How does one put this delicately? Mitch McConnell and his gang that couldn’t shoot straight are trying to fuck us in the ass. Okay, maybe that’s not delicate, but there is no way to over-emphasize the degree to which this Senate Republican health care initiative is a screw job, the same as what was passed in the House. Their version is called the “Better Care Reconciliation Act,” and in some ways it’s worse than what was passed in the House.

So  how did we get here? Let’s review:

• The Clinton administration initially tried in its first term to pass a universal health care bill, and famously appointed his wife Hillary to lead the project. The effort failed after it ran into unplaccable opposition from the health insurance industry and their very effective “Harry and Louise” ad campaign.
• Shortly after (and in response to) the ill-fated Clinton Health Care Initiative, the Heritage Foundation conceived of the idea of the “individual mandate.”
  This is well known among health care experts and has never been disputed.[1]
• Republican Governor Mitt Romney incorporated the “individual mandate” into the Commonwealth’s first in the nation universal health care bill, enacted in 2006 as Chapter 58.
• When working on the Affordable Care Act (aka “Obamacare”) President Obama and his team used some of the same ideas, as well as some of the same architects, in crafting the federal act.
• Although Obama assiduously sought out Republican input and participation, the Republicans steadfastly refused to participate in the crafting of the Affordable Care Act. At the time, Mitch McConnell, recently installed as Senate Majority Leader, let it be known that his #1 priority was to see that Obama was not re-elected.[2]
• Since then, the Republican engaged in a six year campaign to demonize the Affordable Care Act so that Obama would not get credit for being the President to finally enact universal health legislation in the United States.
• Along the way the Republicans voted to repeal the Affordable Care Act somewhere around 60 times, knowing that the President would veto the repeal.
• Now that they have control of the Presidency, the House and the Senate, the Republicans have pushed forward with repealing and replacing the affordable care act because it has been so central to all of their campaigns.
• Several months ago, after an initial false start, the Republicans managed to pass the “American Health Care Act,” which even President Trump conceded was “mean.” The non-partisan Congressional Budget Office estimated that among other things, it would likely throw 14 million American off the health care rolls in 2018, 21 million by 2020, and 24 million by 2026.[3]
• Since arriving in the Senate, Mitch McConnell and a group of 12 additional male Senators have been working in secret on a Senate version of the plan. They have had no committee hearings, circulated no drafts of the bill, and excluded even the rest of their Republican colleagues, all because they know that if their plan looks anything like the House plan, it would run into virulent opposition.
• This is the plan that McConnell has finally released today, and which he wants the Senate to vote on next week. Even though the plan is not a budget, McConnell and friends have structured in such a way that they can use the budget reconciliation process in the Senate to avoid what would otherwise be a certain Democratic filibuster.[4]

What I really want to say to the Republican Congress is, Members, Obama is out of office now. You can stop obsessing about his legacy. You can stop trying to destroy the Affordable Care Act to score political points.

But with our Republican friends, it’s always politics first. Always.

McConnell has violated every rule relative to the normal historic operating procedure of the Senate. This immense Überhypocrite, who has had the temerity to complain about how the Democrats ran the Senate when they were last in power, wants to pass a bill that would literally screw millions of Americans out of health care. He knows it. The Gang that can’t shoot straight knows it. His Republican colleagues know it.

They don’t care.

No sane person has ever argued that the Affordable Care Act is a perfect bill. We all know that it’s not perfect, and it definitely needs some adjustment. Democrats practically begged Republicans to work with them on adjusting it while Obama was still in office, but the Republican response was their 60 efforts at repeal.

The Affordable Care Act is not “in a death spiral” as Republicans have repeatedly claimed. What is in a bit of chaos these days is the health insurance market, and the cause for that chaos is the Republicans continued attempts to completely repeal the Affordable Care Act.

I have some history with the efforts to enact universal health insurance in Massachusetts, and I’ve written extensively about the Affordable Care Act. Anybody who is interested in the details can read about them here. In any case, the enactment of the Affordable Care Act – whatever flaws it may contain – was at least a sincere best effort at finding a way to bring Universal Health to the American people in a way that would not generate total opposition from the health insurance industry (in a way that a single-payer solution would).

But this, this American Health Care Act, that the Republicans are promoting: this is just a cynical attempt to score political points at the expense of the American people, and which more than anything would hurt the people who largely supported Donald Trump.

[1] See “Assuring Affordable Health Care for All Americans” by Stuart M. Butler (1989).

[2] In this he clearly failed, but it set a pattern for the depth of his hypocrisy. One might reasonably think that the #1 priority of the Senate Majority Leader should be the proper governance of this country, and doing whatever possible to “make it great again,” but McConnell was at least honest enough to disclose his obsession with obstructing Obama.

[3] While an in-depth examination of the American Health Care Bill is well beyond the scope of this post, there are plenty of articles that have demonstrated in great detail what a disaster this bill would be for the American people.

[4] The budget reconciliation process is a complex set of rules that are designed to insure that budgets can pass in the Senate and not be waylaid by opposition filibusters. Budgets often have special rules because Congress must pass a budget in order to keep the government functioning. An in-depth examination of the reconciliation process and why it is inappropriate for this bill is also beyond the scope of this post.