Senate Majority Leader Mitch McConnell is not usually one for doomed gestures or abstract ideals.

So why on earth is he scheduling a sure-loser vote on Obamacare "repeal today; replacement later?” Yes, President Trump has requested it—but McConnell has long since learned how to manage Trump’s fleeting mental vagaries. If this vote is held, it’s because McConnell wants it, fully aware that it will lose.

Again: why?

The stated motive for the vote is to appease congressional conservatives who claim they really and truly want to eliminate the Affordable Care Act, root and branch. There is a lot of reason to doubt the sincerity of these conservatives, and especially the noisiest of them, Kentucky’s Rand Paul. Rather than “repeal and replace” Paul's strategy looks more like "denounce and preserve.” As noted here in March:

[It] is Kentucky’s Appalachian Southeast that has seen the biggest gains from the ACA. And it so happens that southeastern Kentucky voted more staunchly for Paul’s 2016 reelection than did any other section of the state.

Paul won 76.6 percent of the vote in Clay County, where 15.6 percent of the total population has gained coverage via the ACA’s Medicaid expansion. He won 81.5 percent of the vote in Jackson County, where 15.1 percent owe their Medicaid to the ACA. He won 84 percent in Leslie County, where 18 percent would lose Medicaid if Obamacare were repealed.

But even if Senate conservatives do truly crave one more opportunity to put their feelings about ACA on record, why would McConnell accede? Republicans have already burned without result one-fourth of their best opportunity since the 1920s to remake government. Why waste yet another fleeting week?

The effect of the “Repeal Now; Replace Later” is to force a choice upon senators: either cast a vote truly dangerous to their careers—or admit that they have been playing politics all along. Again, why? Sam Baker at Axios  quoted the pungent comment of a Senate aide: "Repeal and 2015 are pathologically stupid and it's criminal for Trump and conservatives to put us in that position.”

McConnell is not doing what is best for his party—in fact, he is pushing it further along the path most likely to cost Republicans one or both houses of Congress. He is not doing what is best for President Trump, who would be better served in his present legal jeopardy by trying to pass laws that Americans would like: a tax cut or an infrastructure bill. He is certainly not serving the cause of conservative healthcare reform by choosing as his probably final effort a vote that cannot pass and that would plunge health markets into chaos if it somehow did.

But what he is doing is reasserting his own personal leadership, punishing and rewarding senators all at once—in ways that diminish everybody in his caucus other than himself.

The vote is a reward to the ultras who sabotaged repeal and replace by allowing them to posture one more time as purists who have not forsaken the true faith. It punishes the cautious senators who recoiled from huge Medicaid cuts by thrusting upon them a clear alternate they would prefer to evade. It intensifies mutual suspicion and ill-feeling inside a caucus where two senators—Nevada’s Dean Heller and Arizona’s Jeff Flake—have been explicitly threatened by the president and head of party.

As Republican poll numbers sink, as the Russia scandal putrefies, as enraged donors complain they have received nothing for their contributions, as the caucus snarls and snaps in frustration, as defeat looms, a terrible paradox is revealed. Dissension and disunion guarantee an even worse outcome in November 2018. The only thin and fading hope for safety is to cling ever tighter to the leadership that has led Republicans to the edge of disaster … and that now demands they jump over the ledge and into the abyss.


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