TrumpCare Ain’t Dead
By 
Every iteration of the Republican health care bill gets terrible CBO scores, because cutting hundreds of billions of dollars out of federal health care spending means tens of millions of people losing their insurance. For this reason, every Republican proposal is staggeringly unpopular.
And yet, the bill could still pass:
The real fate of American health care lies with five Republicans — Dean Heller (R-NV), Shelley Moore Capito (R-WV), Rob Portman (R-OH), John Hoeven (R-ND), and Lisa Murkowski (R-AK) — whose behavior since McConnell rolled out BCRA 2.0 has been strange.
These five all clearly and unambiguously stated that the Medicaid cuts in BCRA 1.0 were too severe. But then McConnell went back to the drawing board and came up with a new piece of legislation that made no changes whatsoever to the Medicaid provision. At that point, you would expect everyone who called the Medicaid provision a deal killer to say no to the new bill. And that is, in fact, what Collins did. But the other five all laid low.
Once the bill was dead due to objections from the right, the moderates came out of the woodwork and announced their opposition. But the pattern we saw in the House was that once the Freedom Caucus was fully on board with the leadership’s plans, moderates lacked the backbone to actually kill the bill.
The Senate moderates have the power, right now, to band together and kill the bill by fundamentally rejecting the idea of massive insurance coverage losses. They could cross the aisle and work with Democrats on fixes to stabilize the exchanges. But they keep rather pointedly not doing that.
[…]
But until work starts on a bipartisan deal, it’s dangerous to assume that repeal is dead. Relying on conservatives to kill a fundamentally conservative bill is inherently risky, and if the perception that repeal is dead demobilizes opponents, then the odds of more moderate Republicans doing anything only fall. Obamacare repeal looked dead in the House at one point, but the very perception that it was dead turned out to give it new life. The only people who can really kill repeal are so-called moderates — who’d have to say no to coverage losses and yes to bipartisanship.
There are three key factors here. First, Republican “moderates” are distinctly immoderate; if they weren’t, we wouldn’t be having this discussion. Second, as Yglesias says, the desire for a Republican “win” might override the objections of marginal senators who don’t like the bill as policy or politics. And, third, is the insanely favorable-to-Republicans Senate map in 2018. If passing this bill put Mitch McConnell’s ability to confirm a potentially transformative Supreme Court nomination for the last 2 years of Trump’s first term at serious risk, it would already have been sent to the glue factory. But with the political bill probably not due until 2020, McConnell would be willing to pass it is he can get the votes.
Is this likely? Not that I can see. Is it impossible? Definitely not, and it is incredibly dangerous to assume that.