The real reason Republicans can't answer simple questions about their health care bill

President Elect Donald Trump, center, walks through the halls of th U.S. Capitol for a meeting with Senate Majority Leader Mitch McConnell on Nov. 10, 2016.
Bill O'Leary | The Washington Post | Getty Images
President Elect Donald Trump, center, walks through the halls of th U.S. Capitol for a meeting with Senate Majority Leader Mitch McConnell on Nov. 10, 2016.

On Friday, my colleagues at Vox, Tara Golshan, Dylan Scott, and Jeff Stein published a remarkable piece collecting interviews with eight congressional Republicans about their health care bill. They asked the simplest question possible: What problems do you think this bill will solve, and how do you think it will solve them? Not a single Republican has a clear answer. The exchange with Sen. John McCain is particularly bizarre:

Tara Golshan

Generally, what are the big problems this bill is trying to solve?

John McCain

Almost all of them. They're trying to get to 51 votes.

Tara Golshan

Policy-wise. What are the problems [in the American health care system] this is trying to solve — and is the bill doing that right now?

John McCain

Well, it's whether you have full repeal, whether you have partial repeal, whether you have the basis of it. It's spread all over.

Tara Golshan

But based on the specifics of the bill you have heard so far, is it solving the problems [in the health care system]?

John McCain

What I hear is that we have not reached consensus. That's what everybody knows.

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But McCain's reply, while incoherent, isn't as offensive as Health and Human Services Secretary Tom Price's straight lie that Americans will "absolutely not" lose Medicaid coverage under the House bill.

It's worth asking why Republicans are lying about this, why they can't give a clear explanation as to what their bill does, why they're jamming the legislation through a secretive, rushed process that even their own members are criticizing. Because there is a reason. And it is damning.

In 2009, Democrats had an easy answer to what the Affordable Care Act was meant to do: They wanted to cover more people and cut costs. They could give that answer because it was a basically popular position, and because it's what their bill actually did, or at least tried to do.

In 2017, Republicans have a similarly easy answer for their bill: They want to cover fewer people and use the savings to fund tax cuts for the wealthy. That is what their legislation does. But they can't give that answer because it's a horribly unpopular position.

That is why they are trying to write a bill in secret and pass it before the public has a chance to mobilize against it. That's why, when asked to describe the bill's provisions, Republicans offer baldfaced lies or word salad.

The difference between Obamacare and Trumpcare

Democrats always believed the Affordable Care Act would be popular. They believed that even when polls said it wasn't popular. They were certain that when Americans understood what was in the law — when they saw it would cover tens of millions of people, and regulate away the worst abuses of the insurance industry, and let children stay on their parents' plans, and use Medicare to pilot a host of cost-control experiments — they would come around.

This basic belief carried through the more than year-long process behind the bill. It's why Democrats held dozens of hearings, and released draft after draft of their legislation. It's why, when the bill was in danger, President Obama invited congressional leadership to the Blair House for a multi-hour televised debate over the bill. He was certain he had the better of the argument, and that if the American people could just hear it, Democrats would win.

By contrast, Republicans have concluded the public will hate their bill if they know what's in it, and so they are doing everything in their power to keep it a secret and move on from it as fast as possible.

The process that produced the House health bill was shocking. The law was rushed to its first vote, with barely any public hearings, in less than a month. It was passed before the Congressional Budget Office had even scored the final version. It wasn't just that House Republicans didn't want the public to know what their bill did. They didn't want to know what their bill did!

The Senate process has been less chaotic but even more cynical. The legislation is being written by 13 Republican senators — all of them men — in secret. No one has seen a draft of it. No public hearings have happened, and none are scheduled. Republicans briefly considered banning cameras from the halls of the Senate so they couldn't be asked about the bill on television. Various Senate Republicans have condemned the process — "The process is better if you do it in public, and that people get buy-in along the way and understand what's going on," Sen. Bob Corker (R-TN) told the New York Times — but they're not forcing any changes to it. Though no bill exists for public viewing today, Mitch McConnell's plan is to pass the legislation before July Fourth.

"The extreme secrecy is a situation without precedent, at least in creating health care law," writes Julie Rovner, one of Washington's most respected health reporters. My colleague Sarah Kliff, in a searing piece, recalls the hours she spent covering hearings during the drafting of the Affordable Care Act, and notes C-SPAN is empty of similar hearings today. "I've covered Obamacare since day one," she writes. "I've never seen lying and obstruction like this."

A bill you can't defend is a bill that won't survive

The strategy Republicans have chosen may work to pass a bill, but it won't work to defend the chaos that bill creates. Democrats thought the Affordable Care Act would become more popular as it began delivering insurance to people, and so the world they were creating was a world they would be able to defend. Do Republicans really believe their health plan will become more popular when it begins taking insurance away from people?

And if they don't, then what do they think will come next? I've written my prediction: They're paving the way to Medicare-for-all, as the next Democratic majority will respond to Obamacare's destruction by passing the law liberals wanted to pass in the first place.

I assume Republicans have a different view than that. But what is it? If their plan is so unpopular they can't defend it in theory, how will they defend it in practice? Each day this goes on, it seems less like a legislative process and more like a form of madness.

The only plausible explanation I've heard for the persistent progress of this bill no one likes is that Republicans feel they need to keep their promise to repeal and replace Obamacare, and this is a version of keeping that promise. But this isn't what they promised. Donald Trump swore everyone would be covered under his plan. Mitch McConnell promised lower deductibles and copays, and criticized Obamacare for leaving 25 million people uninsured. Read the clarity of McConnell's critique of Obamacare, and compare it with how he and his colleagues are talking about health care now:

Well, what you need to understand is that there are 25 million Americans who aren't covered now. If the idea behind Obamacare was to get everyone covered, that's one of the many failures. In addition to premiums going up, copayments going up, deductibles going up. And many Americans who actually did get insurance when they did not have it before have really bad insurance that they have to pay for, and the deductibles are so high that it's really not worth much to them. So it is chaotic. The status quo is simply unacceptable.

Republican voters thought the GOP would replace Obamacare with something better, something that would help them. They thought that because that's what Republican politicians told them. That was what they were promised. This bill breaks the GOP's health care promises.

Commentary by Ezra Klein, editor-in-chief at Vox. Follow him on Twitter @ezraklein.

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