wheelchair-bound protestors arrested after staging a “die-in” outside your office. He also knows that in politics it’s easier to attack than defend. The last thing he wants is to have to spend the next few years publicly defending legislation that takes away health insurance from tens of millions of Americans and raises the premiums for tens of millions more (whether he believes in the merits of that legislation or not). In his mind, no doubt, the one appellation worse than “Trumpcare” right now is “McConnellcare.”

Beyond the primary motive is a secondary one: There’s a whole bunch of stuff—tax reform being at the top of the list—that McConnell does want. And he and his fellow GOP’ers can’t get it, or get it quickly, if they face a full-fledged civil war with Democrats in the Senate. Passing the GOP healthcare bill with a 50-50 vote (and a tiebreaking aye from Vice President Pence) would presumably set that war ablaze.

That’s what happened, after all, when Democrats pushed through the Affordable Care Act early in President Obama’s first term. The day after the House barely passed the Senate’s ACA bill—without a single Republican vote—the minority party introduced a bill to repeal it. McConnell, then in the Senate minority, led a fierce, relentless opposition to virtually everything President Obama’s party proposed. So, it’s fair to ask, what he would gain by pushing through health coverage reforms that would not just alienate, but also inflame, his Senate opposition and countless voters.

Next, in our Friday conjecture, we have an alleged weapon, discovered at the scene: McConnell in the Senate Chamber with the candlestick. (It’s always the candlestick.)

Benjy Sarlin at has a terrific and thorough examination of what McConnellcare would do—including cuts to Medicaid that may be more draconian even than what’s proposed in the House’s AHCA bill. But the proffered legislation does something more remarkable: It incorporates provisions that outrage not only the so-called “moderate” Republicans in the Senate, but also infuriates a hard-line conservative faction led by Kentucky’s Rand Paul. (Paul said yesterday the bill “does not repeal Obamacare,” and that he would oppose it in its current form.)

It should go without saying that McConnell (and the cabal of 13 Republican senators, who crafted the proposal behind closed doors for weeks) knew full well the red lines that both groups said they wouldn’t cross. But the bill does a fair amount of line-crossing, and seems even to make a point of it.

Why? Because that gives the Senate Majority Leader a way out of this mess. McConnell gets to claim credit with his base for putting through a (mostly) conservative bill that parallels much of what the House bill does. He can now rush it through a vote and wash his hands of it when it fails. “Hey, I tried.”

And that, at last, gives him and House Speaker Paul Ryan the chance to push through what they really want—tax reform. Now, all they have to do is hope that voters forgive and forget this debacle come the 2018 midterm elections.

Happy weekend, everyone. More news below.


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