Republican efforts to repeal and replace the Affordable Care Act (ACA) have seemingly entered a final death spiral.
The whole undertaking has been perhaps the most massive legislative embarrassment in history, inflicting untold damage on the Republican Party, President Trump, Senate Majority Leader Mitch McConnell (R-Ky.) and House Speaker Paul Ryan (R-Wis.).
In poll after poll, the Republican Party is more unpopular than it, or the Democrats, have ever been.
Approval of the way Republican congressional leaders are handling their jobs is the worst ever recorded by either party, and down 19 points since the beginning of the year in CNN’s polling.
Support for the plans Republicans have put forward has generally ranged between just 12 percent and 25 percent.
I can’t find a single piece of legislation that’s been as poorly received as the GOP’s health reform efforts. Many more Americans wanted to bail out Wall Street banks than to adopt Republican health plans.
Perhaps most embarrassing internally, Republicans achieved what Democrats never could — they made ObamaCare popular.
At the end of 2013, opposition to the ACA surged to a high of 57 percent. With Republicans bringing forward their alternatives, opposition fell to 41 percent.
President Trump blames the Senate filibuster, seemingly ignorant of the fact that Republicans couldn’t muster even the 50 votes they actually needed to pass an ACA replacement.
But a deeper look reveals two original sins that hobbled GOP efforts:
• Republicans don’t really want what the public wants from health care reform.
• Republicans lied to us, and to themselves.
What do voters really want?
They’d like insurance to be cheaper but know that won’t happen, so they’d be content with holding down costs.
They want to protect those with pre-existing conditions.
They want to make affordable health insurance available to more people.
Republicans never wanted those benefits.
When Medicare was first adopted, it enjoyed support from the public as well as from some moderate and liberal Republicans — creatures that then existed — but the future leaders of the GOP — Barry Goldwater, Ronald Reagan, George H. W. Bush and Bob Dole — opposed it.
Republicans have tried to cut health-care spending ever since.
In the 1990s, I worked with Democratic leaders in the Senate and House on a Patients Bill Of Rights, designed to protect people from insurers. Republicans opposed it.
Whether then or now, you can’t protect those with pre-existing conditions through deregulation.
At the end of the day, Republicans just don’t want the kind of health-care system that most Americans favor — and that makes it almost impossible for them to construct a bill most Americans support.
Republicans also suffered from their dishonesty.
For the last seven years Republicans said they had a plan in waiting. They didn’t.
When President Trump told us he had a “beautiful” health-care plan, he was lying.
They may have had some ideas and goals, but no real plan.
Bereft of a plan, Republicans were left to secretly concoct half-baked bills in the dead of night.
Medicare was subjected to eight years of debate before it passed. ObamaCare was the topic of some 180 hearings in the House and Senate.
Graham-Cassidy had one. So, when Sen. Lindsey Graham (R-S.C.) says his bill followed the same process as ObamaCare, he just isn’t being truthful.
As University of North Carolina scholar, Jonathan Oberlander, told the Los Angeles Times, “It is really hard to find an example of something where Congress was this reckless.”
Republicans also lied to themselves.
They told themselves spending could be cut, while coverage increased.
They said those with pre-existing conditions could be protected without regulations.
They seemed to believe people could be allowed to buy insurance only after they got sick, without rendering insurance companies insolvent.
It wasn’t John McCain. It was their original sins — dishonesty and their disconnect from public preferences — that brought Republicans to their current humiliation.
Mellman is president of The Mellman Group and has helped elect 30 U.S. senators, 12 governors and dozens of House members. Mellman served as pollster to Senate Democratic leaders for over 20 years and as president of the American Association of Political Consultants.