First, let’s be clear: “Trumpcare” is a misnomer for the awful legislative proposal that has just hit the dust. Beyond egging the Congressional Republicans on, Trump had nothing to do with their proposal: he hardly knew what was in it, he didn’t understand it, and he didn’t care about its substance. All he cared about was winning. He lost. That is a big deal. It was the first really significant political defeat for Trump as president. May he have many more.
Why were the Republicans, from the president on down, so intent on obliterating Obamacare? One answer is that they had been promising to do so for seven years, and, given the opportunity, felt obliged to follow through. But that begs the question: why do Republicans hate Obamacare? Basically, two reasons:
Obamacare repeal failed because there remain enough genuine conservatives in the Republican Party—often mislabeled “moderates”—who had qualms about the disastrous consequences of shredding the safety net. It was impossible to fashion legislation that could satisfy the extreme radicals in the GOP without alienating the “moderates.” Of course, there was important context to this disunity. Trumpcare was tremendously unpopular, and its unpopularity was manifest in the impressively wide mobilization of ordinary citizens who stood to suffer from its passage. That mobilization ensured that the Democrats stood united in their opposition, while the Republicans couldn’t unite in their support. Yes, democracy does work, sometimes.
So, what happens next? McConnell is saying that he will go ahead with a simple “repeal” bill without even pretending to replace Obamacare. That bill would have no chance of passage.
A more realistic possibility—the most favorable possible development at this point in time–would be for the Republicans to work with the Democrats to fix the legitimate problems with Obamacare. McConnell once hinted at this possibility, but it’s unclear whether he would actually take this course. Congressional Democrats need to come up with a comprehensive set of constructive tweaks to Obamacare and challenge the Republicans to respond.
Another real possibility would be for the Congressional Republicans to take no further action on health care, maybe after a symbolic losing vote for a delayed repeal. Then, the Trump administration might just do its best to sabotage Obamacare, aggravating its problems in the hope of killing it. This ploy might or might not work, but it would disrupt the insurance markets enough to inflict a good deal of hardship on some of the millions of people who have benefited from Obamacare. Undoubtedly, this would be the option preferred by our sociopathic president unless someone convinces him that the political price would be too high.
In short, the defeat of Trumpcare is a great victory for decency, but it was a battle in a war that is likely to continue.