The Affordable Care Act War Is Not Over, But the First Battle Was Lost

Kilgore has a good run-down:

So did Democrats get anything of value from this truncated exercise? Perhaps so. Republican senators are now on record as having rejected opportunities to keep Medicare, Medicaid, and the children’s health program CHIP off the cutting-room floor; to make it possible to import prescription drugs from Canada; to prevent erosion of women’s health services and support for rural hospitals; and perhaps most tellingly, to protect Medicaid funding for the 32 states that accepted the option of expanding that program under the Affordable Care Act.

For the moment, the budget resolution will go to the House, which is expected to approve it on Friday unless the Freedom Caucus (some of whose members share Rand Paul’s heartburn over moving ahead with an Obamacare repeal without a replacement) decides to rebel. And then the real rubber will meet the road as Republicans try to figure out what exactly to put into the repeal legislation to deal with the transition and to satisfy wildly varying Republican views on the post-Obamacare health-care system.

The future for Obamacare remains fuzzy. The big, potentially derailing disagreements over repeal among Republicans — most importantly between the Congressional leadership and Trump — remain very much in place. Nothing about last night’s vote changes that. But the fact that the party could pull together to pass the repeal budget has to be encouraging for conservatives. It’s a relatively easy part of a long process — but there’s no question that America is now a little bit closer to losing Obamacare.

This was the relatively easy part, and the internal tensions about how to replace the ACA and how many people to impose suffering and/or death on remain. Supporters of the ACA should by no means give up. But, still, this is bad, not least because it’s a strong signal that McConnell is committed to repeal.

Pierce has more in an even darker mood.