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Michael A. Cohen

It’s ‘Groundhog Day’ for Republicans and health care

House Majority Leader Kevin McCarthy celebrated with fellow House Republicans following the passage of the Tax Cuts and Jobs Act on Thursday.Chip Somodevilla/Getty Images

How desperate are congressional Republicans to pass a tax cut plan — any tax cut plan? It appears they are willing to shoot the ball into their own net for the second time this year.

Earlier this week, Senate Republicans, in a last-minute effort move to lower the cost of their $1.5 trillion tax cut plan added a truly poison pill to the legislation: repeal of Obamacare’s individual mandate. While the move would save more than $300 billion over 10 years — and thus allow the tax bill to meet budgetary requirements in the Senate — it will also cause 13 million Americans to lose health insurance and, according to the Congressional Budget Office, will increase health care premiums by an estimated 10 percent.


At the same time, Republicans will make slashing the corporate tax rate from 35 to 20 percent permanent while allowing tax breaks for the middle class to expire in 2025. To be sure, cutting health insurance for millions of Americans in order to pay for a tax cut that will primarily benefit big business is officially The. Most. Republican. Thing. Ever. Nearly as bad is adding a last-minute change to a tax bill that will have a huge and potentially deleterious impact on health care outcomes for millions without even so much as a debate about the policy implications.

But the real head-scratcher here is why would Republicans want to restart a fight over health care.

There is no policy issue that has been more disastrous for Republicans in 2017 than their repeated pattern of trying and failing to repeal Obamacare.

Consider what happened in Virginia two weeks ago. In the state’s gubernatorial election, health care was the number one concern for voters, with 39 percent of the electorate calling it their top priority. There is no policy issue that has been more disastrous than their repeated pattern of trying and failing to repeal Obamacare. Democrat Ralph Northam won those voters by a stunning 54 points. In New Jersey, health care was the third most important issue, but for those most focused on it, Democrat Phil Murphy won an astounding 86 percent of their votes.


Recent polling highlights even further the challenges facing Republicans on this issue. According to an October Democracy Corps poll, the two most effective messaging frames for Democrats heading into 2018 are “trying to protect benefits and make health care affordable, not recklessly repealing” and “Protect Social Security, Medicare, and Medicaid.”

Republicans have brought all of this on themselves. It’s important to remember that the initial effort by House Republicans to repeal Obamacare failed in early March when the House leadership wasn’t even able to bring a bill to the floor for a vote. Perhaps if the GOP had at that point accepted defeat and left well enough alone, they could have limited the damage. Instead, they spent the next five months dragging out their misery, in the process mobilizing Democrats and enraging voters before the whole effort crashed and burned, in spectacular fashion, in July. Then, in September, they tried again will the ill-fated Graham-Cassidy bill.

It was almost as if Republicans were actively trying to ensure that voters saw them in the worst possible light when it comes to health care. If that is the case, kudos to the GOP on a job well done. In a mid-September poll, voters gave Republicans an approval rating of 11 percent on health care. That’s the friends-and-family electorate.


So considering the GOP’s long-form disaster on health care, it simply beggars the imagination as to why they are injecting toxic health care politics into their tax cut bill. Indeed, according to a Quinnipiac poll out this week, voters are already deeply skeptical of the GOP’s tax agenda. Only 25 percent of voters have a positive view of the tax cut plan. Just 16 percent think it will reduce their taxes and 6 out of 10 believe it will be of greatest benefit to the richest Americans . . . which it will be.

Making matters worse is the fact that Republicans have a narrow majority in the Senate. Threatening health care for millions could make it that much harder to hold the votes of key Republicans like Susan Collins, Lisa Murkowski, and John McCain, who sank the GOP’s repeal effort over the summer.

Even if the GOP tax plan somehow gets through Congress and is signed into law by President Trump, Republicans are handing Democrats yet another weapon with which to make health care the centerpiece of the 2018 campaign.

At this point it seems Republicans have concluded that they simply must pass something — anything on taxes — to have any hope of being competitive in midterm elections in 2018. But that they “had to do something” was the same misguided thinking that convinced them to support the slow-motion car crash that was repeal and replace. If “doing something” means repeatedly kicking the ball into your own net, maybe the better path here would be “do something Americans like.”


Michael A. Cohen’s column appears regularly in the Globe. Follow him on Twitter @speechboy71.