McConnell, Trump, and Ryan at the White House in March. (Reuters photo: Kevin Lamarque)

Republicans need to decide if they want to use the power they were given by the voters.

More than five months after a Republican president was inaugurated and began to work with Republican majorities in both houses of Congress, it’s time to ask the party a question: Would they like to hand the reins of government over to the Democrats?

After years of promises to repeal Obamacare, the time is rapidly approaching when we’ll know the real answer to that question. Because if Republicans can’t find the votes to pass health-care legislation that will fulfill their vow, it’s clear that they are not ready to govern the country.


The Senate bill is something of a mess and is, like Obamacare was in 2010, being hastily pushed through via quirks in the rules to allow it to be reconciled with the version passed by the House, rather than undergoing a more exhaustive process that would allow for lengthy debate on every aspect of the law. Conservatives are right that it is more of an effort to fix the misnamed Affordable Care Act than a genuine repeal. Moderates are right that the political costs of placing any limits on Medicaid spending will be considerable.

In other words, it’s the sort of bill that nobody really likes, which is why several Republicans are refusing to commit to voting for it, with Democrats solidly lining up in opposition. Perhaps Senate majority leader Mitch McConnell already knows it can’t pass and is just looking to push for a vote as soon as possible to get it over with before moving on to other items, such as tax reform or infrastructure spending, that will be easier to pass. Given the difficulty of finding a compromise that conservatives and moderates can live with and the certainty that passage will unleash a wave of liberal rhetoric that will be echoed in the mainstream media about the changes to Obamacare being tantamount to sentencing millions of Americans to death, that might be enough to cause the GOP to wave the white flag.

If so, GOP conservatives will be able to tell their voters that they refused to sign on to a bill that compromised their principles, and moderates will be able to assert that they prevented something from being passed that might harm the interests of some voters. But what they will really be saying is that Republicans are no longer a party of government.



Contrary to the opinions of those who believe the failure of the effort to repeal and replace Obamacare will be just a temporary setback, the fate of the current bill will provide a watershed moment in American politics.

In 2010, faced with many of the same problems that now face Republicans, Democrats refused to back down on their health-care promises. Their bill was a far bigger mess than the one before the Senate. Few knew what was really in it or how it could be put into effect. The method by which it was passed was also a legislative trick rather than the result of an open process. But handed what turned out to be a relatively narrow window of opportunity to make their mark, President Obama and the Democrats didn’t shrink from the challenge. They passed their bill imposing federal power on the health-care system, which also set in motion a series of related mandates that sought to roll back religious liberty. The result was awful and doomed to failure by its willingness to disdain basic principles of economics. But it showed they were ready and willing to govern.

Neither conservatives nor moderates should be deceived as to the consequences of not passing any repeal-and-replace bill.


Fearful Republicans can point to what happened to Democrats after they passed Obamacare as a warning that they should not be so bold. But neither conservatives nor moderates should be deceived as to the consequences of not passing any repeal-and-replace bill.


Such a failure will be as close to a parliamentary no-confidence vote as we can get in our constitutional system. If they fail on this issue, not only will they be unlikely to succeed on other issues that they may think will be easier lifts, but a vote against the Senate bill is tantamount to a vote for leaving Obamacare in place as it is. That will erode voter confidence — both in the GOP base and among independents — that Republicans have the will or the competence to run the country.

It’s true that President Trump’s antics already have put that thought in the minds of many Americans who are not otherwise ideologically committed to “resist” his administration. But health care is the crucial test by which this Congress and the White House will be judged, no matter what they are able to do in the next year prior to the 2018 midterms. Failure here is tantamount to an engraved invitation to the voters to throw them out and give Nancy Pelosi and Chuck Schumer another chance in power.

Though Republicans have controlled the House since 2011 and the Senate since 2015, so long as Obama was in the White House, they did not fully shoulder the burden of governing. They could indulge in meaningless gestures, such as the dozens of Obamacare repeal votes, and care more about reaffirming their principles than about making actual choices. But they no longer have that luxury.


For conservatives, their choice is not between an ideal conservative repeal of Obamacare and the current imperfect version. It is between this bill and being stuck with Obamacare. If they choose the latter, they must prepare to spend the coming years fighting not to reform the Affordable Care Act but against Democratic efforts to impose a single-payer universal-health-care bill that will further erode economic freedom and restore the worst aspects of Obama’s signature achievement. By contrast, the current GOP bill has several aspects that are clear conservative victories. It will terminate an open-ended entitlement and turn it into something that will hopefully develop into a system that will be more affordable and allow more individual choice. Moreover, it will allow Republicans to fight Democratic efforts to expand government power from a stronger position, since they will be able to say they have provided a clear alternative.

Moderates may quail at the coming wave of largely false Democratic propaganda but — as with conservatives — their reelection chances will not be improved if they are part of a Republican majority that shows that it is unfit to govern.

The nation laughed when an exasperated President Donald Trump said back in February that, “nobody knew health care could be so complicated.” Of course, just about everyone knew that. But right now, a great many Republicans in the Senate who think they know more about policy than the president are acting as if they had no idea governing could be so hard.

Running a country in a democratic system involves compromise and choice. Majorities that make those hard choices aren’t guaranteed future victories, but they always stand a better chance of being reelected than those that demonstrate that they would prefer to be in the minority. If Republicans can’t pass an imperfect health care bill that is still better than the status quo, then they will not only be likely to be back in the minority two years from now. They will also deserve it.

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