Sometimes failure is a good thing. That was especially true last week when the U.S. Senate failed to pass legislation repealing the Affordable Care Act (ACA). It meant that Congress was stopped from taking health care away from tens of millions of Americans, at least for now.
What happened? Senate Majority Leader Mitch McConnell (R-Ky.) desperately pushed the Senate to pass something he could describe as repealing the ACA. That would have allowed the Senate to negotiate with the House of Representatives on a final bill, since the House already had passed a repeal and replace bill in the spring. McConnell tried three different versions of repeal, and the Senate voted against all three:
- Repeal and Replace: This bill was the latest version of Senate leadership’s proposal to repeal and replace major parts of the ACA. It would cut taxes for the wealthy few and corporations, while slashing Medicaid, jacking up premiums and deductibles for individual plans, and making permanent a 40% tax on high-cost workplace plans. The nonpartisan Congressional Budget Office estimated that an earlier version of this bill would take health care away from 22 million people by 2026. This bill failed by a vote of 43 to 57.
- Repeal and Run: Like a bill passed by Congress in late 2015 and vetoed by then-President Barack Obama, this bill would repeal major parts of the ACA and leave it to a future Congress to come up with any replacement. This bill would take health care away from 32 million people. The Senate rejected this by a vote of 45 to 55.
- Skinny Repeal: A last-ditch effort to get at least 50 senators to vote for something, this bill would repeal a few parts of the ACA, like the individual mandate. It would take health care away from 16 million people. The Senate rebuffed this by a vote of 49 to 51. All 48 Democrats plus Sens. Susan Collins (R-Maine), Lisa Murkowski (R-Alaska) and John McCain (R-Ariz.) voted against it. Had this bill passed, Senate leaders then would have tried to negotiate a comprehensive repeal and replace plan with Republican leaders in the House.
Why did repeal fail for now? Although Republican leaders got very close to getting the 50 votes they needed, they could not overcome how bad each of their proposals compared to their campaign promises. President Donald Trump himself had assured Americans that under his plan, “We’re going to have insurance for everybody,” and that insurance would have “much lower numbers, much lower deductibles.” He also promised repeatedly he would not cut Medicaid. In reality, the Republican plans would do the opposite. The CBO showed that the proposals would take health care from between 15 million and 32 million people, spike premiums for many and lead to individual deductibles as high as $13,000 a year. In addition, their main plans gutted Medicaid, jeopardizing health care for millions of people already struggling the most to make ends meet.
What could this failure of repeal mean? Americans made it clear they want health care to be better and see it increasingly as a basic right. That is why millions of people called and wrote their senators and members of Congress and showed up at public events to protect health care.
If Congress and the president were listening to Americans, they would start doing things to make that happen. Some Democrats and Republicans in Congress are now talking about ways to stabilize the individual insurance markets. Others are working on plans to lower deductibles and out-of-pocket premiums, tackle unjustified spikes in prescription drug prices, and create alternatives to profit-centered insurance companies, like expanding Medicare eligibility.
Unfortunately, it appears many of the key health care players have not gotten the message. President Trump’s budget director, Mick Mulvaney, says the Senate should vote on repeal yet again, before it does anything else. Trump, himself, is threatening to destabilize the individual insurance markets, something that could cause people to pay much more or to lose their health insurance. He says he might do this by stopping reimbursements to insurance companies for the extra financial help they are required by law to provide certain low- and middle-income people.
The labor movement will continue to vigorously oppose any attempts to gut or undermine our current health care system and insist the debate be shifted toward how to build on what we already have.