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The Senate GOP’s audacious health care Jedi mind trick

“No Senate bill yet exists.”

Mitch McConnell John Cornyn
Mitch McConnell John Cornyn
Tom Williams / Getty Images
Dylan Scott
Dylan Scott covers health for Vox, guiding readers through the emerging opportunities and challenges in improving our health. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo, and STAT before joining Vox in 2017.

Health care bill? What health care bill?

A strange line has trickled out from Senate Republicans in the past few days: We don’t even have a health care plan.

Those 145 pages of detailed legislative text? The ones that were rigorously analyzed by the Congressional Budget Office?

What are you talking about?

It’s a Jedi mind trick for the ages. Vox’s Sarah Kliff wrote last month about the remarkable lengths Republicans have gone to to mislead and obfuscate about their health care plans. It was no accident that Senate leadership decided to draft its bill entirely out of public view.

But denying the existence of a bill altogether is misdirection of a different kind. It started with this tweet from Senate Majority Whip John Cornyn (R-TX), who has often been the public face of the Obamacare repeal effort — like when he insisted in late June that Senate Republicans would vote on this nonexistent bill, right before McConnell pulled the plug.

Cornyn had a new line on Friday night.

Just to be clear: Yes, there is a Senate bill. Yes, it’s technically an amendment in the nature of a substitute to the House bill — that’s a distinction without meaning. Yes, it’s technically a discussion draft that has not been filed for a vote. But it’s a bill. It is 145 pages that the Senate could take up and pass, if Republican leaders had the votes. The CBO itself refers to it as “the Senate bill” in its analysis.

But this misdirection does serve a purpose.

First, it lays the groundwork for Senate leaders to claim that the revised legislation they are expected to release later this week is a brand new product. The current bill is devastatingly unpopular. It is projected to lead to 22 million fewer people having health insurance in 2026 than would if Obamacare remained in force, and only one-quarter of Americans approve of it, according to a Fox News poll released in late June.

That bill doesn’t have the votes to pass. As many as a dozen Senate Republicans have said they oppose it — Senate Majority Leader Mitch McConnell can lose only two of the 52 members of his conference. Moderates oppose the bill’s Medicaid cuts and projected coverage losses; conservatives are angry that the plan doesn’t do more to roll back Obamacare’s insurance regulations.

So Senate leaders have been working to tweak the existing bill to win over those holdouts. The underlying structure of the bill is unlikely to change, per early reports: It will probably still scale back Obamacare’s financial aid, repeal many of the law’s taxes, eventually end the generous funding for its Medicaid expansion, and place a hard cap on federal Medicaid spending.

The proposed changes — loosening the insurance regulations more, keeping some taxes on the wealthy, boosting financial assistance — might be politically important, but the outline of the existing bill seems almost certain to be preserved. There simply isn’t enough leeway for McConnell to overhaul the plan.

But to give holdouts cover to come around and support the revised plan, it helps to pretend the first bill didn’t even exist. Cornyn more or less ceded that this was his strategy when pressed on the above tweet by Dan Balz from the Washington Post.

The GOP also seems to think these Peter-esque denials will help defuse the progressive protests against the Senate bill. As Vox’s Jeff Stein has chronicled, the protests back in the states and here in Washington have helped stall the GOP’s momentum. They have surely contributed to both the bill’s unpopularity with the public and the reluctance of persuadable senators to support it.

So it seemed notable when an aide to Sen. Richard Burr (R-NC) adopted Cornyn’s strategy to dissuade protesters camped outside Burr’s DC office on Monday.

Of course there is a Senate health care bill. But after months of painful legislating, with no promise that Republicans can deliver on their seven-year promise to repeal and replace Obamacare, this is apparently the best they can do.

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