Everyone Says Taking Back The Senate In 2018 Is Impossible, But Is TrumpCare Making It Less Impossible?

Earlier this morning, we looked at Bernie's rally in Morgantown and at West Virginia GOP Senator Shelley Moore Capito's statement that she's willing to cast the decisive third vote to kill TrumpCare in the Senate if it comes to that. Recently released polling on the Senate version of TrumpCare by the Global Strategy Group and the Garin Hart Yang Research Group, is nothing but bad news for Republicans seeking reelection. How about this: "Senate Republican candidates take an approximately 30-point hit when voters learn they’re supporting their party’s bill to repeal and replace Obamacare." Of course that's an average across states but let's look at half a dozen Republican senators up for reelection in 2018 and how they did last time they faced the voters (2012). The first number was each senator's 2012 vote percentage. The second one is what their theoretical percentage would be if they took just half the hit that the national average predicts-- 15 points:

• Jeff Flake (AZ)- 49.2% (34%)
• Dean Heller (NV)- 45.9% (31%)
• Ted Cruz (TX)- 56.5% (41%)
• Bob Corker (TN)- 64.9% (50%)
• Orrin Hatch (UT)- 65.3% (50%)
• Deb Fischer (NE)- 57.8% (43%)

The news gets worse for Republicans.

The poll found that, in a vacuum, voters in 10 battleground states are split almost evenly about Republican senate candidates-- with 21 percent of voters viewing them favorably and 20 percent viewing them unfavorably.

But when told their Republican senate candidates supported the GOP’s health care bill, voters turned sharply against their representatives. In that case, the candidates’ unfavorability rating jumps from 21 percent to 52 percent, according to the new polling from Priorities USA and Senate Majority PAC.

The numbers are even more dramatic when the polling is mixed in with attacks on the GOP health bill. “After hearing criticisms of the Republican plan, voters in these Senate battlegrounds went from leaning toward voting the Democrat in 2018 by a healthy 48-38 margin, to leaning toward the Democrat by an even more robust 56-35 margin-- an 11-point jump,” the poll stated.

Now, it’s not particularly surprising that the health bill would prove a drag on Senate Republicans’ polling numbers. Both the House and Senate versions of Obamacare’s repeal bills have consistently polled below 20 percent, in addition to sparking dozens of protests across the country.

But the poll may prove encouraging nonetheless to Democrats looking at a 2018 Senate map so friendly to Republicans that many experts consider it largely out of reach. As Vox’s Andrew Prokop has explained, Democrats will be defending a massive 25 seats in 2018, compared with just eight for Republicans. Donald Trump won five of the states Democrats will have to defend; Hillary Clinton only won one of the seats Republicans are defending.

And Capito isn't the only Senate Republican reading numbers like that and telling McConnell and Trump bye-bye. With their baboon-president largely unengaged and AWOL in the final sprint to pass the bill and with "no plans to play a larger role in selling the Republican health care bill this week," regular Trump rubberstamps like Corker, John Hoeven (ND), Chuck Grassley (IA) and John Boozman (AR) won't commit to voting yes. The 4th of July break put the fear of God-- or fear of unemployment-- into many Republicans, especially from rural states. Heaven, in fact, says he's a no vote at this point.

In small counties, rural hospitals and other health care providers are often the largest employers, and after years of railing against Mr. Obama’s law, Republican senators are now grappling with the impact of its possible demise.

“I am a product of rural Kansas,” Senator Jerry Moran, Republican of Kansas, told constituents this week. “I understand the value of a hospital in your community, of a physician in your town, of a pharmacy on Main Street.”

Well short of the 50 votes needed to pass his bill, Senator Mitch McConnell of Kentucky, the majority leader, repeated his fears this week that his party may be stuck tweaking the Affordable Care Act with Democrats. He raised the prospects of a bipartisan fallback last week on the driveway of the White House, and again on Thursday in Glasgow, Ky.

If Republicans cannot pass a bill on their own, they may need to work with Democrats on short-term measures to stabilize insurance markets that, by their account, are on the verge of collapse in many states.

The original Republican opposition to the repeal bill was led mainly by senators from states that have expanded their Medicaid programs under the Affordable Care Act, providing coverage to millions of people who had been uninsured. Now senators from largely rural states, where hospitals stand to lose millions of dollars under the bill, are expressing concerns.

On Thursday, Mr. Moran faced constituents upset at the prospect that the health law might be repealed, and he reiterated his opposition to the bill as it stands now.

Earlier this week, Mr. Hoeven, after a round table with health care executives in North Dakota, said he did “not support the Senate health care bill in its current form.”

Republican leaders may have worried most about Republican senators from states that expanded Medicaid and feared the loss of federal funds, but objections have also come from other places. Twenty Republican senators are from states that have expanded Medicaid; 32 are from states that have not.

Those nonexpansion states are concerned that the repeal bills devised by Republicans in both houses of Congress could harm their residents.

Health care providers and others in the nonexpansion states worry that the legislation would lock in significant disparities in federal Medicaid spending, to the disadvantage of those states.

“We need Medicaid parity,” said Herb B. Kuhn, the president of the Missouri Hospital Association. “Our research shows that per capita federal spending on Medicaid would be much higher in states that have chosen to expand Medicaid, two-thirds higher in 2026. We’d be left with ‘have’ and ‘have-not’ states.”

In Georgia, doctors, hospitals and business groups expressed similar concerns. “Without the increased federal funding that comes with Medicaid expansion, health care providers in nonexpansion states are left with all of the cuts, but none of the coverage,” said a letter to Senator Johnny Isakson, Republican of Georgia, from the Georgia Chamber of Commerce, the Georgia Academy of Family Physicians and the Georgia Hospital Association.

And in a letter to Mr. Moran, Kansas’ health care providers said the Senate bill was “uniformly inequitable to states like Kansas that have not expanded Medicaid.”

The Senate bill would provide some financial assistance to nonexpansion states, estimated by the Congressional Budget Office at $29 billion in the coming decade. But Mr. Kuhn said the funds “fall far short of true equity.”

In Texas, hospitals are putting pressure on Senator Ted Cruz, the state’s junior Republican senator, who is up for re-election next year. If the Senate bill is adopted, said Ted Shaw, the president of the Texas Hospital Association, more people will be uninsured and “more Texans will be forced to rely on hospital emergency departments for care.”

And the Texas Hospital Association isn't the only source of intense pressure on Cruz. El Paso Democrat and single-payer advocate Beto O'Rourke is running even with Cruz according to polling by Texas Lyceum, which finds them splitting the decided vote 30% to 30% as O'Rourke barnstorms rural and small town Texas like Democrats used to do many years ago (back when they used to win in Texas). "We need a single-payer healthcare system for all Americans," Beto tells Texans. "It's the only way to ensure that everyone who needs to see a doctor is able to see a doctor-- preventatively, consistently and with real continuity of care. If we wait until someone is in crisis or shows up at the Emergency Room to take care of them, it's going to be worse for them and more expensive for the taxpayer."

How do we ensure that everyone in this country can see a medical provider when they need to and at the same time drive down total medical spending? How do you ensure that doctors, nurses, psychiatrists and psychologists are focused on their patients and not spending their time working for the insurance companies? How do we free up the economic and creative potential that could be unleashed if healthcare were not a function of wealth, employment or luck?

The only way I can figure out how to get all of that done is to have one system that covers every American and works with every hospital, clinic, and doctor's practice-- private, public or non-profit-- in the country.

I like Medicare. It's not perfect, but the satisfaction rates are high, the administrative costs are low, and it may be the single most successful healthcare program in our country.

There's a bill called "Medicare for All" (HR 676) that has gained a lot of support for these very reasons. Like the woman who spoke with me in Austin this weekend, many of you have written to me to ask why I have not signed on.

The way it's written, HR 676 would only provide Medicare reimbursements to non-profit providers. In other words, unlike Medicare-- which reimburses care at both for-profit and not-for-profit providers-- HR 676 would fundamentally change Medicare, limiting the pool of potential providers, and therefore the choice available to Americans when seeking healthcare. I've asked the author of HR 676 to change the bill and have it do exactly what Medicare does: reimburse medical providers, regardless of whether they work at a not-for-profit or for-profit institution. If Medicare works for current beneficiaries, why would we change it when we open it up to all Americans?

I am exploring an alternative to the Medicare for All bill that would allow Medicare to work for everybody the way it does right now for Americans ages 65 and over. I'm hopeful that this will provide a path for members of Congress who want to make sure that we do the right thing in a way that has the best chance for success and the greatest level of support across the political spectrum.

What we invest in our nation's healthcare system, we're going to get back many times over in the productivity of the American citizen, in the health of our communities and the success we see in our families. Those are our values-- and those values transcend party lines. Those values are family values. Those values are Texas values. And that's what we must continue to fight for.

Texas is a pretty red state. Obama lost it to McCain 55-44% and to Romney 57-41%. The state went for Trump last year 52.2% to 43.2%, but Hillary made major inroads in educated middle class suburbs around Houston, Dallas, Ft. Worth, San Antonio and Austin. Earlier in the day I spoke with 3 of the best candidates running in two flippable districts, TX-07 in Houston and TX-21 in the Austin-San Antonio corridor. Jason Westin is a nationally known oncologist and cancer researcher. "TrumpCare," he told us, "is not a serious attempt to fix our healthcare system and will not make Americans healthier. What it will do, very successfully, is provide a massive tax cut for the richest Americans, paid for by cutting essential health benefits and critical coverage for the most vulnerable Americans. The Republicans will try to spin this as 'allowing choices,' as if anyone would choose to go bankrupt when bad luck comes their way. This plan, absolutely supported by John Culberson, will devastate tens of thousands of Texans that he is takes to represent. I still have a hard time saying this, but on this issue I agree with President Trump: this bill is mean."

The other good progressive in the TX-07 race is Laura Moser and she also speaks out on the dangers of TrumpCare. She told us that "These days, the famed 'redness' of Texas-- at least in urban areas-- has as much to do with gerrymandering, voter suppression, and low turnout as with actual conservative principles, whatever those mean anymore. In districts like TX-07, where I’m running, in a diverse, relatively wealthy part of Houston, the GOP will certainly take a hit at the polls for supporting this inhumane bill. Even though my district voted for Hillary, the low-initiative incumbent still votes at every opportunity to kick 60,000 more of his constituents off healthcare.  Many will get sicker; some will die.  Universal healthcare is universally popular, even in 'red' Texas where we pay such a high price-- both morally and economically-- for our huge uninsured population."

Derrick Crowe is the progressive champion in the TX-21 race against anti-science crackpot Lamar Smith. Derrick is a very outspoken Medicare-For-All proponent. "The GOP plan," he told us, "forces people to get sick, go broke, and die early so rich people can have a tax cut. Everyone knows it, and I've yet to find a single person-- even among Republicans-- who supports it. The backlash you saw in city after city during the recess makes that clear. That's why I and several others were willing to go to jail last week to protest the BCRA and to support Medicare For All. If the Republican bill passes, people die. It's really that simple."

Although he's not from Texas, I'd like to close with a little tweet storm I noticed from a member of Congress when I woke up this morning. Ro Khanna (D-CA) makes the point-- aggressively-- that members of his own party "need to make the economic arguments for our policies and not let Republicans get away with their fake math." Here's how he did it this morning-- a beautiful-- and very important-- thing to behold: