We are only a few weeks into the booyah! boasting phase of the Trump GOP Era. But we are already seeing a central theme emerging, especially on health care policy. Both on repealing Obamacare and phasing out Medicare, Republicans are now realizing they have to ask Democrats for help, despite the fact that they control every branch of the federal government.
It's important to understand why this is happening. One key reason is that on both Obamacare and Medicare, the GOP - especially the House GOP - is the dog who caught the car. What do they do now? Paul Ryan, whose genial demeanor and packaging conceals a political radical on fiscal policy, social insurance and almost everything else tied to money, risk and financial security, got House Republicans to vote for Medicare Phaseout for five years straight. But it was an easy vote since nothing would ever come of it.
Republican Senators are now telling pretty much everyone who will listen that they don't want to get dragged into phasing out Medicare this year. Some of that is the complexity of the legislative calendar. You can only push through so much at a time. But don't believe the hype. They know that killing Medicare is toxic politically. Unlike their GOP brethren in the House, they have to run in districts (i.e., states) that were drawn in the 17th, 18th or 19th centuries (with a handful of exceptions). Not big data driven maps gerrymandered in 2010. To paraphrase Augustine, they want Movement Conservative purity, but just not yet.
They're getting a similar message on Obamacare. A couple weeks ago, Paul Ryan was boasting that he might take down Obamacare and Medicare in the days just after the inauguration, in one combined action. Just a few days ago, House Majority Leader Kevin McCarthy announced that Repeal and Replace could be set aside in favor of Repeal and We'll Look Into It. But Senate Republicans are saying Obamacare repeal could be a years' long process.
The key political reality is that Senate Republicans are spooked by going after both Obamacare and Medicare, though to much different extents. One big reason they're hesitant is that they believe they'll have to do it on more or less straight party line votes, with no Democratic cover. A number of Senate Republicans have also made clear they do not foresee flat repeal in any case - rather something between reforming and repealing and then replacing with something that is significantly similar to Obamacare.
On the other side of the equation, there will certainly be Republicans in the House and the Senate who will resist any move to compromise on Obamacare and Medicare, particularly Obamacare. Where do you figure Ted Cruz will be if a mushy Obamacare semi-repeal comes through the Senate? There's no question that his mix of extremism and opportunism will make him jump for the chance at being the leader of the Obamacare-Pure Republicans. With possible defections on the right, that's another reason why Republicans will need some Democratic votes. But the biggest reason they will want Democratic votes is that people who face real elections won't want to face the electorate with that much health care carnage without bipartisan cover.
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