The unveiling of “Ryancare” is off to a disastrous start. Seven years of campaigning against Obamacare and promising to “repeal and replace” it was joined by vague promises from the President to keep the most popular pieces of the Affordable Care Act while saving everyone money. To say that the American Health Care Act fails to bridge this divide would be an understatement. Well done, Speaker Ryan.
To be fair to Paul Ryan, the AHCA never had a chance. The Democratic party, and the left in general, were never going to support reform– 8 years of GOP obstructionism basically guaranteed that. No problem, right? After all, the Republican party has control over every branch of government now. They are in an even stronger position than the Democrats were when they “jammed” Obamacare down our throats. Victory is assured!
This would be true if the current GOP had anything that resembled a working or coherent coalition. But the responses to healthcare reform highlight just how disjointed and ineffective the Republican party is when it comes time to actually govern. This is not because of some inherent weakness of “conservative” ideas. Nor should it be attributed to the weakness of Paul Ryan’s faux-wonk policy credentials (though they are just that) or Donald Trump’s ignorance and inattention (which are real and significant problems). This coalition is simply a mess.
You have the Tea Party/Freedom Caucus/Libertarian types like Jim Jordan and Rand Paul who think that Ryancare is just “Obamacare lite,” with all the tax credits and “stifling” regulation of the original with no Obama to blame it on. The donor class hates it for these reasons too.
The moderate Republicans in swing states dislike it because it throws out the good parts of Obamacare– namely, it effectively strips healthcare coverage the millions of poor, working class people of these states– while leaving the bad (like mandates and regulation). The hardcore Trump voters are in this camp too.
Ross Douthat explains it well:
But in fairness to its designers, there was no bill that could have united all of the right’s disparate factions, because on health care policy, as on a range of issues, the Republican Party as an organism does not know what it believes in anymore.
The Grand Old Party has no idea where it is or where they are going. Hell, they don’t even know who they are anymore.
Think about who the current party represents, what those groups want, and how you make a coherent platform out of it.
- The Steve Bannon tribe: White nationalists who want to stop immigration, support protectionist trade policies, push for big government programs that they see as beneficial to whites (especially members of the white working class), an aggressive police state, a retreat from global leadership, and a desire to instigate a clash of civilizations with the Islamic world. Oh yeah, since these guys are militia adjacent, they also love guns.
- The James Dobson followers: Evangelical Christians who want to roll back rights for the LGBTQ community, ban abortion (and destroy sexual health education and proactive healthcare clinics), increase government funding of religious schools, to use the military to support the position of Christians throughout the world, increase tax breaks for religious organizations, advocate for pro-wealth/anti-poverty economic and social programs, and a baffling pro-gun position.
- The Reagan/Bush leftovers: Neocons who still believe in free trade, a muscular interventionist foreign policy (with a realist orientation), pro-amnesty/pro-immigrant, a more limited (but still large) government, pro-gun, lower taxes, pro-business/Wall St economic policies, deregulation, and market solutions to healthcare and education.
- The Kooky Ron Paul Memorial squad: Libertarians who want the government to stay out of individuals lives, limit spying and “security” measures that compromise individual freedom, disengage from foreign entanglements, and generally return to a Jeffersonian way of governing. Guns for everyone.
There are only a few clear areas of agreement. They all love guns and will want to prevent any regulation of firearms. Not that any such threats were coming. They’d all like to kill Obamacare. Likewise, they all want to dismantle a variety of federal institutions that they view as liberal intrusions on their lives. Their reasons for seeking the destruction of the modern federal government are often at odds, but this doesn’t matter when you are simply raging against the system. However, when you gain control of the machine you find that there is little here that you can make a sane and workable domestic or foreign policy out of.
In the case of healthcare, the Kooks and Neocons will never agree to the subsidies and regulations necessary to guarantee health care coverage regardless of previous illness/injury. This is a non-starter for the Bannonites, who join the liberals in widely supporting this provision of Obamacare. The Focus on the Family crowd doesn’t seem to care, as long as we stop abortion. How do you replace Obamacare and meet these disparate goals? You don’t. In trying to throw a bone to each group Ryan has created a policy that pleases no one and draws the anger of nearly all. Optimistic GOP’ers are holding out hope that they can work this bill and make something palatable out of it. More realistic observers are curious as to how they expect to make chicken salad out of this mess when the chefs keep disagreeing over which parts are actually chicken and which parts are chicken shit.
The Republican leadership faces serious issues in creating a functioning budget (how do you increase military spending, practice austerity, cut taxes, and maintain social welfare programs that your new base loves?), forging trade policies (good luck squaring the circle of protectionist trade policies for industrial and consumer goods while promoting free trade for our exports), navigating international relations (a racist, a religious fanatic, Henry Kissinger, and a pacifist walk into a bar…), and every other aspect of governing in the modern era. These schizophrenic tendencies will paralyze both the Trump and Ryan/McConnel agendas (another bad sign, when your executive and legislative branches have wildly different plans for the future). There is no method here, only madness. Maybe that is a good thing.