Viewpoints: GOP factions will kill more than health care bill
Passing legislation is always a difficult, messy task. Americas highly polarized political environment, with party activists demanding ideological purity on both sides of the aisle, makes that task even harder.
The announcement by U.S. Sens. Mike Lee and Jerry Moran that they would oppose bringing the Better Care Reconciliation Act to the Senate floor has derailed Republican attempts to replace the Affordable Care Act.
During his campaign, Donald Trump claimed that passing health care reform would be so easy. So why were Republicans unable to pass a health care law despite controlling both the White House and Congress?
It turns out that the relationship between Congress and the president is more complicated than Trump thought. Most citizens and political scientists assumed that conservative Republicans would prefer any health care law that Trump supported over the Obamacare status quo.
However, my research shows that this assumption is too simplistic. As Trump now knows, ideological extremists may also vote against bills proposed by their partys president. The recent struggle to pass a Republican health care law is a prominent example of this phenomenon.
Trumps two-sided task: President Trump, House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell are waging a legislative battle on two fronts with no compromise in sight. Both moderate Republicans and extremely conservative Republicans oppose the current health care bill for completely separate reasons.
Moderate Republicans are concerned about how Medicaid cuts and changes to Obamacare regulations, like guaranteed essential health benefits and protections for people with preexisting conditions, will affect their constituents. On the other hand, extremely conservative Republicans want to both remove those Obamacare regulations and repeal all Obamacare taxes. This puts Republicans leaders in a bind. Anything they do to please moderates will tend to alienate the extreme conservatives, and vice versa.
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