I Worry That Republicans Might Not Have Enough Brain Cancer This Time
They've got the WRONG TYPE of brain malady
Let’s recall that there are tens of millions of people in this country who have health insurance right now because John McCain had brain cancer. This was the situation: It was 2017. Game of Thrones was still good, Elon Musk and J.D. Vance were vying for the title of Liberals’ Most Favorite Person In The World, and Donald Trump had just become president. Trump wanted to repeal Obamacare, which would have caused somewhere around 20-30 million fewer people to have health insurance. It was the standard Republican thing where they run on standing up for Real America against “elites” and then defund health insurance so that they can lower the top marginal income tax rate.
Republicans — probably rightly — saw this vote as political poison. Having spent decades spreading the lie that low taxes and a balanced budget could be achieved by eliminating “wasteful” spending — because the government is mostly programs that send gerbils to space camp and give breast implants to at-risk youth, right? — Republicans feared that the public might react badly when they learned that the GOP’s real plan was to shift healthcare costs onto citizens in a way that would also lead to more sick people. But Republicans talked a big game about repealing Obamacare; they were like parents who promised their kid a unicorn if she got straight A’s, and then the little fucker shocked everyone and actually did it. So then what do you do?
It all1 came down to a tight vote in the Senate. If the bill passed, swift electoral death for Republicans would likely follow. But a “no” vote would enrage the GOP base and create a real risk of being ousted in a primary by a part-time car wash employee dressed like Patrick Henry. Many Republicans wanted to vote “yes” and see the bill fail so that they could say “I can’t believe that Senator _____ stabbed us in the back”, and then send Senator _____ the most delightful muffin basket that money can buy for saving their skin. But who would bring a lifetime of intra-party wrath on themselves by casting that vote?
Then, Republicans got a huge break: John McCain was diagnosed with an aggressive form of brain cancer. Mere weeks after the diagnosis, McCain stepped to the Senate rostrum and cast his famous “thumbs down” vote that killed Obamacare repeal. We’ll never know if McCain’s disease influenced his vote, or if a different Republican would have killed the bill if McCain hadn’t, but it sure looks like Republicans were too chicken to cast the vote that they knew they needed to cast, were desperate to wiggle out of the trap they’d set for themselves, and ultimately decided to make the dying guy bail them out.
Republicans seem poised to go after health care spending again. They’re already talking about cutting Medicaid and other safety net programs, and Speaker Mike Johnson has called for “massive reform” of Obamacare. Once again, they hold the White House and both houses of Congress, and once again, they’ve promised the American people a unicorn. They won’t touch the Trump tax cuts and have been railing against the deficit and the inflation that deficit spending can cause, but Trump promised not to touch Social Security and Medicare. Also, he spent the last week of the campaign pointing at various objects and saying “no tax on that”. The GOP is clearly hoping that the new Department of Government Efficiency can work a miracle, but early ideas from the office’s co-chairs (nothing says “efficient” like co-chairs!) include defunding health care for veterans and just not paying our bills.
At the risk of sounding like Waylon Jennings doing a Dukes of Hazzard voice over: How in tarnation are they gonna get outa this kettle o’fish? If I’m Mike Johnson or John Thune, I’d send an e-mail to the caucus saying “Hey — anyone gotten any interesting results from the doctor lately?” Because they need to recruit fall guys who will snuff out the least popular parts of the Republican agenda, and fast. And since a Republican with a spine is about as common as a toddler with a subscription to Cigar Aficionado, the most likely candidate to step up is someone with a terminal disease who will do the GOP’s dirty work before riding off into the sunset in a hearse.
It’s not just health care; Republicans will face pressure to do all sorts of wildly unpopular things. It’s already started with Trump’s cabinet picks, which feel like the “I’m putting a team together” part of Ocean’s Eleven except that Danny Ocean just lingers outside a jack shack and enlists whatever freaks walk out. Several of his picks clearly deserve a “no”, but which Republicans have the balls to defy Trump? Trump also has ideas about tariffs and deportations that aren’t remotely workable, plus at some point, some Republican caucus member will take advantage of a moment of silence in a meeting and blurt out “abortion ban?” (and then immediately look behind them and say “who said that?”) The right wants stuff that would be enormously unpopular if it happened, but they’re terrified of their base, so they might choose to simply pass the Carnage And Mayhem Act Of 2025 instead of taking a stand.
I’m stunned that my list of grievances about the Republican Party includes “brain health is too robust.” But here we are. The danger of Republicans doing something that even they know is a bad idea seems very real, especially since Trump has figured out that one inappropriate thing draws scrutiny, but a million inappropriate things just causes people to get tired and give up. If Republicans knew how to sack up and defy their base, then they would have impeached Trump after January 6 and wouldn’t be in this jam in the first place. And I don’t know what will happen this time, because the “get John McCain to do it” plan was really a one-time thing.
I’m abbreviating the legislative history by quite a bit here: By the time the crucial Senate vote happened, full Obamacare repeal was off the table, and the Senate was voting on the “skinny” repeal, which would have cut back the Medicaid expansion, repealed the individual mandate, and reduced benefits.
“The right wants stuff that would be enormously unpopular if it happened, but they’re terrified of their base, so they might choose to simply pass the Carnage And Mayhem Act Of 2025 instead of taking a stand.” I think you could replace “right” with “left” and this sentence would be equally true. And that’s one of the biggest problem with modern politics.
I use Obamacare and am glad we have it, but it is in need of massive reform. The "marketplace" is kind of a joke. Where I live, you really don't have much choice other than Blue Cross Blue Shield because the health care networks won't take anything else. There are like nine combinations of BCBS plans that all add up to the same amount of spend (you either pay higher premiums or higher deductibles). So, the promise of competition driving down costs was a pipe dream that never materialized. The whole subsidy thing is confusing and hokey. You have to predict how much you will earn the next year, which is easy to do if you have a job with a regular paycheck. But, most of those come with employer coverage. Beefing up Medicaid (raising the income level to cover Uber drivers, pay the providers more so the recipients can get better care) instead of the subsidies would be better. Opening up Medicare to early retirees for a fee would be better, too. Then, what's left is an insurance pool for regular working people who don't have access to employer plans. The existing ACA marketplace is pretty much designed to do this. Costs would go down because the subsidized and the semi-elderly would be removed from the pool. So, if this is the kind of common sense types of reforms they are thinking about then please have at it.