Senate Republicans are once again just a few votes away from repealing and replacing Obamacare. It's a plan that senators themselves struggle to explain and defend and that emerged on the public stage mere days before an expected vote.
How have they found themselves here again, after their previous repeal bills failed in July? The underlying truth, the beating heart of Obamacare repeal that refuses to let it die, is: Republicans just want to pass a bill, any bill, to say they repealed Obamacare. Whatever standards they've set for their health care plan, whatever promises they made before, don't matter.
The policy is, in a very real sense, beside the point. Republican senators will tell you that themselves, in their own way.
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"If we bring this up on the floor, I think every Republican senator is in play because every Republican senator will be faced with that binary choice," Sen. Ron Johnson (R-WI), one of the bill's co-sponsors, told reporters. "Okay, maybe this isn't everything they want, but the binary choice is: 100 percent guarantee that Obamacare remains in place, and we may have a path to single-payer, versus this choice of federalism, where we start putting the states back in charge."
This bill, authored by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), keeps most of Obamacare's taxes (once a deal breaker for many Republicans), turns the revenue into a block grant, and sends the money down to the states with very few strings attached.
The block grant looks like nothing from any bill Republicans considered in late July. Several provisions cross what used to be red lines for Republican senators. Graham-Cassidy cuts Medicaid deeply by overhauling the program's financing and ending the Medicaid expansion. It would allow health insurers to once again charge people higher premiums based on their medical history.
The bill should be untenable for other reasons: Graham-Cassidy promises steep spending cuts to most states, including those represented by Republican senators. It institutes a timeline — states would need to create brand new health care programs by 2020 — that most experts find unreasonable.
Yet Senate Republicans could be just a few votes away from passing it. There is only one red line the GOP is really afraid to cross: failing to repeal Obamacare.
"Apparently no one cares what the bill actually does. That's a tough thing to say, but it is more true than not," one Republican lobbyist told me. "There are so many senators whose public positions in June leave them absolutely no conceivable way of voting for this."
"Yet," this person added, "here we are."