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OPINION

5 reasons why health care bill would fail, 3 why it may not

By ALAN FRAM Associated Press Published: August 2, 2017 12:00 AM

WASHINGTON -- There are many reasons why the Senate will probably reject Republicans' bill razing much of former President Barack Obama's health care law. There are fewer why Senate Majority Leader Mitch McConnell might revive it and avert a GOP humiliation.

Leaders say the Senate will vote today on their health care legislation. The latest bill by McConnell, R-Ky., would end penalties Democrat Obama's health care law slapped on people without insurance, and on larger companies not offering coverage to workers. It would erase requirements that insurers cover specified medical services, cut the Medicaid health insurance program for the poor and shrink subsidies for many consumers.

IT FAILS:

Awful Poll Numbers

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In an Associated Press-NORC Center for Public Affairs Research poll, 51 percent supported the health care program while 22 percent backed GOP legislation.

Perhaps more ominously for Republicans, the AP-NORC poll found that by a 25-percentage-point margin, most think it's the federal government's responsibility to ensure all Americans have coverage. That's a growing view.

Awful CBO Numbers

The nonpartisan Congressional Budget Office says under McConnell's plan, 22 million more people would be uninsured by 2026, mostly Medicaid recipients and people buying private policies. For single people, the typical deductible -- out-of-pocket expenses before insurance defrays costs -- would balloon that year to $13,000, up from $5,000 under Obama's law.

Note to the entire House and one-third of the Senate, which face re-election in 2018: 15 million would become uninsured next year. And though CBO says average premiums should fall in 2020, they'll head up in 2018 and 2019.

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Awful Senate Numbers

With a 52-48 GOP majority, the bill would survive if no more than two Republicans oppose it. With the indefinite absence of the cancer-stricken Sen. John McCain, R-Ariz., McConnell's margin of error shrinks to one.

At least a dozen senators have expressed opposition to the legislation or been noncommittal.

Moderate senators from states with vast Medicaid populations want to protect those voters. Conservatives consider it their mission to eliminate the law they've campaigned on abolishing for years.

Presidential Drag

President Donald Trump wants "Obamacare" repealed. He also has public approval ratings below 40 percent -- Bad! -- and a propensity for turning on people.

Just ask House Speaker Paul Ryan, R-Wis., and Attorney General Jeff Sessions.

After Ryan labored for months before the House approved its health care bill and earned a Rose Garden celebration, Trump called the measure "mean." Trump said he wouldn't have picked Sessions for his job had he known he'd recuse himself from investigations into Russian meddling in last year's campaign.

Some lawmakers might not be blamed for declining to carry Trump's water.

Lemons into Lemonade

The bill's rejection would still let lawmakers cast votes showing their positions. Supporters could say they honored their repeal "Obamacare" pledges, foes could say they protected their states or adhered to conservative principles.

Defeat would let the Senate refocus on tax cuts or other initiatives.

A loss means there won't be a GOP law voters might blame for health care problems they encounter.

IT PASSES:

The Unthinkable

This isn't happening, right? Republicans have run on repealing "Obamacare" for years. The administration won't let the effort fail without a fight.

Trump lunched with senators at the White House last week and tweeted that Republicans "MUST keep their promise to America!"

McConnell

The health bill's floundering has tarnished McConnell's reputation as a legislative mastermind. Many Republicans privately say if the votes were gettable, he'd have gotten them already.

But the 33-year Senate veteran is wily and doesn't want his record stained with this failure. He understands what GOP senators need and has time, and if anyone can rescue the legislation, it's him.

Trump Factor

GOP senators cross Trump at their own peril. Eight in 10 Republicans still rate him favorably. In the 2018 midterm elections, when turnout is traditionally down, those loyal voters could make a difference.


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