Opinion: 'Skinny' cynicism

View in [Browser]( | Add nytdirect@nytimes.com to your address book. [The New York Times]( [The New York Times]( Thursday, July 27, 2017 [NYTimes.com/Opinion »]( [David Leonhardt] David Leonhardt Op-Ed Columnist There is no actual health care plan with enough support to pass the Senate. [Mitch McConnell]( the Republican Senate leader, knows this. So he is pursuing a cynical, but potentially effective, strategy. He is asking senators to pass a bill largely without substance — the so-called [“skinny repeal,”]( as a Times [editorial]( explains — and vaguely claiming that they can work out their differences later. In this case, later means during the conference when the Senate and House negotiate over the bill’s final version. McConnell’s deputy in the Republican leadership, John Cornyn, acknowledged as much [to The Hill]( yesterday, saying, “All we’re looking at is a way to get to that conference quick.” The House bill, Cornyn said, would then become the “template” to start those negotiations. The problem for McConnell is that delaying the discussion of substantive problems won’t make them go away. The problems include deep, unpopular cuts to Medicaid in the Republican plans, as HuffPost’s Jonathan Cohn [notes]( as well the likelihood that the plans would collapse the private Obamacare insurance markets, as Larry Levitt of the Kaiser Family Foundation [says](. And McConnell has no answers to those problems. That’s why no bill yet has enough support to pass. That’s why groups representing doctors, nurses, hospitals, retirees and patients of virtually every disease — diabetes, birth defects, cancer, heart disease, lung disease — have [opposed]( both the House bill and the Senate’s tweaked (and failed) version of it. That’s why a [strong majority]( of Americans opposes the bills, too. So what is McConnell’s game plan here? It seems to be this: He is hoping that he can wear down his Republican colleagues and ultimately persuade them to vote for a bill in the name of party unity, substance aside. That vote would come later this summer, after the House-Senate conference, when every Republican would face enormous pressure to set aside any specific objections to the bill and remain unified. In the short term, McConnell is succeeding. He has convinced his colleagues to keep the process moving. Yesterday, one potential swing vote — Dean Heller of Nevada — [suggested]( he would support “skinny repeal.” The vote on it will likely come today or tomorrow. Last night, a new [Congressional Budget Office report]( confirmed that if skinny repeal became law, it too would do terrible damage. For now, senators can still tell themselves that they are not really voting to deprive millions of Americans of health coverage. They can pretend that the problems with the various bills will disappear, somehow, later in the process. In National Review, Ramesh Ponnuru [describes]( skinny repeal as “terrible” policy based on “magical” thinking. There is [no fix for these bills]( because they are not really intended to improve the health care system. They’re intended to repeal benefits for the middle class, poor, elderly and sick. Again, that’s why the bills have inspired such unusually broad opposition from outside of Washington. That’s why a few brave Republican senators have [prevented]( them from passing so far. I understand why McConnell and Cornyn are pursuing their current strategy. But I think the savvy move for the Republican senators who will at some point face a tough vote — not just Heller but also Shelley Moore Capito, Rob Portman, Jerry Moran, Rand Paul, Mike Lee, John McCain and Ron Johnson — is to recognize that it will get only tougher as the process moves along. Also in The Times, Thomas Edsall writes on Obamacare’s [death by 1,000 cuts]( and J. B. Silvers [has more “skinny” repeal](. In other news: Trump’s barring of transgender troops comes right out of the authoritarian playbook, argues Garry Kasparov. “If real enemies don’t exist, they will be created,” Kasparov [tweeted yesterday](. “Minorities preferred.” I also recommend [this 2015 Times op-doc]( by Fiona Dawson on transgender soldiers, as well as Katie Couric’s eye-opening [National Geographic]( [documentary]( on transgender issues. The Nourishment Project. A couple of weeks ago, I wrote that I was going to spend part of this summer [grappling with hard political questions]( full of uncertainty and trade-offs. I also invited readers to do the same, and many of you have written thoughtful emails about your own internal political conflicts. Today, I’ll be appearing on 1A, the public radio show hosted by Joshua Johnson, to talk about the project. [Listen in]( if you have time. I plan to talk about some of those emails. The full Opinion report from The Times follows, including [Bret Stephens]( on the White House’s lying — about him. Editorial [Donald Trump’s Assault on Jeff Sessions]( By THE EDITORIAL BOARD The president’s attacks on his attorney general are too much even for some of his staunchest defenders. Op-Ed Columnist [‘First They Came For ...’]( By CHARLES M. BLOW All the targets of Trump’s ire must push back with a united front before it is too late. 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