On “Moving On” From Health Care

by Yuval Levin

There is much to be said, in due course, about the sorry fate of the AHCA. But one particularly striking feature of many conversations with Republicans on and off Capitol Hill about it today had to do with a peculiar facet of the way the debate about the bill came to an end. Again and again, people expressed surprise at how the language of “moving on” from health care appeared to have been taken by some observers.

For some, that surprise took the form of bemusement at various things written by analysts on the left about how Republicans were done trying to repeal Obamacare and now it was here to stay. But as the day went on, I think people on the right came to the view that this idea was being taken too seriously—not only by liberals and (therefore) by many journalists, but by some on the right, and perhaps even by the president. 

When Trump said late last week that he had lost his patience with the health-care debate and would move on to something else if the bill didn’t pass, most of the people he was talking to took him to be trying a hard sell. After all, he had only really been engaged in the debate for a couple of weeks, a number of policy challenges seem likely to force some kind of action on Obamacare this year, and in any case there wasn’t really anything else ready to move to. 

It’s still not entirely clear what Trump had in mind, but it does seem that he genuinely did lose his patience after a couple of weeks. Perhaps he really does think he will now move on from health care, or that he actually has the option to just sit back and let the law “explode,” as he put it. 

But other Republicans don’t seem to want to move on. So I would expect that in the course of the next few days we will see statements from various Republican quarters backing down from claims about moving on and making it clear that they’re still engaged in health care conversations, which they expect to continue for some time. 

That doesn’t mean things would simply pick up from the rejected bill. The various factions of the House Republicans certainly made some progress toward each other over the past few weeks despite the bill’s considerable failings, and they (and Senate counterparts) will likely try to build on that, but the process they will pursue seems likely to be a good bit slower, less intense, and less leadership-driven. It may have trouble aligning with reconciliation schedules, at least as they now stand, and its relation to any efforts toward tax reform will need to be thought about as things proceed. 

This is also not to diminish or understate the damage done by last week’s epic failure. It has surely left Republicans in Washington with less confidence in one another and complicated the entire Republican agenda for the year. The failures of policy development, salesmanship, and brinksmanship by the self-proclaimed masters of each in the party will not soon be forgotten. And the bizarrely hurried schedule—originally adopted with a very different (dual-reconciliation) strategy in mind and then retained largely by sheer inertia—did a lot of needless damage to the ultimate prospects for replacing Obamacare. 

Failure in that effort is certainly possible in time. But it has by no means come already, and it is surely avoidable. Back in January, when that first dual-reconciliation strategy was still the aim, I argued that it seemed likely to fail, and that it might not be the only failure along the way, but that a year of intense action on health care was only beginning. That still seems likely, on the whole. 

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