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Will We Always Have Been At War With Obamacare?

If the AHCA fails, will the base be furious, relieved, depressed -- or simply forget that the fight ever happened?
obama sebelius frustrated
President Barack Obama listens to comments while meeting with healthcare stakeholders in the Roosevelt Room at White House May 11, 2009. At right is Department of Health and Human Services Secretary Kathleen Sebelius. Official White House Photo by Pete Souza. This official White House photograph is being made available for publication by news organizations and/or for personal use printing by the subject(s) of the photograph. The photograph may not be manipulated or used in materials, advertisements, products, or promotions that in any way suggest approval or endorsement of the President, the First Family, or the White House.

I’m going to be boarding a plane shortly, and I’ll likely be in the air when the AHCA vote happens. So it’s possible that this post will look pointless in a couple of hours.

But assuming the vote fails, as it currently looks likely to do, we’re about to learn just how Orwellian the GOP electorate is.

A failure of the AHCA isn’t necessarily the end of the road for GOP attempts to reform President Obama’s healthcare reform. They could start again pretty quickly in the Senate, which was unlikely ever to pass the House’s bill in the first place. They could also move on to other business, hope to expand their majority in 2018, and then try again. They could even campaign on a particular vision of reform in 2018, and then claim a mandate if they did expand their majority.

But of course, to do that they’d need to have an intra-party debate about what that policy agenda should be. Which would require somebody — and that somebody is probably President Trump — to stand up and say: the House Freedom Caucus’s vision is wrong, and here’s my alternative, whether that’s Medicaid for all or some as-yet undescribed alternative to both Obamacare and the status-quo ante circa 2008.

It’s possible that’s a fight Trump doesn’t want, because he doesn’t care much about healthcare except as a way of bashing Obama and the Democratic Party. Indeed, it’s possible that much of the Republican party sees the matter in precisely the same way: that there wasn’t anything in particular they objected to about Obamacare (other than the tax hikes to pay for it); they just hated that it was a Democratic initiative. It may be that Paul Ryan and the House Freedom Caucus folks are the only ones who actually want to have this fight on the merits. If that’s the case, then if the bill fails that will be the end of any action on health care, and Obamacare will remain the law of the land.

The question then is: how will the party membership react?

If the reaction is fury and renewed attempts to unseat Republicans deemed insufficiently determined to repeal the ACA, and to expand the ranks of the ultras whose demands made any plausible compromise impossible, then we’ll know that what we’re dealing with is a real ideological conflict. Our political system might have a particularly hard time negotiating it, but a substantial irredentist faction would pose a real challenge to any political system.

If the reaction is a mix of soul-searching and teeth-gnashing, and a concerted attempt to find whatever formula delivers a more durable majority, then we’ll know that at the end of the day the GOP is a normal party after all, one that, when it loses, tries to figure out how to win. It wouldn’t be as encouraging as an open fight about policy and principles, but it would be far more encouraging than continued irredentism.

But I wouldn’t be completely shocked if the whole debate just dropped down the memory hole, and the party leadership acted like repealing Obamacare was never that big a deal — and the rank-and-file mostly went along as the party moved on to whatever they are told was always really the priority. Which would be the most depressing — indeed, alarming — possibility.

The vote’s in half an hour. We’ll find out pretty soon whether my whole premise is fallacious.

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