Like the proverbial horror-movie character whose hand rises up from the grave, let’s not assume that the monster known as Trumpcare is dead and buried yet.

Yes, Senate Majority Leader Mitch McConnell has, ironically enough, delayed the effort to kill the Affordable Care Act until after Sen. John McCain (R-AZ) recovers from surgery to remove a blood clot near his eye. However, once McCain recovers, it’s quite likely that there will be a renewed effort to push Trumpcare through the Senate–if for no other reason than to provide a nice, shiny distraction from the gathering Russiagate storm.

Speaking with Jake Tapper this morning on CNN’s State of the Union, Sen. Susan Collins (R-ME)–one of only two on-the-record Republican opponents of Trumpcare–noted that there are several Republican Senators who still have misgivings about Trumpcare. The problem is, it’s impossible to imagine these Senators resisting hyper-intense right-wing pressure to vote for the bill; frankly, it’s impossible to see Collins and fellow Trumpcare opponent Rand Paul (R-KY) not ultimately changing their minds and surrendering to McConnell and Trump.

As Philip Bump suggests, one cannot ignore the influence of the GOP’s extremist base in the discussion over whether skeptical Republican Senators will ultimately fall in line with the effort to kill the Affordable Care Act:

More worrisome for Republicans hoping to pass a new bill is how the support broke out by demographic. Only among Republicans, conservatives, white evangelicals and white men without college degrees did more Americans support the GOP bill than Obamacare. In every other group analyzed, including older respondents and white women without college degrees — an important part of President Trump’s voting base in 2016 — backed the [Affordable Care Act] by some margin.

If skeptical Senate Republicans conclude that “older respondents and white women without college degrees — an important part of President Trump’s voting base in 2016” will keep voting Republican even if the Affordable Care Act is scrapped–because God forbid they consider overcoming the “cultural anxiety” that apparently prevents these voters from considering alternative political routes–then the Affordable Care Act may still be on the verge of death: if there won’t be any political consequences to repealing Obamacare, why wouldn’t Republicans do so?

Regardless of how badly Trumpcare polls, Republicans, both conservative and “moderate,” remain driven by what Paul Krugman identifies as the four tenets of the GOP health-care vision:

1.Health care, even the most essential care, is a privilege, not a right. If you can’t get insurance because you have a preexisting condition, because your income isn’t high enough, or both, too bad.

2.People who manage to get insurance through government aid, whether Medicaid, subsidies, or regulation and mandates that force healthy people to buy into a common risk pool, are “takers” exploiting the wealth creators, aka the rich.

3.Even for those who have insurance, it covers too much. Deductibles and copays should be much higher, to give people “skin in the game” and make them cost-conscious (even if they’re, um, unconscious.)

4.All of this applies to seniors as well as younger people. Medicare as we know it should be abolished, replaced with a voucher system that can be used to help pay for private policies – and funding will be steadily cut below currently projected levels, pushing people into high-deductible-and-copay private policies.

Former Rep. Alan Grayson got it right eight years ago when he summarized the GOP’s approach to health care. History will mark this repulsive right-wing effort to strip health care from millions of Americans as perhaps the most graphic example of the absolute moral squalor of one of America’s two major political parties. This moral squalor will surely resist any effort to move towards a Medicare-for-all system in this country, because sickness of the soul has no known cure.

Our ideas can save democracy... But we need your help! Donate Now!

D.R. Tucker

D. R. Tucker is a Massachusetts-based journalist who has served as the weekend contributor for the Washington Monthly since May 2014. He has also written for the Huffington Post, the Washington Spectator, the Metrowest Daily News, investigative journalist Brad Friedman's Brad Blog and environmental journalist Peter Sinclair's Climate Crocks.