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The recriminations will be televised.
One thing that I think got lost when Senate Republicans tried and failed to repeal Obamacare last month, in the most public and humiliating fashion, is what a rupture that failure would cause within the party.
As we've noted over and over again, Republicans had run for seven years on the promise of repealing and replacing Obamacare. Now they've come up short, with no obvious alternatives. GOP lawmakers and leaders are talking openly about taking steps that would cement, not uproot, the Affordable Care Act.
But first, the Republican Party is going to have to reconcile itself to that. It's not going to be pretty.
"There's going to need to be a cooling-off period," one Republican health care lobbyist told me shortly after the failed Senate vote.
Or as another put it: "Some wound licking must happen first."
We are still in the midst of that process, it seems. Two jarring reminders of how far Republicans have to go popped up today.
First, there were Sen. Ron Johnson's comments on Sen. John McCain, who had cast the decisive vote to stop Obamacare repeal on the Senate floor.
“I'm not gonna speak for John McCain — he has a brain tumor right now — that vote occurred at 1:30 in the morning, some of that might have factored in," Johnson said in a local radio interview, as Vox's Tara Golshan documented.
McCain's office fired back, calling Johnson's comments "bizarre and unfortunate."
One senator implying that another's cancer explained his vote against the party — that was enough bad health care blood among Republicans for one day.
Then the president tweeted.
"Senator Mitch McConnell said I had 'excessive expectations,' but I don't think so. After 7 years of hearing Repeal & Replace, why not done?" Trump tweetedWednesday afternoon, responding to reported comments made by the Republican leader.
Now the Republican president was going after the Senate's Republican leader for failing to deliver on their party's promise of undoing the ACA.
This is why some Republicans aren't letting go of the Obamacare repeal dream. Sen. Lindsey Graham is still preparing to roll out his own bill, maybe as soon as next week. (Read Sarah's explainer.) House Freedom Caucus Chair Mark Meadows is also bullish on reviving repeal.
Leadership wants to move on. They know they've wasted the best months of Republican power on Obamacare repeal and are finally eager to take up another issue.
But as long as this kind of discord festers, it could prove difficult for Republican leaders to move on from health care or on to a bipartisan plan. Today's flurry of bad blood is a useful reminder of how far the rank and file — and the Republican in the White House — still have to go.
Chart of the Day
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Americans and health care shopping. The idea of a better health care "consumer" gets a lot of play as we search for ways to lower health care costs. It's an idea that we as Americans like — but not one we're very good at, per this new research from Health Affairs.
Kliff’s Notes
With research help from Caitlin Davis
Today's top news
- “Ron Johnson suggests John McCain's brain cancer factored into no vote on ‘skinny repeal’”: “Sen. Ron Johnson, R-Wis., suggested Tuesday Sen. John McCain's brain tumor, coupled with the timing of the healthcare vote in the Senate, may have played a role in McCain's vote against the bill to repeal provisions of Obamacare.” —Melissa Quinn, Washington Examiner
- “‘May you die in pain’: Another GOP lawmaker grilled at health-care town hall”: “It was the most recent of a declining number of health-care-focused town hall meetings charged by emotional pleas and debates between constituents and their representatives, meetings that have sparked anxiety among GOP lawmakers heading home to face tough questions.” —Alex Horton, Washington Post
- “White House rejects appeal to call national emergency over opioid epidemic”: “The Trump administration on Tuesday stopped short of declaring the opioid epidemic a national emergency, rejecting an urgent recommendation from a White House panel on tackling the crisis.” —Erin Mershon and Andrew Joseph, STAT
Analysis and longer reads
- “Carper cast as governors' lobbyist in health care debate": “When Sen. Tom Carper was shopping for votes to block GOP health care bills, he didn’t just turn to his fellow senators. He turned to their governors. A self-described 'recovering governor' himself, the Delaware Democrat carried out a communications blitz — calling, texting, emailing — and made contact with up to half of them.” —Nicole Guadiano, USA Today
- “Generic Drug Prices Are Falling, but Are Consumers Benefiting?”:“The declining prices are broadly beneficial to the health care system, and may put some slight brake on rising premiums. But most of those with health insurance pay a fixed co-payment — $10, for example — for each generic prescription, and therefore don’t pay more or less, regardless of any fluctuation in the actual price.” —Charles Ornstein and Katie Thomas, New York Times and ProPublica
- “Receive a surprise medical bill? Here are three federal actions that may address surprise bills”: “The following three federal actions could offer distinct forms of protection from surprise bills — from requiring that any amount paid toward a surprise bill must count toward the maximum out-of-pocket limit to holding patients financially harmless for any cost above in-network amounts.” —Margaret Darling, Caitlin Brandt, Loren Adler, and Mark Hall, Brookings
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