Bill Cassidy
Sen. Bill Cassidy (R-LA), co-sponsor of the latest proposal to repeal and replace Obamacare. Credit: Gage Skidmore

Senate Republicans seem exasperated with Rand Paul’s contempt for their stupid Graham-Cassidy health care idiocy. But apparently they aren’t even trying to change his mind. I don’t think most Democrats trust Sen. Paul to vote ‘no,’ but his Republican colleagues seem convinced that he will. That’s why they’re focused on flipping two votes from the three members who voted against and killed the moronic skinny repeal bill back in early August.

Of the three, Sen. Susan Collins of Maine seems like the hardest case. But if they can’t convince her to basically walk back everything she’s said about health care over the last two months, they’ll have to get both Sen. John McCain of Arizona and Sen. Lisa Murkowski of Alaska to come over to their fantasyland idea of rational health care policymaking.

Now, Murkowski and Collins are both supporters of Planned Parenthood and while they might not have the best voting records, they’re more pro- than anti-choice. I suppose neither side would really want to claim Murkowski, but she’s definitely an unnatural ally of the Graham-Cassidy bill.

Which makes this interesting:

[Rand] Paul is also drawing opposition from the anti-abortion lobby, a reliable ally. Susan B. Anthony List President Marjorie Dannenfelser said Paul’s “outright opposition to the bill and his dismissiveness of the pro-life priorities within it is alarming and damaging” and called his stance an “unacceptable position for a pro-life Senator to have.”

Sergio Gor, a spokesman for Paul, replied: “There is no one more pro life then Senator Rand Paul.”

If opposing Graham-Cassidy is an unacceptable position for an anti-choice senator to have, then supporting it must be an unacceptable position for a pro-choice senator to have. If that holds, it would seem that there’s no chance that Collins and Murkowski will flip.

Now, Murkowski has a nuanced position. She’s Catholic and personally morally opposed to abortion, but she also interprets her oath of office as committing her to upholding the Constitution. And she says that the Constitution protects abortion rights. On the other hand, she also interprets the Constitution as allowing “reasonable federal and state laws to limit when and where abortions can take place,” has voted to ban partial-birth abortion, and opposes all federal funding of abortion.

Now, here’s why the Susan B. Anthony List thinks Graham-Cassidy is a must vote for the anti-choice movement:

Like previous bills, Graham-Cassidy imposes new restrictions that would make it harder for people to get insurance coverage for abortion, and for low-income patients to visit Planned Parenthood. Also like the other bills, it threatens Medicaid coverage and makes it easier for states to get rid of maternity care requirements.

And here’s what Murkowski committed to over the summer:

Sen. Lisa Murkowski has assured an Alaska constituent that she’s committed to preserving Planned Parenthood funding as part of a health care bill — the strongest line she’s drawn yet over one of the most controversial elements of the Obamacare repeal effort.

“I am committed to ensuring that important provisions of the ACA, such as covering those with pre-existing conditions, continued support for Medicaid expansion, coverage for dependents and no lifetime limits, and funding for Planned Parenthood remain intact,” Murkowski wrote in the constituent letter obtained by POLITICO.

It’s hard to see how she could keep those commitments and support Graham-Cassidy. I’m willing to say that she couldn’t.

Will it matter?

I might not be willing to bet money on it except that Murkowski surely hasn’t forgotten the way she was bullied and disrespected back in July:

With a couple of phone calls to Alaska’s Republican delegation, the Trump administration apparently thought it could bully Sen. Lisa Murkowski into supporting her party’s attempt to repeal Obamacare.

The approach was both rookie and reckless, according to former Interior officials. In the end, the Alaska senator stood her ground, joining two other Republican senators in defeating a “skinny” repeal of the Affordable Care Act early Friday morning.

The issue began when Murkowski voted Tuesday against a measure to begin debate on a health care bill. President Donald Trump used Twitter the next day to voice his dissatisfaction, saying Murkowski “really let the Republicans, and our country, down.”

On Wednesday night, the Alaska Dispatch News first reported that Interior Secretary Ryan Zinke had phoned Murkowski and fellow Alaskan Sen. Dan Sullivan (R) following Tuesday’s vote. Zinke delivered a “troubling message,” indicating that Murkowski’s defection could jeopardize future Alaska projects, in particular those involving energy extraction, Sullivan told the paper.

If she didn’t back down then, will the mere passage of time allow her to back down now for a substantially more submental piece of legislation?

It depends on whether she can be convinced by arguments like these:

Jeff Stein: I was hoping you could explain, in broad detail, what the point of Graham-Cassidy is.

Sen. Chuck Grassley of Iowa: Let me give you a political answer, and then I’ll give you a substance answer.

The political answer is that Republicans have promised for seven years that we were going to correct all the things that were wrong with Obamacare, and we failed the first eight months. This is the last attempt to do what we promised in the election.

Jeff Stein: Senator, I wanted to ask you for a policy-based explanation for why you’re moving forward with the Graham-Cassidy proposal. What problems will this solve in the health care system?

Sen. Pat Roberts of Kansas: That — that is the last stage out of Dodge City… [Graham-Cassidy] is the last stage out of Dodge City. I’m from Dodge City. So it’s the last stage out to do anything. Restoring decision-making back to the states is always a good idea, but this is not the best possible bill — this is the best bill possible under the circumstances.

If we do nothing, I think it has a tremendous impact on the 2018 elections. And whether or not Republicans still maintain control and we have the gavel.

Jeff Stein: But why does this bill make things better for Americans? How does it help?

Pat Roberts: Pardon me?

Jeff Stein: Why does this make things better? What is this doing?

Pat Roberts: Look, we’re in the back seat of a convertible being driven by Thelma and Louise, and we’re headed toward the canyon. That’s a movie that you’ve probably never seen —

Jeff Stein: I do know Thelma and Louise, sir.

Pat Roberts: So we have to get out of the car, and you have to have a car to get into, and this is the only car there is.

“If you vote against us, you’re voting to keep Obamacare,” said Sen. Bill Cassidy of Louisiana, one of the bill’s namesakes, when asked about Paul’s intractable stance. “Period. End of story.”

The most honest responses there are from Sens. Roberts and Grassley who both admit that the vote is about “whether or not Republicans still maintain control” of Congress after the upcoming midterm elections. That’s obviously a big concern for most senators, but McCain is battling a form of brain cancer that is usually fatal within two years, Collins has plans to run for governor of Maine, and Murkowski could caucus with the Democrats tomorrow if she wanted to, which she might.

Personally, as bad as things look for the Republicans if they fail to repeal Obamacare, kicking 25 to 30 million people off their health insurance is hardly letting people keep their plan if they like it. It’s like jumping out of Thelma and Louise’s car and directly into an active volcano.

Other than his precarious health, I haven’t mentioned John McCain here, but he’s also a person who would have to swallow a lot of words in order to get to ‘aye’ on this asinine and criminally cruel piece of crap. If the last bill was bad, this one is far worse. It would cost Arizona a lot of federal money, too, because they actually have expanded Medicaid. It hasn’t been introduced through regular order, there have been no hearings, there’s no bipartisanship about it whatsoever. McCain soaked up a lot of praise for killing the dumb skinny repeal bill and giving a nice speech, but he’d lose it all if he voted for the dumber Graham-Cassidy atrocity. I know he’s best pals with Lindsey Graham, but that can only count for so much.

Despite all these reasons why the Republicans shouldn’t be able to convince fifty of their senators to support this murderous and unconscionable excuse for public health policy, I still can’t feel fully confident that they won’t succeed.

You see, I am using reason and consistency and a desire to avoid hypocrisy and some actual analysis of what the craptastic bill would actually do. That’s reality-based thinking.

Sadly, it may not apply here.

The GOP is clearly in panic-mode.

Martin Longman

Martin Longman is the web editor for the Washington Monthly. See all his writing at