In a nutshell, what the debate has really shown is that the passage and implementation of the ACA has given rise to a latent majority in Congress — or at least one in the Senate — that has more or less made peace with the ACA’s spending and regulatory architecture and its fundamental ideological goals, either for political or principled reasons, or for some combination of the two. The debate has forced this basic reality out into the open. And this, I think, is one key reason it is proving so hard for the GOP to repeal it.

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The Post’s David Weigel has an extraordinary report on a town-hall meeting held by GOP Sen. Jerry Moran of Kansas that neatly illustrates the point. Moran is a GOP loyalist who previously headed the GOP Senate campaign arm and sits firmly in the mainstream of today’s GOP. Yet even he is having trouble supporting the GOP bill. At the town-hall meeting, there was no sign of his previous calls for repeal:

He did not describe the task facing Republicans as repeal; it was “repair, replace, whatever language people are using.” Pressed by activists and voters, Moran said that he did not want to cut back Medicaid. “I have concern about people with disabilities, the frail and elderly,” Moran said. “I also know that if we want health care in rural places and across Kansas, Medicare and Medicaid need to compensate for the services they provide.” After the town hall meeting, Moran told reporters the version of the GOP’s bill that he opposed put too much of Medicaid at risk. “Medicaid, except for the extension part of Medicaid, is not really a part of fixing the Affordable Care Act,” he said. “So we’ve coupled two things, both of which are very difficult. Kansas is a place that’s treated Medicaid payments very conservative. If there are people receiving those payments who don’t deserve them, deal with that issue.”

Moran appears to mean that the GOP bill would not only phase out the ACA’s Medicaid expansion; it would also cut Medicaid funding far beyond the expansion (to the tune of $776 billion over 10 years, leaving 15 million fewer covered by the program). Moran is saying this would hurt untold numbers of people, including the disabled and sick, and suggesting that such deep Medicaid cuts would threaten to close rural hospitals. He is suggesting that, while able-bodied adults might allegedly be scamming their way onto the Medicaid expansion, this issue should not be taken to justify the deeper cuts to Medicaid. And this, as Weigel notes, unfolded in one of “the reddest parts of a deep red state.”

The bottom line is that Republicans who currently oppose the Senate bill object to it because it would roll back federal spending in a way that would hurt millions and millions of people. This includes Moran and moderates such as Dean Heller of Nevada, Susan Collins of Maine, Shelley Moore Capito of West Virginia, and Rob Portman of Ohio, all of whom have made variations of this argument. Some, such as Collins and Sen. Bob Corker of Tennessee, have even objected on the grounds that this would finance a massive tax cut for the wealthy, and that this is indefensible.

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All of this is dramatically at odds with the ludicrous spin coming from GOP leaders such as John Cornyn of Texas and House Speaker Paul D. Ryan of Wisconsin, who argue that the millions left uncovered under the GOP bill will be choosing that plight, because they will have been liberated from the hated ACA mandate. To summarize, Republicans are arguing both that (1) millions won’t actually be hurt by these Medicaid cuts, either because they aren’t really cuts, or because everyone will have “access” to health care later; and that (2) if many millions of people go without coverage who would otherwise have been covered, they did so by choice.

It is true that scrapping the mandate would be a partial cause of the rise in the uninsured. But how many of the 15 million fewer covered by Medicaid would be choosing that outcome, as opposed to not being able to afford coverage on their own? The point here is that, while it is of course possible to make a principled argument against the mandate, Republicans are doing something else entirely: They are hiding behind their arguments against the mandate to evade acknowledging the true human toll their proposed Medicaid cuts would inflict. What this really means is that they are basically fine with rolling back the ACA’s massive coverage expansion to facilitate a massive tax cut for the rich, but just won’t say so out loud.

But all indications are that moderate Republican senators — and even senators such as Moran — are not fine with this outcome. And this also applies to the ACA’s provisions barring discrimination against people with preexisting conditions. As Philip Klein points out, Republicans are badly hung up on this — they are struggling to find some other way of realizing that goal while also repealing the mandate, which means they still want government to act to accomplish the same thing.

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Now, these objecting senators may still end up supporting a revised GOP bill in the end, due to party pressures and other factors. But if they do, they will only justify it by pretending that a few additional last-minute dollars (in relative terms) added to the bill would put a meaningful dent in the enormous coverage loss the bill would produce, which that money would not actually do. This would mean their current objections were insincere. But right now, if we take those objections at face value, we have learned that they — and a majority of the Senate, when taken along with all Democrats — just aren’t willing to be associated with rolling back the large coverage expansion that the ACA has achieved.

* McCONNELL SEES POSSIBILITY THAT HEALTH BILL COULD FAIL: Senate Majority Leader Mitch McConnell (R-Ky.) is now saying that if the GOP bill fails, Republicans will have to act to shore up the insurance markets. But as Juliet Eilperin and Amy Goldstein point out:

His suggestion that he and his colleagues might instead try to bolster the insurance exchanges created under the ACA is at odds with Republican talking points that they are beyond repair … Until now, both congressional Republicans and the Trump administration have contended that the “collapse” of the ACA marketplaces is a main reason to erase much of the 2010 law.

Exactly! McConnell’s concession blows up one of the biggest and most mendacious stories President Trump and Republicans have been telling about Obamacare for months.

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* G-20 LEADERS WILL URGE TRUMP TO REJOIN PARIS DEAL: Reuters reports that leaders of the Group of 20 meeting today in Hamburg will press Trump to rejoin the Paris climate accord, while stressing it cannot be renegotiated. Here’s British Prime Minister Theresa May:

“The collective message that will be given to President Trump around this table will be the importance of America coming back in to that agreement and I hope we will be able to work to ensure that can happen.”

Worth a try, but good luck with that. Any pressure from all these Euro-weenies is likely to deepen Trump’s conviction that pulling out of the deal actually constitutes putting America first.

* WHAT’S ON THE AGENDA FOR TRUMP/PUTIN MEETING? It’s worth recalling this quote from H.R. McMaster, Trump’s national security adviser:

“There’s no specific agenda — it’s really going to be whatever the president wants to talk about.”

If only there were people who were tasked with advising the president and preparing him for moments such as this one. Oh, wait …

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* GOP HEALTH BILL LEAST POPULAR IN THREE DECADES: Axios reports that Chris Warshaw of MIT looked at polling of all major legislation since 1990 and found:

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The Republican health care effort is the most unpopular legislation in three decades — less popular than the Affordable Care Act when it was passed, the widely hated Troubled Asset Relief Program bank bailout bill in 2008, and even President Bill Clinton’s failed health reform effort in the 1990s.

It turns out cutting hundreds of billions in health spending on poor people to finance a huge tax cut for the rich is deeply unpopular, and not even Trump’s mighty Twitter feed can change it.

* NO END TO THE GOP LYING ABOUT HEALTH CARE: Paul Krugman runs through multiple lies and deceptions that Republicans are telling about their health-care bill, including this one:

Senior Republicans like Paul Ryan dismiss declines in the number of people with coverage as no big deal, because they would represent voluntary choices not to buy insurance. How is this supposed to apply to the 15 million people the C.B.O. predicts would lose Medicaid? Wouldn’t many people drop coverage, not as an exercise in personal freedom, but in response to what the Kaiser Family Foundation estimates would be an average 74 percent increase in after-tax premiums?

Republicans like to say the coverage loss would be the result of people’s choices once the hated mandate is scrapped. But if this is about the mandate, why the huge cuts in taxes for the rich and Medicaid?

* AND TRUMP KEEPS UP ASSAULT ON MEDIA — FROM ABROAD: While Trump was preparing early this morning for meetings with world leaders, including Putin, he found time to tweet this: