Repeal and replace Obamacare collapses in the Senate

The collapse of repeal and replace Obamacare, with the announcement by Sen. Mike Lee, R-Utah and Sen. Jerry Moran, R-Kansas that they will oppose the bill, is bound to enrage voters who thought they elected Republicans to control the House, Senate, and the White House to get rid of the healthcare reform law. Senate Majority Leader Mitch McConnell has now pledged to put up to a vote a bill that will repeal the so-called Affordable Care Act with a two-year delay to allow for a replacement portion.

The Senate had passed the same bill before when Barack Obama was available to veto it. Will it do so again with Donald Trump available to sign it?

What happened?

While voters are scratching their heads wondering why a Republican majority cannot pass a bill to address the dysfunctional Obamacare regime, they are asking the wrong question. The Senate especially does not have a conservative majority. Moderates found themselves afraid of rolling back the provisions of Obamacare that expanded Medicaid. Conservatives opposed any measure that retained any of the taxes, spending, and regulations featured in the law.

Despite monumental efforts to forge a compromise, the two positions were not reconcilable.

A 52 seat majority was simply not enough. All the Democrats had to do was to sit aside and do nothing, secure in the knowledge that Republicans could not get their act together. No moderates in the Democratic caucus were available to deal with.

Will the repeal now replace later pass?

One would think that the Republican caucus could pass the same bill that they passed several times during the Obama presidency. The senators have to realize that if they fail to pass anything, the wrath of the voters will be incandescent. However, the capacity of politicians to be both cowards and hypocrites may be too much for even that to pass.

The only other alternative is a measure to shore up Obamacare with Democratic votes, substantially preserving a regime that the Republicans promised to end.

Is the United States doomed to single payer?

The conversation on social media suggests that the United States is on an inexorable path to a Canada-style government run healthcare system. There is less prospect of that happening than ending Obamacare. Both Vermont and California, progressive bastions, drew back from instituting such a system because of its enormous costs. One estimate for a nationwide system pegs the cost at $32 billion over ten years. No American government, not matter how left, would pass such a measure.

What happens now?

The Senate Republicans can salvage things if they pass repeal now replace later, especially if the replacement part is devolved to the states. However, the capacity of the Congress to do anything sensible in regards to healthcare is now very much in doubt.