Republican “moderates” and health care

You know how to get labelled a “moderate” Republican.  Pretend like you care about things like health care for poor people before voting otherwise.  It has proven to be a damn successful trick.  Josh Marshall (emphases in original):

As we noted a few weeks ago, the Iron Law of Republican Politics is that the GOP moderates always cave. But the cave is never without a stage managed drama. And that appears to be the part of the story we’re now entering.

Axios just reported that Sen. Shelley Moore Capito is expressing concern over Medicaid cuts in the Senate Trumpcare bill. “I don’t look favorably on it, that’s for sure,” Capito told Axios.


It’s been clear from the word go that taking an axe to Medicaid was the entire point of this exercise, indeed, an inevitable end point given the budgetary priorities. These are beyond ending Medicaid expansion. They’re the starvation diet Republicans put Medicaid on after kicking everyone off their coverage kicks in.

This is sort of a subchapter of what I discussed in my last post about ‘policy literalism’. It is not only that the ‘GOP moderates always cave.’ It is that we are asked to (and almost always do) indulge this fainting couch routine or a furious bout of chin stroking that comes as a prelude to the cave.

If Capito doesn’t get that this was part of the plan all along she’s literally a fool since this has been a publicly discussed goal from the git-go. This is almost to a certainty a safety-net version of what wingnuts now commonly call “virtue-signaling”, in this case a staged demonstration or interlude put on for effect to soften the blow of signing onto the policy outcomes that are frankly unconscionable. In other words, virtue-signaling but virtue-signaling in bad faith.

This isn’t negotiating or putting a foot down. It’s play acting. It is so consistent, routine and predictable that it needs to be reported as such. Much like hiding behind the lack of a legislative text, on the off chance Sen Capito is serious, she should do something to make that clear. Otherwise, it’s just a yarn, just more nonsense to hide the ball and pave the way for the preordained outcome.

Yep, yep, yep.  And it’s not just Capito, of course.

Meanwhile, great take from Greg Sargent on how Republicans’ strategy of secrecy is working and why they need to rely on secrecy:

Unfortunately, there are signs this morning that the Republican strategy is already working precisely as intended.

First, let’s note that the secrecy adopted by Senate Majority Leader Mitch McConnell is explicitly designed to shield the Senate GOP health-care bill from as much debate and public scrutiny as possible. The text of the bill will be available for all of one week before it is likely to be voted upon, after having been drafted in such secrecy that even Republican senators complained that they were being kept in the dark. There have not been, and apparently will not be, any hearings before the vote…

But this rolling scandal doesn’t end there. This compressed schedule is not only designed to limit debate on the bill. As the Journal reports, the vote is being rushed for the express purpose of getting it done before the July 4 recess, because the failure to do so “could open Republican lawmakers up to pressure from constituents,” some of whom might be “concerned about losing their health coverage.” Thus, the schedule is also explicitly designed to shield lawmakers from public exposure and questioning about the immense human toll the measure they are considering could have — before they vote on it. [emphasese mine]

As Brian Beutler has argued, GOP leaders are not merely lying about what is in the bill. They are also lying about the process itself, because copping to what they are actually doing would implicitly admit that their bill — which is very likely to be almost as cruel in its broad strokes as the House bill — cannot survive genuine public debate. This new polling illuminates the point: Republican leaders are willing to endure the public’s disapproval of their efforts to hide the bill from the public (to the degree that they care about that disapproval at all), precisely because those efforts are keeping the public ignorant about what they actually intend to do to our health-care system.


About Steve Greene
Professor of Political Science at NC State

9 Responses to Republican “moderates” and health care

  1. Nicole K. says:

    Yep and that’s why all of the big changes take years to kick in. They probably won’t destroy Medicaid until at least 2020. Some of the moderates want it to be 2025. It’s like they think people won’t realize that the GOP has literally lit a ticking time bomb on their health insurance.

    However one has to wonder if there wouldn’t be a lot of pressure to do something three years from now when people are actually facing the end of medicaid. I’m most worried about the GOP potentially allowing states to go back to offering insurance with caps and coverage limits. That is great for healthy people because they will see much lower premiums. But you’re basically making insurance worthless to people who actually need it.

    • rgbact says:

      “Literally lit a time bomb”. More lefty violent rhetoric…..literally.

      Yes, taking an axe to Medicaid was the entire point. If states want to make up the difference…..they are welcome too. Kudos to moderates for seeing beyond the “free federal money” to understand the fiscal disaster of ACA. Just think Democrats……you now have an open invitation to campaign in West Virginia!

      • Nicole K. says:

        So you don’t think poor people deserve access to the health care system? States do not, and have never had, the ability to fund a program like medicaid. You have either read too many conservative talking points or really just don’t understand the differences in the money that is available to a state government and money that is available to the federal government.

        Do you not know that 40% of medicaid spending goes to take care of disabled people?
        Do you not know that 20% of medicaid spending goes to take care of the elderly?
        Do you not understand that about 1/3 of medicaid spending is for long-term care facilities? (that’s nursing homes and in home nursing care for old people and disabled people.)
        Do you not realize that 1 out out of every 7 senior citizens requires long term care costs in excess of $250,000

        That’s what medicaid pays for. It’s great to say just get rid of medicaid but that’s because you don’t understand that medicaid who actually benefits from it.

        You for some reason don’t understand that health care actually impacts people’s lives. What happens to people when they get sick and can’t get treatment? They suffer and die. That’s not some abstraction as you seem to keep trying to make it.

        I would really love it if you or someone close to you got cancer or a chronic illness. Somehow I really don’t think you’d be such an asshole if this actually had clear consequences to your future wellbeing.

      • rgbact says:

        Now you’re wishing I got cancer. Sheesh. I’ve lost plenty of family to various stuff….I don’t need your wishes for more, thanks. You honestly don’t give a damn that the country is drowning in health costs. You now appear to think the federal government has access to some special stash of money that can pay for all this. They really are magical.

      • Nicole K. says:

        First of all I wasn’t being literal and I think you know that. Second of all every single other wealthy nation manages to provide access to health care for all its people. Telling poor people tough shit is just inhumane and immoral. There is plenty of money to fund healthcare. If you’d pay attention you would know that the huge premium increases are pretty much 100% related to the Republicans destabilizing the marketplace.

        Take NC as a key example. They have made it very clear that they have a handle on costs with their ACA plans. The rate increase without Republicans messing up cost sharing payments would be around 8%. They specifically say that they need around 25% due to Republicans and Trump destabilizing the market by threatening the subsidies. The subsidies are funded by taxes on the wealthiest Americans, and they represent a very small share of their income. If the subsides get cut off then the insurance companies are going to have to pass the cost of insuring poor people – who can’t afford to pay for it themselves- to their middle class policyholders. That is why we are seeing the huge rate increases.

      • rgbact says:

        Sorry, poor people are already covered in a shared responsibility with states. States are free to cover more people at any time if they agree to pay half. If you can;t agree to pay half (like in ACA) then you don’t deserve money from the magic unending federal money tree.

        And despite the NC “success story”, average increases are running at a healthy 13.5% so far. Even NC’s 8.5% is double income growth….ie unaffordable. And sorry, “taxes on the wealthy” don’t cover it. Many of the painful ACA taxes have been delayed…..which causes the deficit to grow even more.

      • Nicole K. says:

        I guess it just comes down to priorities. I think providing health care to the least able to pay for it is a moral responsibility. I think it’s something that is worth paying for because the consequences are people’s health and lives. If you don’t agree that’s an important thing to value, then there is no point continuing to argue with you about this.

      • Nicole K. says:

        The taxes that have been delayed have been due to Republicans preference for an increasing deficit over increasing taxes. Again, it’s another disingenuous argument. The funding mechanism has been created. It’s beyond hypocrisy to claim to care about deficits when you are completely opposed to ever raising taxes. This is especially true when proposing additional tax cuts that will cause increases in the deficit.

  2. R. Jenrette says:

    Nicole – thank you for the discussion and for your clear statements of the basics of the issue. Even more basic is that the health care discussion is between people whose primary concern is preserving their own wealth and status and those whose primary concern is the quality of life of their fellow citizens.

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