Why The Repeal Effort Failed: There Was No There, There

Most of you, I suspect, did not find out until you woke up this morning that the Republicans’ 7-year effort to repeal Obama died by one vote in the Senate very early today. Republicans had pinned their hopes on a pared-down repeal bill – the so-called “skinny bill” – that they hoped would attract enough party support to go to a conference with the House, which passed its own repeal bill by a vote of 217-213 in early May.  It was the House bill that was the basis for the Senate debate and the hope among Republicans was that by getting an amended bill to conference, party members could work out their differences and agree on legislation that would repeal and replace Obamacare.  Alas, it was not to be.  With Vice President Pence waiting to cast the tiebreaking vote, three Republicans: Susan Collins (Maine), Lisa Murkowski (Alaska) and John McCain (Arizona), all broke party ranks, and it was enough to send the Senate bill down to defeat 51-49.

The defections by Collins and Murkowski were no surprise, of course. They were two of only three Republican Senators (Dean Heller was the third) to vote against both the Senate counterpart to the House health care bill, and a bill designed to achieve straight repeal without a replacement of Obamacare.  But heading into the final vote early this morning McCain’s vote remained a mystery.  He, of course, had heightened the drama by making a dramatic return to the Senate two days before to support a motion to proceed on debating the bill, which then passed the Senate when Pence cast the tiebreaking vote. That set the stage for a series of votes to amend the House bill that unfolded over the next two days, culminating with the final vote this morning.  In the lead up to that vote, McCain, along with his Senate colleague and good friend Lindsay Graham, and Ron Johnson, had expressed worry that if the pared-down “skinny” bill passed the Senate, the House might simply vote to pass it as is – something many senators, including those three, opposed.  Despite assurances from House Speaker Paul Ryan that the House would, in fact, go to conference if the pared-down bill passed the Senate, McCain did not seem convinced.  As many observers noted, many Senate Republicans were in the awkward position of having to vote for a bill that they did not want to see become law, in the hope that something better would result.

McCain seemed unpersuaded that this was the route to take. As Senators milled about just prior to voting on the final bill, he could be seen laughing with his Democratic counterparts. Those of us watching on C-Span tried to interpret his body language. McCain deliberately heightened the suspense by telling reporters stationed outside the Senate floor to “watch the show.” At one point he left the floor, reportedly to take a phone call from President Trump.  If so, McCain remained unmoved. He returned to the floor and, in a dramatic moment, barked “No” when queried as to his vote, and marched off, producing gasps and some applause which Senate minority leader Chuck Schumer quickly tried to stifle. But the die had been cast.

This morning McCain explained that his opposition was motivated in large part by the process in which the pared-down bill had been written.  “We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of the aisle, heed the recommendations of nation’s governors, and produce a bill that finally delivers affordable health care for the American people,” McCain’s statement read. This is probably wishful thinking on his part, if he believes it at all.  It is true that Mitch McConnell, the Senate Majority leader, put this bill together entirely behind closed doors, and at the last minute, bypassing the committee system entirely – a process about which Democrats complained bitterly. But the reality is that no Democrat was going to vote for a health care repeal bill supported by Republicans no matter how transparent the process.  And McConnell’s decision to craft this bill outside the traditional lawmaking system is really the culmination of a long-term process in which legislating is increasingly conducted using unorthodox means – something the late, great Barbara Sinclair masterfully documented in a series of congressional studies. The reason for this, of course, is that in an era of deeply divided congressional parties, the textbook lawmaking process taught to a generation (cue School House Rock video) has become increasingly dysfunctional, forcing party leaders to devise creative ways to shield legislation from the oppositions’ efforts to obstruct and defeat it by any means.

This may not be the ideal way to make legislative sausage.  But it increasingly has become the only viable method for doing so. Despite his herculean efforts to shepherd the bill to a conference, however, McConnell and Republicans fell one vote short. For the diehards among us who study this stuff for a living, watching the Senate vote in the wee hours was about as dramatic an event as you are likely to see in Congress.  (It’s too bad C-Span2 didn’t sell advertising commercials – they would have made a fortune!)  Today, of course, come the recriminations. As is their wont, journalists will focus on personalities and tactics as the reason Republicans lost.  Undoubtedly some will interpret McCain’s vote as revenge against President Trump, who famously called McCain a loser for being taken prisoner during the Vietnam War.  It is true that Trump’s effort to pressure Murkowski, via tweets and through his Interior Secretary Ryan Zinke, after she voted no on both the repeal, and repeal and replace legislation, was clumsily handled. It’s Neustadt 101  that these threats are more effective when issued behind closed doors. But the reality is that Murkowski has felt little debt to the Republican Party since losing her party primary in 2010. (She then beat her primary opponent by running as an independent in the general election.) For her part, Collins reportedly is eyeing a bid to become Maine’s governor in 2018, and she evidently felt that being on the wrong side of repealing Obamacare in her blue state would not help the cause. In short, it’s not clear what Trump could have done to win any of these three over.  That won’t stop pundits from spinning this as a reflection of his inability to bargain, of course.

But the reality is that this bill died for a more fundamental reason.  Beyond a basic agreement that Obamacare needs to be fixed, Republicans were a deeply divided party.  Small government Republicans like Rand Paul sought a total repeal of Obamacare, and a return to a purely-market driven system of health care – a vision shared by the House Freedom caucus.  Moderates like Collins and Murkowski wanted to retain some features of Obamacare, such as the Medicaid expansion. No matter how much legislative wizardry McConnell conducted, he was never able to demonstrate a way to bridge that divide.  Moving to conference merely postponed the inevitable day of reckoning.  In this respect, McCain may have done the party a favor by pulling the plug on a bill that was likely destined to fail anyway.  This allows Republicans to move on tax reform, an issue that in theory is more amenable to the type of horse trading that might unite the various Republican factions. We shall see.

Make no mistake about it.  This was a bitter blow to McConnell, and to the Republican Party.  After this morning’s vote a visibly dejected McConnell invited the Democrats to come forth with their own ideas for fixing Obamacare, but he did not sound very optimistic, and with good reason, that this route would be any more productive. In the end, however, the effort to repeal Obamacare did not fail because of McConnell’s lack of legislative legerdemain, or unwillingness to work with Democrats, or Trump’s clumsy bargaining tactics, although pundits will certainly cite all three factors. It failed because, in the words of the great political scientist Gertrude Stein, “there was no there, there.”  And all the deliberation in the world didn’t seem to change that basic fact.


  1. Nice discussion, Matthew. It was a hollow and rotten bill in the first place. Way to much of the Republican lawmakers are captured by Ayn Rand’s philosophy of Rugged Individualism. RI is a myth, we all depend on the social context in order to realize our own uniqueness and abilities. A kid in Africa with little or no education is not going to invent an iPhone. Bill Gates, genius though he is, had a stellar education in Seattle with resources most folks did not have. Leaving Harvard was just his mind being ready for a ‘next big leap’ and would not be stifled.

    I’m currently reading “The Evolution of Everything—How New Ideas Emerge” and “The Rational Optimist—How Prosperity Evolves”, both by Matt Ridley. Thought-provoking, to say the least. Certainly gives the lie to Ayn Rand.

    My big concern about health care is how are we going to provide health care for everyone (and what kind) through single-payer and still keep the creation and invention engine going that resides in Big Pharma. (I’ve got to go peel beets, will return to this thread later.)

  2. Higgledepigeldly my red hen
    she lays eggs for gentlemen
    and with neither rope nor lariat
    can you get her to lay them for
    the proletariate.

    Renowned political scientist

  3. J. Paul,

    I agree with you – a significant reason why the Republicans were not able to repeal health care is that ideologically, they couldn’t coalesce around an alternative. The Ayn Rand/Rand Paul wing was never enamored of the Medicaid expansion – even the pared down version in Senate bill – which they saw as a payout to insurance companies and a tacit support of government expansion. But the moderates weren’t going to adopt what they saw as a rollback of a popular benefit. McConnell was never able to bridge that gap. All the united Republicans was that Obamacare needed to be ended, or at least mended. Going forward, it will be interesting to see if they work with Democrats to do so.

    Haven’t read either of those books. I’m lucky if I have time to read a good magazine article! One of the hazards of trying to produce research and blog….

  4. “But the reality is that no Democrat was going to vote for a health care repeal bill supported by Republicans no matter how transparent the process.”

    I don’t think that’s so. To their credit, no Democrat was going to vote for the repeal or de-funding of Obamacare without a serious attempt to replace it with a system aimed at making health insurance universally available and affordable in some other way. In January, before taking office, Donald Trump said he was just days away from finalizing a plan that would give all Americans better, cheaper access to health insurance. If this magical wonder-plan, which has never surfaced, had actually existed instead of being another of his shameful lies or delusions, I see no reason to think it couldn’t have won support from Democrats. But in the end, Republicans chose to try to destroy or seriously undermine Obamacare when they clearly had no real replacement — which is why in the end they found themselves voting on a “skinny bill” that didn’t even claim to be one. Of course Democrats would not support this, but that doesn’t mean they’re refusing in principle to support anything that Republicans do.

  5. Well, in an ideal world – one that doesn’t exist – Republicans and Democrats would have enough in common to make it possible to construct a health bill that both could support. I don’t think we live in that world, however. Given the current configurations of preferences in the Senate, anything that Republicans can support Democrats probably can’t, and vice versa. But perhaps the next year will prove me wrong – McConnell grudgingly told the Democrats to give mending Obamacare a shot, and Collins says she’s putting together a bipartisan committee to study the problem. So, hope springs eternal I guess.

  6. OK, but your phrasing made it sound like Democrats were being arbitrarily or recalcitrantly partisan, just refusing for no good reason to support anything that Republicans came up with. There are good arguments that this in fact has been the GOP’s position, at least on some issues, since 2009 when McConnell explicitly said that unified opposition was essential to deny the Democrats a bipartisan achievement and thus to make Obama a one-term president. (Didn’t quite work out.) It clearly has not been Democrats’ position, certainly not on health care, where they spent a lot of time soliciting Republican support and included numerous GOP amendments in the ACA. Democrats have actual policy goals, not just the goal of defeating the other party, and if their policy goals can be achieved with Republican cooperation, then it seems like they’re happy to have it and are well aware that it would make the policies more popular and sustainable. The unbridgeable distance you posit between the parties is therefore not of their making.

  7. I didn’t mean to imply Democrats would oppose anything Republicans put up just for the sake of opposing them. My point is that I can’t conceive of many policies that both parties would support. If the Republican’s propose a single payer, or public option, I’m pretty sure many – most Democrats would say Yes! But, of course, Republicans won’t do that because they don’t believe it’s good policy. Similarly, had Obama and the Democrats included much deeper tax cuts as part of the stimulus package, I’m pretty sure they could have peeled off more Republicans. But of course, they didn’t think it was good policy.

    And I’m not sure I buy your characterization of what motives Republicans versus what motivates Democrats. But regardless of motivations, the practical impact, at least so far, is the lack of bipartisanship on many issues. Certainly on health care there doesn’t seem to be any.

  8. Right, I could have been more precise. Republicans do of course have policy goals too, but have chosen to wrap these in a legislative strategy of noncooperation with Democrats. McConnell explicitly said so in 2009, and before that, the Republican leadership in the House embraced the so-called “Hastert Rule,” whose purpose was to prevent legislation from passing if it had a majority of the House overall but not of the Republican caucus. They haven’t absolutely stuck to these positions in all circumstances, but have been pretty consistent about them for more than a decade now — eons in political time.

    Democrats have also whipped their caucus into total opposition at times, on specific policies, like the recent Obamacare repeal efforts. They’ve never had any such general strategy of noncooperation, though, extending across many years and issues. They’ve certainly never had leaders like McConnell and Trump, who truly do seem to have little or no interest in what specific policies are enacted as long as they can engineer a “win” for the party. Trump doesn’t even seem to know what policies the GOP is trying to enact; McConnell is happy to write a bill at lunchtime and try to pass it that evening, all but completely bypassing normal legislative order, with the only apparent criterion for what’s included or not being what will attract 50 Republican votes. Many Republican Senators were publicly complaining in recent days about this way of doing things, but they didn’t try to stop him, so apparently the GOP Senate caucus basically endorses it too.

    Personally, I think it’s regrettable that Democrats *haven’t* been more like this themselves. The GOP has tried to make congressional politics more like the politics of parliamentary systems, where the winning side just goes ahead and enacts its agenda without any pretense of input from the other side. The other side gets to criticize, and if it persuades enough voters and/or if the governing party’s policies are seen to fail, then the opposition wins the next election and gets to implement ITS agenda with a similarly free hand. (The British, hilariously, have the Queen personally read out these agendas each time as if they were her own and she were commanding them, making her appear to be either the most capricious or the most politically schizophrenic human being on the planet.) Something like this seems to be McConnell’s vision of how American politics should work too, and I think it has much to recommend it, in that it makes for greater clarity and transparency as to how the parties stand, what differentiates them and which of them is responsible for which policies. The problem is that it doesn’t sit well with the U.S. constitutional design, which there seems no prospect of changing.

  9. I agree that the Republican strategy throughout the Obama era was: 1) reject all proposals, 2) disrupt all initiatives, and then 3) complain that they weren’t being included. Yet this case touches on key differences in party in party objectives as well. The Democrats really wanted to do something that would move at least incrementally toward universal health care, a party goal since the 1940s. For the Republicans, although there may be individual exceptions, the party as an institution just doesn’t care about health insurance one way or the other. The Republicans would not have brought it up except that the Democrats passed a bill that involved extensive taxes and regulations–two things that they do care about. Even if the GOP hadn’t been following its obstructionist strategy (which they were), the conflicting objectives or providing health insurance and eliminating the taxes and regulations that make it possible were going to make cooperation unlikely to say the least.

  10. Scott – I pretty much agree with all you’ve written here, except that I do think (some) Republicans in Congress care about health insurance. I just don’t think they believe the government should be involved in providing it – at least not beyond Medicare. And it is possible that they can move closer to their goal by incorporating Medicaid cuts into the budget resolution. That would be consistent with their economic philosophy.

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