Image courtesy of Central-TX10-Indivisible.
Activists opposing the destructive GOP health bill are making undeniable progress in undermining its prospects. It is a truly startling development.
While it is premature to predict TrumpCare’s demise, the signs of oppositional success are unmistakable: several Republicans now say the bill is unlikely to pass the Senate; public surveys show the House-passed bill is very unpopular; support is on the upswing for the Affordable Care Act (ACA) and Medicaid; and congressional proponents of the GOP bill are seeking refuge from their constituents.
Republican Senators Become Doubtful about the Bill’s Passage
Shortly before the Memorial Day recess, Senate Majority Leader Mitch McConnell surprised his Republican colleagues with his less-than-optimistic assessment of TrumpCare’s prospects in the Senate. Leader McConnell, who is typically quite sanguine about bills he is shepherding through his caucus, publicly said he didn’t know how his party will get the requisite 50 votes needed to pass the health care bill.
He is not alone in this confidence-shaking assessment. During that congressional recess, a number of other Republican senators—including Richard Burr (R-NC), Jeff Flake (R-AZ), and Ron Johnson (R-WI)—publicly expressed their skepticism about getting a health bill through the Senate.
Senator Burr, a close ally of Senator McConnell, sits on the key committees with jurisdiction over health care: the Senate Finance Committee and the Senate Committee on Health, Education, Labor, and Pensions. During a local television interview in his home state, he said it is “unlikely that we will get a health care deal.” He added that the House-passed bill is “dead on arrival” in the Senate, and he doesn’t “see a comprehensive health-care plan this year.”
Senator Flake told members of a local Chamber of Commerce that there “are some still saying that we’ll vote before the August break. I have a hard time believing that.” And Senator Johnson, in a radio interview, said “tax reform is an easier lift” than pending health care efforts, and, in a separate interview with home-state reporters, indicated he wasn’t “sure [he] would bet on” a package to repeal and replace the ACA.
Upon returning from the congressional recess, other Republicans also expressed doubts about Senate bill prospects. Roy Blunt (R-MO), a member of the Republican leadership, worried that “I don’t think this gets better over time.” Lindsay Graham (R-SC) said it’s “more likely to fail than not,” suggesting “[w]e need to bring this to an end and move to taxes.”
The Very Unpopular House-Passed Bill
Various public surveys clearly show that the House-passed health bill, the American Health Care Act (AHCA), is very unpopular. Although the surveys differ somewhat in the percentages of the public that oppose the bill, they all concur that the opposition is very strong.
The Kaiser Health Network found that 55 percent have an unfavorable view of the AHCA (with 40 percent expressing a “very unfavorable” view), while 31 percent have a favorable view (with only 12 percent stating a “very favorable” view). Less than one out of ten (8 percent) said they want the Senate to pass the same bill that was adopted by the House.
Significantly, the survey was conducted May 16 to May 22, days before the Congressional Budget Office (CBO), on May 24, released its devastating assessment of the AHCA’s impacts.
Quinnipiac University’s most recent poll, also conducted before the CBO analysis, showed even stronger public opposition to the AHCA. The survey reflected almost three-to-one opposition, 57 percent versus 20 percent. Quinnipiac’s assistant director of the poll commented: “Advisory to Republicans who support the replacement for Obamacare: Backing this bill could be very hazardous to your political health.”
The surveys also demonstrate that one of the last-minute changes to the AHCA, which helped to secure far-right-wing House support, is immensely unpopular. That provision—allowing states to waive a nationwide protection prohibiting insurers from charging higher, discriminatory premiums to people with pre-existing health conditions—receives only scant support. According to the Kaiser survey, only 22 percent of Republicans support this AHCA provision. The latest Washington Post-ABC News poll also reflects lopsided opposition.
Growing Popularity of the ACA
Pertaining to the ACA, the expression “absence makes the heart grow fonder” probably applies to “potential absence” as well. As the Trump Administration and congressional Republicans intensify efforts to repeal the ACA, support for it continues to grow.
A Gallup survey showed that, during the five months since the November elections, support for the ACA grew by 13 percent. At the end of April, a Washington Post-ABC News poll found that 61 percent of Americans favor keeping and improving the ACA, while only 37 percent favor repealing and replacing it. That growth in support is likely to continue as families across the country learn that a repeal may jeopardize their health coverage.
The most recent Kaiser Health News survey shows why support for the ACA has grown. It reflects growing public pessimism that repeal of the ACA, especially via the House-passed bill, would improve their cost of care, their ability to get and keep health care coverage, and their ability to retain quality of care.
The Public Wants to Protect the Safety-Net Medicaid Program
The most significant Republican cuts in coverage target the safety-net Medicaid program, which now serves over 70 million low-income people. CBO estimates AHCA would terminate program coverage for 14.4 million people, most of whom would become uninsured. The coverage losses would occur by rolling back the ACA’s program expansion and by reducing federal support to state Medicaid programs through unprecedented block grants or per person funding caps.
The public, however, not only wants the program to be protected, but it also believes it is important for their families. According to a recent Kaiser Health Tracking Poll released at the end of May, almost six out of ten (58%) believe the program is important to them and their families—including a majority of Democrats and Independents (64 and 57 percent, respectively) and nearly half (46 percent) of Republicans.
The public opposes phasing out the ACA’s program expansion. The vast majority—including 93 percent of Democrats, 83 percent of Independents, and 71 percent of Republicans—say that states that received federal funds to expand Medicaid should continue to receive that support. By a 71 to 26 percent margin, they also oppose changing the program’s overall funding structure through block grants or per capita caps.
Continued Activist Opposition is More Crucial than Ever in the Weeks Ahead
The top Senate Republican leadership has expressed its intent to schedule a health bill floor vote before the August summer recess. Senate Majority Whip John Cornyn (D-TX) promised “We’ll get it done by the end of July at the latest.” Majority Leader McConnell, however, ratcheted up that commitment by saying he wants a vote before July 4; one way or another, McConnell says he intends to complete the health care work this month so the Senate can get on with other business, such as tax reform and a vote on increasing the federal debt.
Activists’ oppositional efforts in the days and weeks ahead are therefore more crucial than ever. We have surely made tangible progress, but we must not forget how the moribund House bill made a successful comeback. We now need to sustain and intensify our activist opposition because we have a chance of achieving the largest legislative upset in recent memory – and, in so doing, we will protect the well-being and lives of many millions of families across America.
For more than three decades, Ron Pollack was the Founding Executive Director, and is now the Chair Emeritus, of the consumer health advocacy organization Families USA. He continues to play an active, independent role on progressive health and economic policy issues, and his blogs and tweets (@Ron_Pollack) provide up-to-date personal commentaries about those developments.