Are There Any Bullets Left In McConnell’s Gun?

McConnell makes it official that, at least for now, he’s giving up on BCRA:

Senator Mitch McConnell, the Republican leader, conceded Monday night that “the effort to repeal and immediately replace the failure of Obamacare will not be successful.” He outlined plans to vote now on a measure to repeal the Affordable Care Act, with it taking effect later. That has almost no chance to pass, however, since it could leave millions without insurance and leave insurance markets in turmoil.

But President Trump was not ready to give up. He immediately took to Twitter to say: “Republicans should just REPEAL failing ObamaCare now & work on a new Healthcare Plan that will start from a clean slate. Dems will join in!”

Evidently, this is enormously unlikely to work. It’s worth considering that a repeal bill that could pass under the Byrd Rule (i.e. a repeal of the Medicaid expansion and the tax credits but not the regulations) would be far worse than BCRA:

Its findings aren’t pretty. CBO estimates that, compared to what’s already projected to happen under current law:

• 18 million more people would become uninsured in the first full year after the bill’s enactment — rising to 32 million more people by 2026;

• premiums in the individual insurance marketplaces would soar — they’d go up 20 to 25 percent above currently projected increases in the first full year after repeal, and “would about double by 2026”;

• and access to coverage on the individual markets would plummet — about half of the US population would live in areas “that would have no insurer participating” in the individual market, CBO projects.

If McConnell brings this to a vote it would almost certainly be to call the bluffs of Trump and the recalitrant senators; it’s very hard to see this passing if BCRA couldn’t. The only thing that gives me pause about BCRA is that except for Collins the bullshit-moderate is remaining silent. Until there are at least two nays from Capito/Heller/Portman/Murkowski/Flake, the possibility of an AHCA ressurection (as Erik implies below) is there. Not very strong, but there.

It also should be obvious that the stalling of the BCRA is not part of some masterful 11th-dimensional chess strategy to guarantee the failure of an unpopular bill. If that was the case, they just would have let the AHCA drop after it was pulled the first time — nobody gets primaried based on a vote that doesn’t happen. Republicans wanted to gut the ACA, and McConnell was playing to win all the way. They’re now likely to fail this Congress, but major healthcare policy changes are an extremely hard lift. They came a lot closer than, say, Bush did to gutting Social Security, and they’re not going to give up on the goal. The fight will continue — but an important battle was won tonight, and countless Americans who made their voices heard deserve a lot of credit.