Let us stipulate right at the beginning that, if you put the menu for Chinese takeout in front of the president* and wrote “Obamacare Repeal” across the top, he’d sign it. So let’s take him out of the whole equation. The tragedy is that, once you do that, you are left with the inescapable conclusion that, on the matter of the Affordable Care Act, the Republican Party is little more than a cult centered around human suffering.

The latest evidence comes to us as The Cassidy-Graham Plan, named for its co-sponsors, Bill Cassidy, Republican of Louisiana, and our old pal, Lindsey Graham of South Carolina. The difference between this proposal and the rest of the Walking Dead plans that have wandered through Congress this year is that this one is at least nominally detailed. And that’s the problem, and the cruelty, of it.

As Sarah Kliff explains at Vox, this plan comes closer to absolute de facto repeal of the ACA as any of the other plans did.

The proposal would eliminate the health care law’s subsidies for private insurance and end the Medicaid expansion. States could allow for waivers that let insurers charge sick patients higher premiums and stop covering certain benefits required under the Affordable Care Act, like maternity care or prescription drugs. The health insurance marketplaces would no longer exist as they are envisioned to continue under other Republican proposals. The federal government would convert some (but not all) of that spending into a lump-sum payment to states. States could choose to spend this money on providing insurance — or they could use it to fund high-risk pools, or do other activities to pay the bills of patients with high medical needs. States wouldn’t get this money for free: They’d be required to kick in a small percentage themselves. The plan hasn’t been scored by the Congressional Budget Office yet, but analysts who have studied Cassidy-Graham estimate it would cut deeply into federal funding for the health law programs, likely resulting in millions losing coverage. Cassidy-Graham would arguably be more disruptive, not less, to the current health care system than the plans that came before it. It would let money currently spent on health insurance go toward other programs, providing no guarantee that the Affordable Care Act programs individuals rely on today would continue into the future.

The individual details of this plan have been exposed as scams, time and time again. (For a party that doesn’t want “government” controlling healthcare, these people seem remarkably enthusiastic of handing it over to governors like Scott Walker and Sam Brownback.) It’s demonstrably worse for people than the plan that famously was sunk by a single vote. And yet it’s just as close to passing right now as that one was. Maybe closer. It’s likely going to be voted on without a score from the Congressional Budget Office, which likely would be as grotesque as the CBO scores its predecessors rang up. It likely once again will garner no Democratic votes. (Joe Manchin on Tuesday said he was against it.) But it is the fundamental anti-politics of the thing that clearly shows that the entire Republican Party is lashed to the side of the whale at this point. The party opposes any attempt to reform the healthcare system in this country—and, certainly, any attempt to improve the ACA—in a fashion that is damned near evangelical in its blind and reckless fervor.

Consider: Dean Heller, Republican of Nevada, voted for the previous bill and likely will vote for this one, despite the fact that his state’s Republican governor, Brian Sandoval, is practically screaming at him not to do so.

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Consider: John McCain, who cast a crucial vote the last time around, has been all over the lot this time around, probably because he’s Damon and Graham is Pythias. This time, McCain has tried to hide behind Arizona Governor Doug Ducey and nobody has any idea what he’s finally going to do.

Consider: state governors in general seem to be reluctant to embrace the freedom that comes with this latest bag of rocks, at least if you listen to its sponsors. From USA Today:

Among the list of governors was Alaska’s Bill Walker, an independent, who had been lobbied by the Trump administration to support the bill because Alaska GOP Sen. Lisa Murkowski is undecided and is a critical vote to get the legislation through. “As you continue to consider changes to the American health care system, we ask you not to consider the Graham-Cassidy-Heller-Johnson amendment and renew support for bipartisan efforts to make health care more available and affordable for all Americans,” the 10 governors urged in a letter addressed to Majority Leader Mitch McConnell, R-Ky., and Minority Leader Chuck Schumer, D-N.Y.

It’s still anyone’s guess if this dog’s breakfast even will get to a floor vote in the Senate. But the insistence on trying marks the Republican congressional majorities pretty lousy. They know the country doesn’t want this. They know that an effective majority of their members don’t want it. They know that governors of their own party don’t want it. And they know that the president* of their own party has moved on to threatening nuclear annihilation, among other hobbies. Why this fanatical pursuit of this one legislative goal? It can’t all be about money; none of the senators in question seems to be in danger of a serious primary challenge or of having the golden spigot turned off.

The only conclusion would seem to be that there is something in their political makeup that believes that the people who benefit from the ACA, and the people who would benefit if it were repaired and not destroyed, are unworthy of those benefits and that it is not the proper function of government to question this fundamental truth. (This, at least, is what Rand Paul is honest enough to say out loud.)

They will wreck lives to prove a point that isn’t even true to begin with, and on which they are such monumental hypocrites that even the elite political press is beginning to notice. (Much as has been the case with immigration, the people seeking to “hand power back to the states” are more than willing to take power away from the states if the states dare do on their own that which the senators are trying desperately to head off nationally.) Listen to Lindsey Graham go all mad-preacher about the subject on Monday Per the Washington Examiner:

"This is Bernie Sanders' worst nightmare," Graham said in an interview on Breitbart News Saturday on SiriusXM, speaking about his healthcare proposal. "It's either this or we're going to Obamacare and Berniecare. Now, Berniecare is full-blown single-payer socialism. It is his dream and that's where Democrats are going."

Don’t tease me, bro.

Update (6:04 p.m.): OK, so it's a little bit about money.



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Charles P. Pierce Charles P Pierce is the author of four books, most recently Idiot America, and has been a working journalist since 1976.

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