This week's expected Senate vote on the Republican plan to alter Obamacare has ignited a debate about who will gain or lose from it. Democrats point to the fact that the GOP bill is so far more unpopular than Obamacare — 48 percent in a new NBC News/Wall Street Journal poll say it's a bad idea, versus 38 percent who think the same of Obamacare.
But many Republicans believe that survey data show voters will punish anyone who doesn't substantially alter Obamacare, making passage of some reform imperative.
Both parties are gambling that intensity of feeling is on their side. Every single Senate Democrat is planning to oppose the GOP Senate bill, including ten Senate Democrats up for reelection next year in states won by President Trump. Some of those Democrats have voted to confirm Trump appointees such as Supreme Court Justice Neil Gorsuch and Energy Secretary Rick Perry, but on health care they are united.
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Senate Majority Leader Mitch McConnell is hoping to keep his 52 Republican members united behind him. He is telling them that while the bill may be unpopular, doing nothing on health care would be even more unpopular and would be considered an abdication of responsibility by many voters.
After all, Republicans have railed against Obamacare for the last seven years and now finally control the executive branch as well as both houses of Congress. "If we don't act now as Obamacare is collapsing, when will we or can we act?" asks Ohio Representative Jim Jordan, a former head of the House Freedom Caucus.
There is polling evidence that a failure to vote for at least an overhaul and partial repeal of Obamacare is politically riskier than voting for it. The Club for Growth, a free-market advocacy group, has taken a poll showing two things: 1) General-election voters will vote against incumbent Senate Democrats in swing states if they continue to support Obamacare, and 2) if Republicans fail to address Obamacare, many GOP and independent voters will fail to show up and support Republicans in the 2018 midterm elections.
"Republicans should be reminding voters why they rejected the seriously flawed Obamacare legislation in the first place," says David McIntosh, a former Indiana congressman and now head of the Club for Growth. "The key is focusing on how harmful Obamacare is for Americans and how Republican free-market principles will improve health insurance."
McIntosh contends that his poll — along with survey research by other groups — backs up his approach. He notes that when independent voters in West Virginia and Montana (two states with vulnerable Democratic incumbents up for reelection in 2018) were asked if they were "less likely" or "much less likely" to vote for senators who support Obamacare, close to 45 percent of independents in West Virginia and 50 percent in Montana said yes. That should make Democratic senators Joe Manchin of West Virginia and Jon Tester of Montana exceedingly nervous.
On the flip side, there is danger for Republicans in inaction. The Club's national poll found that 10 percent of likely Republican voters won't vote to reelect Republicans who don't take a strong stand against Obamacare.
I have no doubt that many Republicans in Congress never thought they would be held to account for their promises – repeated countless times over the past seven years — to repeal Obamacare. Indeed, the current versions of both the House and Senate GOP Obamacare overhaul bills wouldn't amount to a full repeal. "There are twelve regulations in Obamacare," GOP senator Rand Paul of Kentucky said Friday on MSNBC's Morning Joe. "We're [in the Senate] repealing two of them." Paul, an eye doctor, says the failure to reduce regulations makes it impossible to offer low-cost health-insurance plans to people of limited income.
So when it comes to the politics of health care, Republicans find themselves in a tight corner. They regained control of Congress in large part due to their opposition to Obamacare. Now, if a few of GOP senators block even the imperfect bill before them, the entire party will be blamed and will suffer at the polls for falsely advertising they would act on health-care reform.
It would be truly ironic if Republicans suffered steep losses or even effective control of Congress over the very issue that brought them back to power in the House in 2010 and the Senate in 2014. In the end, keeping promises counts in politics — even inattentive voters can spot and punish hypocrisy.
Commentary by John Fund, a national affairs correspondent at National Review. Follow him on Twitter @johnfund.
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