Thank you

First of all, thank you to Senator John McCain, Senator Lisa Murkowski, and Senator Susan Collins for killing the skinny repeal. (McCain was surrounded for over 40 minutes by people trying to change his vote. They failed. Even if McCain has little to lose, that’s a great show of conviction in what he did.)

Everybody knew the skinny repeal was a disaster. Even the most conservative person who wants nothing more than to get rid of the ACA must recognize that removing the individual mandate without repealing the rest of Obamacare would destabilize insurance premiums because the regulations the ACA introduced are simply not sustainable without the mandate. That’s the policy equivalent of having your cake and eating it too, it’s impossible. For all of Paul Ryan’s promises that this would go to conference committee, the economic and humanitarian significance of this bill is too great to leave it to any person’s word that it won’t pass as-is. These three senators voted based on that knowledge, not based on the party agenda and that deserves recognition.



Second of all, we Democrats cannot afford to celebrate. We need to keep an eye on congress and keep fighting to protect and extend healthcare for all Americans.

Nor should we celebrate. We also need to recognize that serious problems remain with the healthcare industry in the United States (generally, we do). The ACA helped address access and it is a beautifully crafted law (whether you oppose it because you want single-payer or because you want to leave healthcare access to the free market, you have to appreciate the risk corridor, reinsurance, and risk adjustment programs and the individual mandate as wonderfully intelligently crafted or you’re blinded by your own bias), but it truly did not do enough to attempt to reform the healthcare industry. Here’s a short list of problems the ACA didn’t address:

Though insurance companies themselves rarely run much profit, their executives often are compensated with stocks that give them a personal disincentive to keep healthcare costs down

Doctors have massive overhead and student debt and not enough doctors are trained in the US to meet demand

There is a lack of transparency in the healthcare market due to private practices and clinics being convoluted

Pharmaceutical companies waste tremendous amounts of money advertising directly to consumers

All of these things can be addressed without touching health insurance or the ACA, they’re a totally separate problem.

Look, Republicans control the entire federal government. Single-payer isn’t happening until we win back the legislature, but there are a lot of things that moderate Republicans might be willing to work with us on now that their leaders have been embarrassed. Senator Schumer gave a beautiful speech extending an olive branch to Cassidy, Collins, McCain, Murkowski, Hatch, and the other Republicans that want a real solution, not a political show. We might have to compromise, but there are still some people on the other side there’s hope of working with. Cloture and passing a law might not be possible, but creating some good bills and getting the ideas out there should be and that is the first step toward meaningful reform.

If nothing else, Democrats need to keep bringing up ideas, they can’t become the party of “no”, nor, in my opinion, can they propose single-payer and only single payer and refuse to engage with the party currently actually in power in any meaningful way. Let’s keep fighting and bring some reforms that we can all agree on to the public’s attention and see if we can actually get some work done for the American people.

Then lets try to win back the legislature in 2018 to speed up the process by an order of magnitude. 60 senators and we can get single payer, until then there’s still so much good that should be possible.