No, John McCain did not make Republicans lose the House

Writing in today’s Wall Street Journal, recently defeated House Republican Jason Lewis of Minnesota offers a surprising explanation for why his party lost control of his chamber in the midterms: It was all John McCain’s fault.

”The Republican Party lost its House majority on July 28, 2017, when Sen. John McCain ended the party’s seven-year quest to repeal ObamaCare,” Lewis’s op-ed begins.”McCain’s last-minute decision prompted a ‘green wave’ of liberal special-interest money, which was used to propagate false claims that the House plan ‘gutted coverage for people with pre-existing conditions.’”

I do not understand why the Wall Street Journal decided to run an op-ed disparaging a deceased decorated war hero on Veteran’s Day. I don’t know the politics of Minnesota’s Second Congressional District to tell you why Lewis lost his seat there. (Although perhaps it had something to do with his 2012 remarks lamenting the idea that its no longer okay to call women “sluts.”)

I do, however, know a decent amount about the politics of health care. And I think Lewis’s argument that Republicans would have had better electoral outcomes if McCain had cast his vote a different way is completely bananas.

First things first, let’s be clear: McCain did not kill the House bill to repeal Obamacare. That bill actually failed days before McCain cast his famous thumbs-down vote on July 28 that Lewis references.

The House bill wasn’t popular in the Senate largely because of its deep cuts to the Medicaid program. In fact, nine Republican senators voted against the House repeal bill. The bill that McCain voted against was “skinny repeal,” a pared-back piece of legislation that was meant to be a vehicle to get the two chambers to conference.

Lewis somehow supposes that, if McCain had voted differently, the House repeal bill (the American Health Care Act, or the AHCA) would have become law. That just wasn’t in the cards: The AHCA was never moving out of the Senate.

Setting that legislative history aside, let’s dive into Lewis’s core argument: that Republicans would have fared better in the midterms if the AHCA had become law. Here’s what I think is the key section:

When older workers lose their coverage along with their job, it creates a serious barrier for entering the individual market, as pre-existing conditions are often the result of age. This is primarily due to an unfair tax code that gives employers but not individuals tax breaks for buying insurance.

Again, the AHCA sought to even the playing field by offering a refundable tax credit anyone could use to buy an individual plan. The bill also would have expanded tax-deferred health savings accounts to help cover deductibles, copayments and over-the-counter expenses.

All these provisions were an attempt to alleviate the pre-existing condition problem, not exacerbate it. To be sure, instead of running away from health-care reform after it failed, Republicans should have leaned in on the plan’s most important aspects. But because the AHCA didn’t pass, it was impossible to refute the lies about it.

Maybe Republicans were trying to alleviate the preexisting condition problem, as Lewis writes. But if that was their goal, they didn’t do a very good job. The AHCA would have allowed states to waive out of Obamacare’s requirement to charge sick and healthy people the same prices. That would absolutely exacerbate “the pre-existing condition problem,” by allowing insurers to charge those people higher premiums.

We can also think about the hypothetical older worker that Lewis mentions, who might lose their coverage at work and have trouble finding a plan in the individual market. The AHCA would have made those troubles significantly worse by scaling back tax credits for older Americans.

As NBC’s Benjy Sarlin points out, the Congressional Budget Office estimated that annual premiums for a 64-year-old making $26,500 would rise from $1,700 under Obamacare to $16,100 under the Republican plan. Raising premiums by 850 percent for low-income seniors doesn’t exactly seem like “evening the playing field” — but does feel like an awfully tough headline Republicans would have had to spend months fighting against if the AHCA had passed.

Lewis’s op-ed doesn’t mention that the AHCA was terribly unpopular when Congress was debating it. Polls regularly came back showing that as few as 17 percent of Americans liked the bill. It was unpopular in deep-red states, too.

Passing a law that unpopular — a law that weakens protections for preexisting conditions while raising premiums on seniors — is not a plan for keeping the House. Instead, it seems like a recipe for even larger electoral losses than the ones Republicans experienced last Tuesday.

This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.

Are you interested in more discussions around health care policy? Join our Facebook community for conversation and updates.