One key reason Senate Republicans have been forced to retract and retool their plan to repeal the Affordable Care Act is that the legislation favors one pole of the party’s modern coalition so emphatically over the other.
The teetering Senate repeal bill, like its predecessor the House passed in May, would shower a large tax cut almost exclusively on the very high earners who compose the party’s fundraising base. Simultaneously, the bill would impose deep benefit cuts—both in the private insurance market and Medicaid—on the older and blue-collar whites who now provide the largest share of the party’s votes.
To the frustration of liberal operatives and analysts (see: the best-seller What’s the Matter with Kansas?), Republicans have been able to surmount similar tensions for decades—in large part by appealing to blue-collar and older whites on cultural and racial grounds. With his brusque agenda of racially tinged nationalism, President Trump last November pushed that support to new heights.
But the congressional GOP’s health-care plans are straining that connection by benefiting those at the top explicitly at the expense of the lower middle class. That marks a subtle but important change. Even previous Republican tax-cut bills that channeled most of their benefits to the highest earners had some benefits trickle down to the middle class. The health-care bills differ in that they fund their tax cuts by revoking aid for older and lower middle-income adults. Resistance to that trade inside the GOP caucus helps explain why Senate Majority Leader Mitch McConnell was compelled on Tuesday to shelve the bill until after the July 4 recess. Yet it is equally revealing that the vast majority of Republican legislators in both chambers have been willing to make that deal.