Donald Trump has labeled the Republican senators who can’t scrape together a replacement for the Affordable Care Act – here’s who he may have meant

This article is more than 3 years old

This article is more than 3 years old

On Monday night Donald Trump reportedly told Republican senators they would look like “dopes” if they couldn’t pass a healthcare bill to replace the Affordable Care Act.

This is one of those occasions when the president might actually be right.

Repeal now, replace later? GOP's last-ditch healthcare effort faces slim odds Read more

Republicans have spent the past seven years trying to repeal the ACA, popularly called Obamacare. Both House and Senate candidates have based entire electoral campaigns around it. Now, in 2017, they control all three branches of government.

But still the GOP has failed. So, here’s a look at the people Trump might have been thinking of when he talked about dopes who couldn’t pass the bill (the Oxford English dictionary defines a “dope” as “a stupid person”) – and one he almost certainly wasn’t thinking of.

Mitch McConnell

The Senate majority leader spent two months drafting a healthcare bill in secret.

When McConnell finally allowed people to look at his work on 22 June, four Republican senators immediately came out in opposition to the bill. McConnell could only afford to lose two of his colleagues’ votes if the bill was going to pass.

Four days later, the Congressional Budget Office offered its assessment. McConnell’s furtively crafted legislation would leave 22m more people uninsured.

As a poll showed just 12% of Americans supported the fruits of McConnell’s labour, McConnell worked away on a revised bill, which he plonked in front of his colleagues on 13 July. They still weren’t impressed, and McConnell was still no closer to passing his bill.

Ted Cruz

One of the changes in the second bill was an amendment brought in by the Texas senator. Cruz’s tweak would allow insurance companies to offer policies that did not meet a list of essential benefits mandated by the ACA.

Cruz had been working on his amendment for weeks. It turned out to be a waste of time.

“It is simply unworkable in any form,” was the verdict from two of the insurance industry’s most powerful organizations.

Cruz’s doomed engagement with the bill represented an about-turn for the Texan, who as a senator in 2012 promised he would “throw my body in front of a train” to stop anything other than a full repeal, according to Real Clear Politics.

It’s unclear what impact, if any, Cruz hurling himself in front of a train would have had on the Senate bill.

Facebook Twitter Pinterest Paul Ryan leaves a news conference on Capitol Hill Tuesday in Washington DC. Photograph: Chip Somodevilla/Getty Images

Paul Ryan

Maybe McConnell could have learned a thing or two from Ryan, who had to stall a vote on the House’s version of a healthcare bill less than an hour before it was due for a vote.

Ryan at least eventually got the legislation passed with one vote to spare. But soon after, the CBO issued a new report on the bill: it would leave 23 million more people uninsured.

And it turned out all Ryan’s effort was for nought. After the bill passed the House, the Senate immediately made it clear it wanted nothing to do with the measure.

“The House made a stab at it,” said John Cornyn, the second-highest ranking Republican in the Senate.

“But that’s not going to be what the Senate votes on.”

Tom MacArthur

There’s a parallel here with Ted Cruz’s doomed effort to save the Senate bill.

Except MacArthur’s amendment actually worked and got the House bill – which was deeply unpopular – passed. MacArthur’s tweak would allow states to opt out of rules that protect individuals with pre-existing conditions from being charged more for healthcare coverage. But in hindsight, that does not look like a success.

The New Jersey congressman went from being seen as a moderate – if he was seen at all – to instead being the man whose amendment seemed tailored towards the far-right wing of his party.

Senate will vote to repeal Obamacare without replacement, after new healthcare bill stumbles Read more

The repercussions were swift. At a town hall in Willingboro, New Jersey, MacArthur was branded a “weasel”, a “killer” and an “idiot”. He resigned from the moderate Tuesday Group in the aftermath, and the Cook Political Report, which is predicting the 2018 mid-term elections, decided MacArthur was at an increased risk of losing his New Jersey seat.

Donald J Trump

On the campaign trail, Trump repeatedly told voters he would repeal the ACA “immediately”.

It was going to be “so easy” to repeal the legislation, he told supporters in Florida in October.

“When we win on November 8 and elect a Republican Congress, we will be able to immediately repeal and replace Obamacare. I will ask Congress to convene a special session,” Trump said in Pennsylvania in October.

But even with that Republican congress, Trump has failed to do as he promised. By February, after six weeks in the White House, the president was claiming that “nobody knew healthcare could be so complicated”.

The president also invested political capital in the bill. He spent the weekend calling Republican senators to win their support.

It didn’t work.

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