Politics Foreign Affairs Culture Fellows Program

The Senate Health Care Bill In Two Tweets

Ross Douthat and Yuval Levin on counting the BRCA's phantom chickens

Ross Douthat on Yuval Levin’s semi-defense of the BRCA:


That’s really by far the most important thing you need to know. The ACA imposed a new regulatory framework on the individual insurance market, raised taxes and provided more funds to subsidize low-income individuals’ access to health insurance via both the insurance exchanges and Medicaid. The Senate bill makes a variety of changes to the regulatory scheme of the ACA that can be debated on the merits. But it also cuts taxes and cuts spending while claiming — in the face of a brutal CBO score and criticism from a variety of independent parties like the AMA — that it will improve rather than worsening access to care. Why should any observer not fully committed to conservative dogma choose to believe them?

If the GOP wanted people to take their reforms seriously as a matter health care policy, they would have focused on those reforms rather than on cutting taxes and cutting spending to keep the budgetary result neutral. They didn’t, so I don’t. This bill is first and foremost about reversing the redistributive effects of the ACA, and only secondarily about a conservative vision for providing health insurance.

Of course, you can argue that this was true of the ACA as well: that the main objective of the Democrats was to provide health insurance to those who previously couldn’t afford it, and only secondarily to reform how that insurance was provided. The thing is, there are far more Democrats who are willing to cop to that charge than there are Republicans willing to admit the primary purpose of their own bill is the opposite.

Meanwhile, probably the most important paragraph in Levin’s article is the following:

[A]nother thing Republicans have learned in these six months is that Donald Trump is an exceptionally weak president, probably the weakest of their lifetimes, and he is likely to accept whatever they do. He’ll celebrate it, sitting himself front and center while they stand around him awkwardly. He’ll praise it wildly and inaccurately. And he’ll sign it—even if pretty soon thereafter, in the wake of bad press, he tries to distance himself from it on Twitter and calls them names.

The GOP saw its entirely leadership overthrown by a novice interloper running explicitly against the traditional movement conservative agenda. Now they are exploiting the personal and political weakness of their novice president to pass as much of that traditional movement conservative agenda as possible, counting on precisely the division between his brand and theirs to obscure any proper accountability.



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