Why McCain Might Not Really Have Been a Hero on the Health Care Bill

by Neil H. Buchanan

The Republicans have reached what we can only hope is truly and finally the end of the road for their obsession with repealing the Affordable Care Act.  The process was indescribably insane, especially in the last week or so, with a series of bizarre show votes that ultimately led to the Republicans' defeat.

Maybe it really is over, but we thought the same thing two weeks ago, only to watch things become even weirder.  Nothing would surprise me at this point.  We might never hear about health care legislation again, or we could within days or even minutes discover that the game is back on.

In any event, the key vote in that please-let-it-be-final showdown was cast by Senator John McCain.  Is that vote proof that, at long last, he truly is the principled maverick that he has long portrayed himself to be?  Perhaps, but I think that there is a better, more cynical explanation.  But first, we need to figure out what McCain's colleagues were thinking during this never-ending farce.

To me, the most interesting question for months has been what the key Republicans -- Donald Trump, Mitch McConnell, Paul Ryan, and others -- were trying to accomplish.  What are (or, if this is truly over, were) they thinking? There simply seemed to be no upside to engaging in this fight, especially given that it was taking so much time.

Back in April, I began a column with this question: "Why should Donald Trump bother trying to do anything during his presidency?"  I suggested that Trump could enjoy his presidency by being a figurehead who did nothing, sitting back and complaining that nothing was getting done and agreeing to things that Republicans were able to do in spite of Trump's disengagement and incompetence.

In the months since I wrote that column, it became clear that Trump did care about repealing the ACA, but not because he had a better idea or anything positive that he wanted to accomplish.  The accomplishment would simply lie in slaying a dragon that he had chased around for the last few years.

But again, why is his hatred of the ACA worth risking this kind of spectacular defeat, when he has been perfectly happy mostly to ignore his other campaign themes?  He burbles every now and then about his stupid wall, he tweets about Hillary Clinton being a criminal whenever it suits him, and he seems unable to decide what to do about international trade.  Meanwhile, his executive powers are sufficient to impose serious (but mostly under the radar) harm on potential immigrants and refugees.

Why is the ACA different for Trump?  And why are almost all congressional Republicans apparently even more obsessed with its repeal?  Yes, I know that "the base" is obsessed with the ACA, too, but there is no evidence that they care more about that issue than immigration, Clinton, or trade.  Yet we have McConnell and others degrading their institutions in a futile effort to harm tens of millions of people.

It could be that this is one of those self-reinforcing disasters, where no one was able to pull away and take a broader look at what has been happening as they were pulled along by the torrent of events.  In fact, however, the news two weeks ago was filled with the idea that the Republicans had reached the end of the road, and people on both sides genuinely seemed to think that there was no way to go forward.

That was a moment when Republicans could have taken a breath and thought about the three possible scenarios that might play out:

(1) Let it go.  Moving onto other issues was the most viable option.  Everyone was already exhausted by the process, and it was clear that the public hated the Republicans' bill.  Although the process to that point had already created plenty of fodder for Democrats' attack ads in 2018, the potential potency of those attacks would be dulled by time.

(2) Try again and fail quickly.  This was the "satisfy the base" fallback strategy, in which Republicans could go back to giving everyone in their caucus the chance to vote against the ACA, safe in the knowledge that a few grownups in the Senate would make it all moot.

Importantly, this would again have put it all behind them as soon as possible, allowing them to move onto the other noxious items on their agenda, such as tax cuts to help rich people, budget cuts to harm everyone else, and fighting with each other about the debt ceiling.

(3) Try again and actually succeed.  In this case, the Republicans would have passed a terrible bill on which they and their president had expended enormous amounts of political capital.  Only Republicans from the safest of seats (House and Senate) would be unaffected by this.

As a matter of political strategy, it seemed obvious that Option 1 was the best for Republicans.  Everyone could continue to live in denial and claim that a handful of traitors had ruined a perfectly good repeal-and-replace strategy.

Instead, out of nowhere, McConnell decided to try again -- but to use a garish process that would become its own negative story line.  Moreover, that process would only work by having the health care debate drag on and on, crowding everything else off the agenda.

When it came to the final stratagem, the so-called skinny repeal, everyone -- even those who voted for that bill -- admitted that they were engaged in a massive fraud.  The idea was not really to pass that bill but to have the process play out even longer.  As a news item in The Washington Post put it:
"It would buy the Senate’s GOP leaders more time, because its passage would lead to a conference committee with the House.

"Negotiations between lawmakers of the two chambers could then continue past Congress’s August recess, preserving the ability of McConnell and other GOP leaders to keep searching for a health-policy formulation that could garner the support of enough members of their caucus."
That bill died, however, because of a lack of trust between House and Senate Republicans, not because of a principled rejection of the substance of the Republicans' efforts to take away health care from millions upon millions of Americans.

Reporting in the immediate aftermath of the 2am vote, in which McCain joined Susan Collins and Lisa Murkowski (and all 48 Democrats) to defeat the bill, Robert Pear and Thomas Kaplan in The New York Times described what can only be thought of as a "trust game," where it turned out that none of the Republicans could trust the others enough to move forward.

Remember, Senate Republicans wanted to pass a terrible bill simply to open negotiations with the House.  In some sense, this is not as cynical as it might seem, because even in normal times, everyone knows that the bills passed by the two chambers will be renegotiated in reconciliation.  Why not simply admit that out loud and let the negotiators go to work?

The not-completely-cynical answers were that the committee would be too secretive and that the result would be presented to wavering not-completely-hard-right Republicans (Dean Heller, Shelley Moore Capito, and so on) as a do-or-die act of party loyalty.  Neither of those problems, however, would seem to be enough to get someone like McCain to balk at passing the bill now.

The real issue was apparently that McCain and a few other senators, including Ron Johnson and McCain's Mini-Me Lindsey Graham, demanded guarantees that the Republicans in the House would not simply vote on the Senate's terrible bill -- which the House could do at any time, because the bill would have already passed the Senate, allowing the bill then to go to Trump, whose "pen is ready."

House leaders' words and actions, however, fell decidedly short of ironclad guarantees.  Left with the possibility that what was supposed to be simply an empty parliamentary vehicle could actually become law, the senators who did not want that to happen had every reason to vote no.

Yet only McCain voted no, while Graham and everyone else who had expressed reservations voted yes.  Forgive my deep cynicism, but this reeks of political theater.

In what might initially appear to be very bad timing, Paul Krugman's op-ed in Friday's Times -- which was written before the final Senate vote but was published a few hours afterward -- described "the awfulness of John McCain."  This is at odds with never-Trump conservative writer Jennifer Rubin's very defensible (but I think incorrect) description of McCain as a hero for voting against the bill.

But as Krugman pointed out, McCain had voted to allow this entire circus of a process to begin, even though his vote could have averted the 50-50 tie that Vice President Pence broke several days before.  McCain then voted in favor of a version of the bill that he had said he would not support.

As long as we are in full-on cynical mode, however, it is worth pointing out that the vote that made McCain look like a hypocrite was not a tie-averting vote, because that bill was going down easily.  So even though McCain voted in a way that he had promised not to, he did so knowing that it did not matter.  Cynicism thus becomes evidence of possible underlying virtue.

Remember, however, that Graham and others agreed with McCain that it would be just fine for the bill to go to conference, and potentially for the conference committee to come up with a combination of the original House and Senate bills that might be even more awful.  But now that we are thinking in double-reverse strategic terms, maybe McCain and his group were hoping that the bill would die in committee, such that their votes to push the bill out of the Senate were not really and truly votes to take away health care from non-rich people.

In any case, we know that McCain and his cohort were not against the Republicans' basic approach to repealing the ACA.  They were simply worried about House Republicans double-crossing them.  If that is the explanation, however, then we have to ask why it was McCain, and McCain alone, who cast the key vote.

Based on their stated rationales, after all, several Republican senators could simply have said, "We know that this might be the last stand for the repeal-and-replace effort, but House leaders have not given us the guarantees that we demand, so we vote no."  McCain could have been among that group, but he need not have been alone.

If no explanation is too cynical, and I think we are clearly operating in an environment where every possibility has to be on the table, we can try this one on for size:

Graham and the others knew that only one of them needed to vote no (given that Collins and Murkowski were solid).  Voting yes shielded each of them from abuse by Trump and his mobocracy.  Voting no -- especially doing so alone -- would thus seem to be a risky and brave move.

Whose "brand" is all about bravery?  Who would like nothing better than to be seen standing alone (not really, given Collins and Murkowski, but it is already being spun that way), especially in order to be viewed as finally facing down the man who disparaged his personal history of (very real) bravery and heroism?

In short, we have a process that could easily have been manipulated to allow McCain to emerge as the last-minute hero, gladdening the hearts of moderates and liberals so much that they would say: "Wow, the guy really came through when it counted -- and even after brain surgery!"

Is this explanation cynical?  Of course.  Too cynical?  I think not.  In the end, McCain joined fifty other people to vote against something terrible, but he did not even do so on the merits.  We can be happy with the outcome without being deceived by the political posturing.