In the end, “Et tu, Mike?” were the last hoarse words of the Better Care Reconciliation Act. It was Senators Mike Lee and Jerry Moran who delivered the frontal stab last night, hardly a surprise given Lee’s fiscally conservative proclivities, but a clarifying moment nonetheless. The health overhaul’s death was a message that the tea party would rather start afresh than half-ass its issue du jour. It was a demonstration, too, that centrists were willing to risk a disorderly spectacle if it meant derailing a bill that does little to arrest rising premiums.
This is a political loss for the GOP, no question, but it’s also a potentially advantageous one. By not passing a third-rate health care alternative of their own, Republicans will avoid the political heat that would have come from touching the insurance system without fixing it. The question now is how seamlessly they can pivot to something else. They need a moment like the New England Patriots had in 2014 following their unexpected and jarring loss to the Kansas City Chiefs, after which head coach Bill Belichick refused to entertain media prognostications of doom and mechanically intoned that his team was “on to Cincinnati.” The Patriots beat the Bengals that next week and went on to win the Super Bowl.
Already the GOP is trying to shift its focus. Mere hours after Lee and Moran delivered their death blow, the House of Representatives unveiled its new budget proposal. It will slash at least $203 billion in mandatory spending over the next 10 years in order to clear a path for tax reform through the deficit neutrality-requiring reconciliation process. Coming off of a failure on health care to tackle taxes is a bit like losing to Floyd Mayweather only to fight Mike Tyson: repairing the nation’s dysfunctional, arcane, labyrinthine excuse for a tax code is going to be an arduous feat, as every uneasy Capitol Hill Republican eyeing its Everest of pages well knows.
Start with the prologue of that trimmed budget. Pusillanimous Republicans were loathe to cut spending during the tea party years, let alone following the election of populist Donald Trump. Yet in order to reduce spending and thereby unlock reconciliation, they’ll need to rifle through entitlements, by far the fastest-growing portion of the federal budget. The House Appropriations Committee will start scrutinizing mandatory spending this week for savings, a Sisyphean task that’s sure to cue the ads from Democrats of suits pushing handicapped nonagenarians off of cliffs.
One of the Republican health bill’s many susceptibilities was its latent reductions in Medicaid spending, which set off a revolt among Senate centrists. Presented with a budget’s potentially radical modifications to Medicaid (and Medicare), the Collins-Murkowski-Capito-Heller quarter could rebel again, timorous about blowback from their relatively low-income constituents back home.
Other potholes lie ahead, too, courtesy of Republicans’ fractious caucuses. The new budget allots $621 billion for defense spending, but that may not be enough for some of the GOP’s more psychotic hawks whose appetite for Millennial-bankrupting Pentagon lard is nigh-bottomless. Conservative members could also object, dissatisfied that entitlements aren’t being more thoroughly fixed.
Still, the White House is bringing enormous pressure to bear on Congress to get something done. And with that “something” inevitably tax reform, and tax reform immovable without a smaller budget, this may be the best gun to the GOP’s head yet on the entitlements issue.
Then it’s on to the tax code, where a vanguard of lobbyists patrols every solitary loophole and Democrats are waiting in the shadows to shriek about “tax breaks for the rich!!!” No one denies all this will be a slog—but it is not health care and that’s a crucial distinction. You might raise an eyebrow if the GOP cancels a tax advantage you like; you’re damn well going to revolt if they menace the insurance system that foots your hospital bills and underwrites your wellbeing. Among Republicans’ many failings of late was not grasping just how urgent an issue health care is for so many. Tax reform, at the very least, won’t carry quite the same emotional charge.
So “on to the IRS”? It’s a sloppy metaphor, I admit. Among its many shortcomings is that Paul Ryan is no Bill Belichick.