A Disaster Wrapped in Victory

May 08, 2017 · 464 comments
21jjrOUSSEAU (NC)
"The bill established a template: devise legislation based on Freedom Caucus priorities, then add just enough concessions to bring in the minimal number of centrists needed to pass — "
If they count on numbers, they fail, if they count on issues, they eventually succeed.
AND, if they count on numbers, there is no strategy to rely on or analyse, The outcome is an eventual failure too.
The Republican disaster is that Trump was starving for a win, a one that he can buy. The driving force is just "winning", an after presidency tactic, not intentionally driven by a promise of people's well being deceptively claimed during campaign, signing a flip flop of Populism, a slide down to no where. Their historical destiny is an eminent failure, a fissure sooner or later.
Paul Dougherty (Saint Paul, MN)
Ahhh the subtle bias of the false equivalency. While a well written piece the last sentence; "last week in the House confirms how tough it is to govern with slim, divided majorities, even when your party controls the government."... Should have said even when the REPUBLICAN Party controls the Government. While sometimes contentious history is filled with examples of Democratic Control of government where monumental legislation was passed to the benefit of the American People. The latest example 2008 - 2010. A spasm of racism has resulted in delivering the legislative process to the GOP but since the GOP has no interest in governing it is all falling apart (at least lets hope so as a GOP success is a disaster for W2 earning America). President Obama, Representative Pelosi and Senator Reid proved what competent governance looks like and proved how it could benefit the American people. Even the neanderthals who voted for Lord Commander NMarmalade. We are all poorer for their ignorance.
Lee Harrison (Albany/Kew Gardens)
The Republicans who enacted this AHCA were elected to do cruel things to "those people" ... and that is exactly what they did. The problem is Walt Kelly's "We have met the enemy and they is us" ... the savage cost increases of the AHCA fall on 50 to 65 year olds -- a key Republican demographic. Many of its other terms will disadvantage rural and poorer "red state" voters.

All of this was really done so that Ryan & Trump might have a big tax cut for the very wealthy.

The only question that remains is the "what is wrong with Kansas" one -- will the Republican voters that this bill harms hold the people who did it responsible? Or is their contempt and anger agains "those people" so high that they will truly cut off their noses to spite their faces?
teej55 (Orlando, FL)
Republicans in government right now are like the dog that finally caught the car. Now that they have it, they have no idea what to do with it.
Pete (Philly)
Congress understands the president's priorities just fine. Trump wants "wins" he can brag about and he doesn't much care what the details are. This satisfies Trump's supporters too, with the added criteria that the win must also upset readers of the NY Times. Trump doesn't care if his policies harm his supporters because they don't care. The Republicans are all on the same page together, and their base are as happy as clams because their leaders are delivering what they want.
Mark Holt (Andover, NY)
It's hard to characterize this is a "victory" for republicans. The AHCA doesn't begin to keep trump's promise: that he would provide ALL Americans with "much, much better healthcare at a much, much lower cost".
Peter P. Bernard (Detroit)
I never thought I’d see white America using a Jesse Jackson rallying cry: “Keep-Hope-Alive.”

What makes anybody think a Republican-controlled Senate is going to behave anymore rationally than the Republican-controlled House?
Republican Senators are under the same gun as were moderate House Republicans—“don’t be seen as a party-divider.”

The Senators are all going to be given a pill they can swallow and “hope” that some of their problems will be worked-out in the Senate/House compromise. However, the composition of the joint resolution committee will consist of “safe” members and Trump will sign a horrendous health-care bill.
By the time the hard effects of the bill take effect, those who created the joint Senate/House monster will be safe from voter’s retribution.
Sarah D (Montague MA)
It may be a terrible way to write legislation, but Republicans are very good at uniting when they need to. Maybe the Senate will come up with something "better," but it will still be the GOP's bill and will still, in all likelihood, not be what the country actually needs. I'm not celebrating yet.
mmp (Ohio)
First, Paul Ryan cannot tolerate Trump. Now he worships him. Do we still have a Constitution?
Alan R Brock (Richmond VA)
The Trump administration and Congressional Republicans: Boldly exploring new limits of incompetence and depravity.
PogoWasRight (florida)
and moving faster and faster toward the cliff of revolution and extinction. Led by a group of clowns under the direction of Trump. I owe George W Bush an apology.......I sincerely thought he was one of the worst Presidents America could conceive of, yet alone produce. Trump has proven me wrong. I am very old and have survived many Presidents, but Trump is the least qualified for the job among all those I have observed. I do not care if I survive him....................
mmp (Ohio)
I agree, Trump is drunk on money and knows only to buy the country, maybe the world. Just a new toy for him.
Mike B. (East Coast)
The current crop of House Republicans are a strange, weird group of politicians. Do they actually believe that this terribly bad piece of legislation that they just passed is actually worthy of praise? What utter nonsense.

The so called "healthcare" legislation passed (without a single "yes" vote from the Democrats) is so deeply offensive, so very toxic to just about everyone who lives and breathes in these United States, that it should be more appropriately called "Death-care".

One would think after passing such garbage that they would run and hide from the public -- a public that they just sentenced to a life of pain and suffering, including financial. Instead, these soulless idiots decide to celebrate in public view, giving Americans everywhere a clear reason to vote them all out of office at the first opportunity.

Once again, their victory over compassion and understanding reveals a party that that is incapable of feeling "empathy". They are a shallow, mean-spirited, selfish group of sycophants who kneel at the altar of greed and power.

These people don't represent the interests of their constituents. They obviously could care less. Instead,this pathetic excuse for legislation will be used to give their wealthiest contributors a huge tax cut that they don't need at the public's expense.

This ticking healthcare bomb is now in the hands of the Republican controlled Senate. They undoubtedly will defuse it and re-write the legislation from scratch. Don't expect much.
Eric (Nevada City, CA)
Trump has to move right, they've got an impeachment gun to his head. Government by hostage taking.
Cogito (State of Mind)
Re the joke about lawyers, where the punch line is "a good start"?
Same applies to the crew in this picture.
RS (Seattle)
The reason the GOP is having trouble in congress is because their group is made up of people trained to hate the other side. They don't have a unifying mandate or direction, because the only thing tying them together is the perverse belief that the previous President destroyed everything he touched.

But that's all policy, and has nothing to do with the fact that he was an extremely educated black man, right?!
A. (New York, NY)
You mentioned these conclusions are based on academic research... cite the sources, please.
Lee Harrison (Albany/Kew Gardens)
Where in the article does it say anything about "academic research?"
Marklemagne (Ohio)
Every one of those guys is regretting that photo-op. They're gonna see it on TV ads for the next 18 months.
Joan Bowers (<br/>)
Wonderful photo. I actually see one woman (couldn't be Pence's wife, could it?)
sarah (rye)
Actually, I think it's half a woman. On the far right of.the photo? Definitely Mother Pence.
Flak Catcher (New Hampshire)
If I see one more photo-op image of Paul Ryan looking for all the world like a proud papa as some GOP bigwig is applauded for selling away our rights, I'll vomit.
Kirk (MT)
Fat old men taking health care away from American women and celebrating with beer on the white house lawn. Evangelical Christians??
Mondray (Suffern, NY)
Look at the photo. The Donald and his cohorts are smiling for the clever obituary they just wrote for millions of uninsured Americans who will not be able to buy affordable health care under their bill.They are ready to congratulate themselves for their work and will dance a jig in their joy around the forthcoming dead uninsured. Most of them did not read the bill before voting on it. The Donald doesn't even understand what's in it because the details are too long for a tweet. After this debacle they will do the work they were paid for....cutting the taxes for the wealthy oligarchs, their bosom buddies.
Lynn cox (Ohio)
Why doesn’t the media understand that the republicans are determining the conversation on all levels? The press let the GOP label the affordable care act Obamacare as a smear, yet not one person in opposition takes up the power of words to brand this travesty derisively as Trumpcare?
Have liberal thinkers become so lost in their swoon to understand the power of words?
Auntie Hosebag (Juneau, AK)
This division you speak of--I'm not seeing it. Far as I can tell, Republicans of all twists are united behind one principle: Only if it makes the rich richer!
Walter Ingram (Western MD)
President Trump couldn't help himself. He feels no greater thrill than to have men of stature pat him on the back in public! Tomorrow matters not.
gregory (Dutchess County)
Sean Maloney the Democratic Congressman from NY18 said on Rachel Maddow last Friday that he would adopt my district NY19 whose Congressman is John Faso who is a right wing extremist trying to pass as a moderate who voted for the draconian health care disaster passed last week. Faso will not hold a town hall as he is afraid of tar and feathers and his own shadow so Maloney came to Kingston NY tonight and held a town hall in front of about 500 cheering rallying activists who are determined to make Faso a one term turkey. It was exhilarating and this may catch on. It was announced at the rally that a Democratic Congressman in Arizona will do the same. I think this is a new idea Maloney has come up with and I hope it catches on because we need single payer...now.
Lee Harrison (Albany/Kew Gardens)
Faso should be among the most vulnerable Republicans in New York. His collaboration with Collins to add the screw-New-York-city provision to the AHCA makes him loathed downstate -- there should be no shortage of money to support a decent candidate.

Put bluntly, the Democrats don't have a clear choice of an opponent for Faso at the moment; the handful who have filed are largely unknown and untested. This is a race the Democrats may end up throwing away for lack of organization and a candidate.
Linda (Nashville)
I never really thought about this before but why don't men have to pay half of the cost of maternity care? Women don't get pregnant by themselves.
Agent86 (Fairfax, VA)
As an alum of the university where the author teaches I would really like to agree with her, but she couldn't have it more wrong. Non-partisan, academically-based research is showing that (1.) Republicans are, especially when compared with Democrats, more and more likely than they used to be to vote for idiosyncratic and racially motivated reasons, even if it really does hurt their self-interests; and (2.) Gerrymandering, dark money, and other forms of voter suppression are indeed having a significant effect in terms of undermining our democracy. Hence it's doubtful that most Republican voters will choose to toss out their Congressmen no matter how much their bodies or bank accounts are harmed by ACA repeal; it's also doubtful that the current makeup of the Democratic electorate, even if vocal and reflecting the majority of public opinion, could undo what a few hundred Congressmen, and possibly Senators, choose to do on behalf of their wealthiest donors. There's no use appealing to most Republicans or counting on them to "switch sides"; the only chance is to appeal to low-income and minority non-voters who can be convinced that they have much to gain by registering and voting Democratic. This portion of the population must also be HELPED to vote, given the above-noted suppression tactics.
ann young (florence, italy)
Unfortunately "his" voters are not reading this wonderful newspaper and our comments. All of it is chilling.
mmp (Ohio)
I agree but suspect the NYT is on Trump's hit list.
C. Morris (Idaho)
" Last week the chairman of the House tax panel called for party lawmakers and the White House to get on the same page before trying to legislate."
Mission Impossible; Trump is not on any page.

" Mr. Trump’s supporters might say a deal on health care was needed to get victories on what he really cares about, trade and infrastructure. "
He doesn't care about trade or infrastructure.
pjc (Cleveland)
To whom do these intrigues matter?

For the next year, Republicans and Mr. Trump will be able to say three magical words -- "Obamacare is Dead" -- and while this may cost them some House seats in 2018 (and I doubt enough to put the Democrats in control) it will not cost them the Senate, and so the levers of government will still be largely in Republican hands.

I think the author underestimates how powerful those three magical words are to a certain virulent portion of the electorate.

We are not, in other words, in anything resembling a rational moment in our politics. It is tribal to the core. And for a too many, the great stain is Obama was of the wrong tribe, and anything he did or touched is primitively tainted and must be destroyed or at the least, put in its proper place.

Do not disregard this aspect of where we are at as a nation currently. Trump's constant raised fist at political rallies is not an empty political gesture. It is a gesture of relatively unambiguous white triumphalism.
N B (Texas)
So are you saying that the magic in "Obamacare is dead" is tantamount to saying "Obama is dead?" Are we so racist, that we will let our own die prematurely?
SN (Philadelphia)
"You're going to end up with great healthcare for a fraction of the price. And that's going to take place immediately." Trump, 2/19/16

"The new plan is good. It's going to be inexpensive. It's going to be much better for the people at the bottom, people that don't have any money." Trump, 2/18/16

"Everybody's going to be covered. I'm going to take care of everybody." Trump 9/27/15

"We're going to have insurance for everybody." Trump, 1/15/17

"We're gonna come up with a new pan that's going to be better health care for more people at a lesser cost." Trump, 1/25/17

"Nobody knew health care could be so complicated." Trump, February 28, 2017
r shearr (malaysia)
"Everybody's going to be covered. I'm going to take care of everybody." Trump 9/27/15
have to admit, the trumper is 'taking care of everybody'!
FireDragon111 (New York City)
Health insurance companies are for profit. Lets not forget this and it is never ever mentioned in any news articles about healthcare. Health insurance companies make their profits by denying claims. The profiteering middlemen corporations need to be taken out of the healthcare equation. Until this topic is brought into the healthcare discussion, any and all articles arent addressing one of the major causes of insurance cost. Instead, the blame is attempted to be solely focused on people who use their health insurance (isnt that what it is there for?). While excessive healthcare costs from long term health problems are part of the problem, it is not the sole cause.
SN (Philadelphia)
Finally! It wasn't health care reform it was supposed to be health insurance reform. Dream on about single payer. the blues, aetna, anthem et al will never allow reform that causes them any financial pain. They exist to make a profit. And for no other reason. They are the money changers outside the temple.
Caring (Citizen)
It's easy to blame the health insurance companies, but the underlying cost of care is a bigger driver in making the health insurance costs unaffordable. Compare US costs of anything - hospital, drugs, medical equipment to any other western civilized nations and you will see that we are always at least 2x-3x and more. Hep C drug is a classic example. $80k for a 12 week regimen in the US, $8k in the U.K. And less than $1k in India. Why the US govt is prohibited from negotiating drug prices is a giveaway to big Pharma.
Ella (Washington State)
The economy of healthcare is inelastic and growing with the Silver Tsunami of boomers which is largely less healthy than previous generations, and more reliant on health services. There is currently a huge shortage of healthcare providers, which makes those healthcare providers short on time and more apt to just prescribe a pill if they can (which incents Dr. payola and junk boner research by big pharma instead of actual lifesaving medicine.)
.
True healthcare reform would require a far more systemic reform, reaching far and wide- from the tuition for med school & how it's paid (with increasing government subsidy to those choosing in-demand specialties such as gerontology and mental health), to overhauling the crony FDA, changing requirements and licensing regulations for nurse practitioners, funding medical research in academia, paying for vocational schools and developing more preparatory high schools et al.
.
Unless supply is also addressed, demand will always outstrip it and costs will outpace the rate of inflation drastically, and trying to address the myriad reasons for those costs will be like playing whack-a-mole.
Gerard (Everett WA)
Next election, vote against every Republican, for every office, at every level. Be patriotic; save the country, and make American truly great again.
elle (New York)
Wrapped in White Men Lies.
publius (new hampshire)
What a disgraceful racist comment.
Susan H (SC)
Seems to me that if the new law allows it, many businesses will opt out of providing insurance as an employment benefit. If they do and the individual market becomes so pricey that more and more people can't afford insurance, will the insurance companies slowly die or will they figure out that to survive they must offer an honest product at an affordable price. Otherwise more people will 1) Go without health care, 2) look for a free clinic if they can, 3) Use the ER and then go broke trying to pay or abscond so they can't be found. The system breaks down and more epidemics of measles etc. occur. If there is tuberculosis around untreated, it can spread quickly through the general population and the wealthy will not be spared. If too many people come to hospitals and can't pay, hospitals will close. Look at the choas in Venezuela because of stupid government decisions that were totally illogical. Think the breakdown of the healthcare system in this country won't lead to big trouble? Don't count on it.
Andrew Zuckerman (Port Washington, NY)
But no billionaires will be harmed as a result of this bill.
Linda (Nashville)
Wonderful. How Republican - a picture with no Blacks, no apparent Hispanics and one woman!
Andrew Zuckerman (Port Washington, NY)
It reflects the party.
CJD (Hamilton, NJ)
Looks like a Log Cabin Republican mixer.
Ricardito (Los Angeles)
Not a very sensitive way to make your point, though your point is taken.
NA (NYC)
What a diverse crew depicted in the accompanying photo. We have a group of old, white Republican men wearing red neckties, blue neckties, and--my goodness--there's even an old, white Republican sporting a colorful bow tie. That renegade!

They look like America, alright, if a men's club in Palm Beach is America.
Laura Black (Missouri)
The GOP has the rest of this term. After that, their opportunity goes away.
Christoforo (Hampton, VA)
"Mene mene tekel upharsin." (They have been weighed in the balance and been found wanting).....enjoy your little Rose Garden beer party now, GOP, because in a short while a socialist tidal wave is coming.
Kosher Dill (Midwest)
Men who say you shouldn't have to pay for maternity coverage -- do you not have wives, mothers, sisters, daughters who need it?

Will you pledge not to father any children who ever will need prenatal care or assistance during their delivery? Are you willing to lie down and spread your legs for a vasectomy, just to make sure? (The no-frills kind, of course; why should the rest of us coddle you with pain medication or other comforts.)

Is it Ok then if my policies don't cover ED meds or prostate cancer? How much do you think your share of the bill will be if you are lumped into a silo with other prostate cancer patients? Hint: A lot more than it would be if the rest of us all tossed a few bucks into the prostate cancer pot, whether or not we own a prostate.

The photo of those smug, self-congratulatory and utterly callous white men enrages me. Even worse is thinking of the smug, self-congratulatory women who voted them all into office.
gordy (CA)
Does DJT or the people surrounding him realize just how stupid his blond 'Hair Do" looks? Swooped off to one side by the wind and sticky sweaty on the sides?
Zsazsa13 (NJ)
He as a Government employee doesn't have to pay for a Gastronologist visit because their tubes and tools would be too clogged with what he has going on. But that is ok we can pay for it. He looks quite tubby to me. even with his designer suits he still can't button the buttons on his suit. It makes me wonder what he snacks upon when he Tweets at 3 AM. Maybe Tweeter Butter on some rich French Bread? He is a tub.
JK (IL)
Are you sure it's sticky sweat and not scotch tape?
Shirley Scott (Kansas City)
You forgot the duck tail he likes to have curling up in the back. A thug with a tie
Casual Observer (Los Angeles CA)
I do not think that any but a few moderate Republicans may suffer for supporting this health bill. Their constituents are more concerned with being free to keep their money instead of paying taxes with it, eliminating regulations which businesses say hurts their ability to prosper, eliminating laws and policies which enable people to disregard local community standards with impunity, posturing internationally as if we could march across the world and subjugate everyone if they mess with us, and generally having a world in which they feel comfortable because it's just like it was when they were children. So the Senate can duplicate the House bill and may be make a few small changes that conservatives find innocuous without suffering any electoral problems. They are elected officials, elected by people who agree with them pretty much on everything.
Bob Shreve (Albuquerque, NM)
This bill demonstrates that President Trump will make any deal in order to claim success. No ethical considerations, only political. Just like all the other politicians. How do you like him now, voters?
Rev. John Karrer (Sharonville, Ohio.)
How many folks realize that the Repubs have also condemned seven to eight MILLION VETERANS to loss of their health care? And those who voted for this travesty wouldn't let themselves be seen in public without their U S flag lapel pins prominently displayed for all to see! And these cretins were actually VOTED into office. Are we in BIG trouble, or what ?
Frank G (New Jersey)
Yesterday I was listening to the Sunday talk shows, such as State of the Union by Jake Tapper and ABC's George Stephanopoulos. They interviewed Tom Price and Paul Ryan. Both Price and Ryan were telling white lies which did not make any sense, but these anchormen could not ask any follow up question to pin them down or expose their lies. It only takes fourth grade math knowledge to expose the falsehoods of these Republican representatives. I don't believe Tapper and Stephanopoulos are stupid, but they are lazy. Too lazy to do some preparation ahead of time. Not only these two, but I see this every week with most TV news people. There are some notable exceptions such as Rachel Maddow who are smart. Rest are not, unfortunately.
Andrew Zuckerman (Port Washington, NY)
If you host a TV "news" show, you must have folks like Price and Ryan who are willing to appear. Ask one too many tough questions and they won't come back and you will be unemployed.
It's not laziness. It's enlightened self-interest.
elfarol1 (Arlington, VA)
Trump has found a winning formula. First, behave in public in ways that endear you to a large voting block. Give no meaningful measure of victory. To under score the lack of measure, make public statements that are opposites. This way it's always a victory. Your true believer base will still love you as you purposely mistreat them.
Martha Turbie (Oxford CT)
What is it that Trump and his minions don't understand about the fact that over half of American voters are not in agreement on Trump's take on healthcare, military spending, 'the wall", or immigration etc. ....and yet, he continues to pander to his far right supporters, instead of finding a middle road to success? When he narrowly won the election he should have surrounded himself with more moderates....what we have now is a dictatorship handing out pronouncements to a population that is disgusted and angry.
Diogenes (Belmont, MA)
Very nice tutorial on legislative politics! Its argument is consonant with a non-ideological president, whose only concern is with winning whatever the medium or long-term cost.

These are halcyon days for conservative Republican leaders from safe districts who will tie Mr. Trump up in knots. Expect him to withdraw from legislative battles and devote the rest of his term to engaging in foreign adventures. There he has only Putin, Xi-ling Pen, Kim Jong-um and Benjamin Netanyahu to deal with.
eyeroller (grit city, wa)
Dear Mr. President -

With all due respect, this is not a "win" for you or your voters. If you would take the time to read even the executive summary of the bill, you would see that it simply DOES NOT do the things you promised.
You got rooked, sir. This bill is designed to make you look like a liar and a hypocrite. And it's working.
This bill is a victory for the people you defeated in the primary. Please, Mr. President, you were elected to be different. Take that to heart. Be different. Stop carrying Paul Ryan's water. We didn't elect him.

Love,
America
C. Morris (Idaho)
Indeed, Trump promised 'beautiful coverage for everyone, lower premiums and deductibles, mandate to cover preexisting conditions'.
How this washes out is beyond me.
So, his base are still buying this lie.
He isn't even a good liar; He tells fake lies.
G (California)
"The bill he [Trump] championed in the Rose Garden runs completely counter to his promises ..."

This is a naif's concern. Trump has never let "his promises" constrain him, certainly not in his political life. He will blithely assert that the bill does precisely what the political moment demands that it does. If (or rather, when) the bill's devastating consequences for his supporters become impossible to ignore, he will just as blithely assert that Congress hoodwinked him.

Both times, a substantial number of people will believe him -- including himself.

Trump himself *has* no true beliefs, other than his insatiable desire for things that can be spun (sometimes out of thin air) as "wins" -- wins for him, that is. If those wins happen to benefit others, great, but the benefits for others are never, ever his primary concern. This legislation never has to reach his desk; the whole point for him was the Rose Garden ceremony.
Chris Parel (Northern Virginia)
A picture is worth a thousand words. Trump has given new meaning to "White House", "Men's Room" and "Compassionate Conservatism".
Sparky (Orange County)
It gives the freedom for all Americans to have insurance, if they can afford it.
carol adams (lancaster pa)
and if they can't afford it?
N B (Texas)
No their problem.
Paul Yates (Vancouver, Canada)
As a Canadian, I worked as a sale executive for several well-known American based Corporations. As a benefit, my medical insurance was paid by my employers as 'golden handcuffs', benefits to keep me and my colleagues from crossing the street to competitors that had a less generous employment package. All I had to do was pay a taxable benefit which I happily did. These businesses were and are still highly profitable, with tens of thousands of Canadians on the payrolls. Yet other parts of my income tax paid for unemployed neighbors who had access to exactly the same extensive coverage I was getting from my employers, and not I nor any of my colleagues had any problem with that, and still don't. Maybe it's the way we were raised as a culture, but Canadians are proud of our health care and whoa be to the politician or party who even tries to even think about taking that away. Most parties at election time try and give us more than we already have, in order to garner voters and prove their Canadian values. Here, we have hockey and we have health care and they are by far the most important religions of the great white north... and it seems perfectly normal to live this way.
Suzanne (Indiana)
The GOP keeps saying that this bill will give people freedom; the freedom to not buy health insurance if they don't want to. If that is the case, shouldn't hospitals and medical providers also have the freedom to turn away people who do not have insurance and can't prove they can pay (hard to do when you are being put under for emergency surgery, but whatever).
Oh, wait. That IS what hospitals used to do...
ck (ago)
I am afraid that it doesn't matter how much Republicans hurt them, voters will still vote for them. They don't vote on these issues. They vote on partisan identity and social issues like abortion.
BC (Renssrlaer, NY)
OK, so the House bill is an abomination, and the Republicans in the Senate announce today that their working group on health is comprised of 13 fat, old white men and not a single woman. As I recall this is what a solid majority of American white women voted for and want. Let the big, strong old white men take care of their health requirements. Too complex for white women to think about.
Armo (San Francisco)
The republican senators must prove that they are not mean spirited and racist, like their house counterparts by re-writing the entire bill. The freeloading congress has not a moral fibre among them - democrats and republicans alike.
carol adams (lancaster pa)
Democrats did not and would not do that,
gratis (Colorado)
Is this what Conservatives... REAL AMERICANS ... think government is for?
Dan Bowman (Los Angeles)
The real "conservatives" who seem to all be taking in tons of cash from Russian oligarchs? Not very "American" in the old days when truth was still respected, and Russia was approached very suspiciously.
Nancy (Upstate NY)
Here is the irony: in promoting this bill which will hurt the red states' rural poor more than any other group (as NY is already talking about ways to make up for the lost Medicaid funds, but I would bet that Kentucky isn't) the President and the Republicans are going to be harming, and perhaps even literally killing, their own base.
Sad!
Frank (Columbia, MO)
Every Democratic leader should simply start referring to the Republican Wealth Care Bill until almost everyone gets it.
Eric W (Scottsdale Arizona)
The GOP doth protest too much about the ACA. It's clear their concern is not about health care, or Obamacare. Their concern is about the revenue side of the equation. They loath taxes on the very most wealthy in America to fund health care for any portion of the public at large. Especially the poor and minorities. This bill proves it. Heartless liars.

America, the home of the brave, land of the free.. we do not shun those less fortunate or those in need. The GOP demonstrates not a shred American decency with this bill. On the contrary, they reveal greed and deceit, the dark side of the force if you will. Queue the Darth Vader theme..
Jean Boling (Idaho)
I will believe that the Republicans have passed a good bill when they give up their Congressional insurance coverage and stand in line with the rest of us.
Timothy Shaw (Madison, Wisconsin)
What if doctors told these Republicans that they thought their actions were despicable, and that they didn't feel comfortable treating them or their family members, as it could affect their doctor-patient relationship which always involves trust in one another. Doctor's can do that now by denying poor people or Medicaid family members and children, and it's perfectly legal. The government can't force you to see these patients. What if Paul Ryan's wife told the doctor that was unprofessional and unethical for not treating her or her family? The doctor could retort - do you not think it unethical that your husband, Speaker of the House, President Donald Trump, Dr. Tom Price and most Republicans in Congress are about to do that to 24 million Americans in need? The doctor could shrug and claim his or her "freedom" from government mandates and coercions. What if every doctor did this? Ayn Rand and her followers would be proud! Most doctors don't do this obviously, as they have a sense of duty and responsibility to their fellow Americans. But they could do this if they followed the Republican ethics of Trump, Ryan and Price.
A Business Owner (Los Angeles, CA)
Any Rand lived out her days on Medicare and Social Security.
Been there (Boulder, Colorado)
Who wants to bet that a bill that skewers Trump's electoral base will make any difference in the way that base supports their skewerer? I'm betting none at all. They'll still support him all the way off the cliff.
Nancy Fleming (Shaker Heights,Ohio)
This is an excercise in a horribly inhumane act by old white men primarily ,and a few middle aged white men,who temporally have what they call power.In the picture Ryan and Trump and Pierce look smugly victorious.It will not last.Throwing such untrustworthy humans on the trash heap will be the pleasure of voters like me.Malignent behavior such has been shown by these men and all the others who joined in attacking the poor,the old and the sick.
Join me and the millions who agree in destroying the political life of these
Moral degeneratives.
r mackinnon (Concord ma)
Birth control - out
erectile dysfuntion - in

Now pick out the old white guy in this picture.

Who voted for these bozos?
If you did - ask yourself what exactly is in this for you and your family.
Richard Marcley (Albany NY)
Not a single woman in this photo! These men are so lame-brained that NO one thought about including half of humankind.
It looked like a gathering of catholic bishops at the Vatican! These stupid gits are deaf dumb and soon, hopefully, they will lie in ruin at the bottom of the dustbin of history!
Dr. Dave (Princeton)
There were no women in the trumpcare photo because they have more sense than have incriminating evidence proving them guilty.
Joe Boltonn (NJ)
This was not a College of Cardinals. The Congress can tinker and adjust over the next 1 1/2 yrs , to reflect public sentiment and budgetary considerations. There needed to be changes made in a law that provided taxpayer subsidies to people earning up to 90K and free or near free health insurance to able bodied adults that don't (or won't) work. The ACA was originally born out of concern for the rising cost of medical bills and rising health insurance premiums. Both are still rising. The belief that government paying for both will reduce costs and premiums long term hasn't worked to control college tuition or military procurement and it won't work here.
Glen (Texas)
June 11, 1963. I believe that is the moment that sealed the fate of the US involvement in Vietnam. For those too young or those with short memories, on that day a Buddhist monk set fire to himself in downtown Saigon. The photo of him ablaze in the middle of a major intersection, sacrificing himself in protest to the oppression by the South Vietnamese of Buddhists, and not just the Buddhist religion but the oppression of all people by all governments.

The Republicans couch the AHCA as providing freedom of choice when it in fact oppresses the poor by reinforcing and emphasizing the primary shortcoming of the less financially fortunate. Republicans have been accused of oppression on all the following bases: age, gender, race, religion. They are especially so disposed toward the poor.

Freedom is not free. The poor know it as a fact of daily life. And now the merely not rich will get a taste of that.
Occupy Government (Oakland)
The problem is not the health care bill. The problem is Republicans don't believe government should work for us, the people. They routinely ignore public opinion to favor the donor class. Oligarchic totalitarian capitalism is not an academic theory. We see it in Washington today.
Casual Observer (Los Angeles CA)
The Republicans have behaved badly for a very long time and overall it's worked to their advantage. So as a body, they have no conscience. Individuals may care about how they affect those without power but who will be harmed but chances are that will be a small number. There is a real likelihood that the Senate will increase the fund for high risk premium support and pass a bill which is pretty much the same as the House's. It will frustrate moderates but it will provide the tax cuts which they think will assure them of winning future elections.
gcspro (Redmond, WA)
Those who get insurance through their employers (the vast majority of adults) need to pay attention: Per the WSJ:" Under the House bill, large employers could choose the benefit requirements from any state—including those that are allowed to lower their benchmarks under a waiver, health analysts said. By choosing a waiver state, employers looking to lower their costs could impose lifetime limits and eliminate the out-of-pocket cost cap from their plans under the GOP legislation."
Those of us remaining in the middle class are in danger of losing the benefits considered essential under the ACA -(like mental healthcare, substance abuse care, pre-natal care) -so that the top 0.1% can get a hefty tax cut.
LCF (Alabama)
The health care crisis in our country highlights what may be the nation's longest-running conflict--the argument between federalists and anti-federalists. Here follows a very simplified explanation of the controversy: Federalists promote the good that a centralized government is able to do for its people. Anti-federalists,by contrast, promote the good that state governments can do. The Civil War was not the first or the last event to expose the falseness of the claims to superiority by States' Righters, but the war certainly was the most cataclysmic. Still today, however, many on the right still believe the states can and will do the work of governing.
I submit the record of my own state, Alabama, as an example of trust in states' rights gone amok. On almost every measure of well-being, Alabamians come in last, and yet our people clamor for "states' rights." Alabamians rail against the overreaching federal government, at the same time that they gladly accept every dollar from the feds. I, for one, would love to experience a government that looks out for my interests, in areas--such as health care--where I do not have the agency to look out for myself. Why is health care for all such a radical idea?
Here is one example of a way that government could make life better, by not tying health care to one's employer: I am retired now, but as a young person I would have loved to have health care that was not connected to my job, essentially tying me to one place.
Casual Observer (Los Angeles CA)
The need for elected representatives who are decent and fair minded human beings is obvious but it's obvious that the conservatives in Congress are mostly those who believe that the rich and powerful are manifestly better human beings and those who aren't are somehow failures in life and not worth considering even if they are the majority of the people. They survive on fear and intolerance controlling the minds of their constituents. Life can be difficult for everyone sometimes and these characters thrive on the bad effects of this kind of stress. It is not for nothing that the most generous and inclusive periods in our history, the leaders were generous and inclusive in their politics. Bring a little hope back to the majority and the conservatives power will shrink considerably.
Sarah O'Leary (Dallas, Texas)
This is a political chess set with several sets of pawns. The American people, millions of whom voted for Trump, were lied to in order to get their votes both for Trump and others running for election and re-election. The second set of pawns are the GOP members of Congress that have taken dark money from Super Pacs who, in turn, clandestinely leverage their votes. The kings and queens are the 1% of Trump's friends, both here in Russia and around the word, who will benefit financially from the decimation of our healthcare system.

As reported earlier this week by the New York Times, the bill is a disguised tax cut for the wealthy. The more money they have to invest into campaigns, the more this group of sinister individuals can exact their will on the rest of us.
Rich (Statesboro, GA)
In poll after poll during the Republican primaries and among Republican voters, there were majorities that said that the voters felt the party had "betrayed" them. The GOP gets voted in and starts on the exact things that "betrayed" the voters. They do this willfully because they no there is no electoral price to pay. They will not lose the Senator (look at how many seats the Democrats have to defend) and not enough people will come out to vote to turn the House over. The GOP is gambling on voter inattentiveness and apathy. They doubled down on it. And would anyone bet, they won't survive?
Nora Webster (Lucketts, VA)
Back in the seventies the old MS magazine had a feature called "What's Wrong with this Picture?", which would show some picture of some group of powerful decision makers which included no women. This picture shows one women, but others show none. When they took the for-the-public official picture they shoved all of the women,all 5, into the front row. It's pretty revolting to think nothing's changed since the early seventies, but these are tone-deaf republicans celebrating a one trillion dollar tax cut, so I guess it's understandable they are so clueless about the image they're projecting.
Jim B (California)
I think this bill is the beginning of the end for Republicans. The legislative activity of the Republicans in Congress, particularly the "Freedom caucus" is so out of tune with a significant majority of American voters that, by pandering to legislate by tailoring bills to the caucus' requirements, with just enough moderation to pass, Republicans will have until 2018 to do this. Then, since it is no longer possible for them to hide their agenda behind obstructionism and 'alternative facts', I think the Republicans will be swept out... Republicans legislation hurts at least 2/3 of Americans, no matter how they spin it. When they do "tax reform" and the public realizes that means huge giveaways to the 1% and a pittance to the rest of us, the agenda will be clear... Republicans goals are so far out of alignment with the needs of ordinary Americans they won't be able to fool enough people to win, even in many of the 'safely gerrymandered' districts.
gratis (Colorado)
"...confirms how tough it is to govern with slim, divided majorities, even when your party controls the government."
Fair enough.
So, why can't the GOP govern in states where they have huge majorities?
BTW, IMO, transferring state tax money to the very rich and corporations does not count as governing. If you disagree, then I withdraw the question.
Nedro (Pittsburgh)
The problem as I see it is that those of us who deplore the current state of affairs in Congress and the White House tend to forget that our arguments and prognostications stem from our unwavering belief in truth, fact, rationality, equity, fairness, and altruism. Conservatives, by and large, do not vote in their best interest; they vote for individuals who personify a form of paternalism, provincialism and authoritarianism that we - the "others" - find difficult to comprehend. (Human behavior theorists, Kohlberg and Gilligan, capture this distinction in moral reasoning with frightening accuracy. Well worth a read.)

Consequently, despite a very solid argument by Ms. Binder for the potential demise of the Republican-led Congress because of their incompetence and greed, their supporters will continue to vote for them. For this reason, Congress hath no fear. This will be no cake-walk for Democrats.
Chanzo (UK)
"Trump’s supporters might say a deal on health care was needed to get victories on what he really cares about, trade and infrastructure"

It was needed for what he really cares about: big tax cuts for the very rich.

The House Health Care Disaster Is Really About Taxes
https://www.nytimes.com/2017/05/06/opinion/sunday/the-house-health-care-...
al miller (california)
Consistent with Trump's approach to governance and life, this was all style ("Hey! Look what we did for you - Trump Voters") over substance (This bill is little more than a proposal awaiting Senate feedback and all indications are that Republicans in the Senate are going to scrap it and start fresh). Anything that comes out of conference will be unrecognizable to Freedom Caucus members in the House.

Thus, Trump pulled yet another PR stunt in order to claim victory in an effort to show he has accomplished at least something. In reality he has accomplished nothing. Oddly enough, that is a blessing to the country.

This Bill is a tribute to the incompetence of Ryan. Not only will it never pass the Senate, House Republicans will be held accountable for the vote they passed.

Ryan should have asked himself who it is that actually knows a remarkable amount about healthcare reform and also votes Republican in droves? Answer: Fox watching, senior citizens.
And while these good people are averse to absorbing information that contradicts their Fox View, when they are threatened with death, they tend to become pretty open minded about voting for democrats.

Senate Republicans are too smart to let this disaster pass.
Ed (Old Field, NY)
This is how the legislative process works, and it helps to start.
Cisco From Nabisco (My Two Cents, CA)
Obamacare is the POINT OF ORIGIN to build FROM. What Obama gave to the U.S. Taxpayers was an engineering model on par with our FREEWAYS, railroad system and space program that pulled it's people out of the MUCK and LIFTED tens of MILLIONS out of the grips of poverty from would be profiteers.

Just like the development of the aerospace and aircraft industry; with all the it's regulatory, certification and compliance requirements, you don't stop after the FIRST ITERATION. You need to build from there and IMPROVE on it. Boeing, Airbus, Bombardier, Gulf Stream, etc. build different aircraft for different needs and uses. But BECAUSE human life is at stake every-single-time, they MUST meet a very high bar to be allowed to operate in this country and across the globe. And it's why piloting and flying a Hot-Air-Balloon is not the same as piloting a 747, A380 or other commercial aircraft.

Similarly as with the development of the first microprocessor for healthcare, Obamacare brought together amplifiers, transistors, resistors, and integrated circuits together AND IT WORKS GREAT for most people (and SAVES LIVES.) We should not throw that away and start from scratch...!

What our misguided administration and the the GOP caucus wants is a system that FUNDS tax cuts while it sprinkles in some healthcare provisions. What they offer fails to meet the BASIC NEEDS of tens of millions of taxpayers and that KILLS PEOPLE and competition.
Avery Leinova (Portland, OR)
The Republican health care bill is anything but. It penalizes the old and the sick, as if health was an indication of worthiness. Well, we are all worthy of health care that works; it is a basic right, not the privilege that the Repugnant party claims it to be. We have much to learn from Europe, where universal health care is largely the norm. Health care costs are much lower in those countries, not because the care is less good, but because the cost is kept down through collective bargaining. Our so-called leaders need to think long and hard about what they are doing: this knife in the back of the American People will cost them their power and privilege.
Yolanda (Brooklyn)
Visually, this says it all and wow is this frightening without even reading the article.
James R. Filyaw (Ft. Smith, Arkansas)
While I appreciate the delicate mechanics of "legislating from the right", has it never occurred to these birds to ask the simple question of whether something is right or wrong? Time was that the republicans would loudly proclaim that government involvement in health care in any shape, form, or fashion was sacrilege. Now, they grudgingly pretend to accept what a majority of the country (and the rest of the civilized world) freely accept, i.e. that access to medical care is a basic human right. All they are left with is sabotage, i.e. Trumpcare.
Spencer Lewen (New York)
The ACA doesn't guarantee access to medical care. In fact, it requires everyone to purchase a good that relies on NOT paying out for medical care. The irony here should not be lost on anyone.
Debi (New York City)
@ James R. Filyaw: "Time was that the republicans would loudly proclaim that government involvement in health care ...was sacrilege."

Actually, in the U.S. the idea of a government mandate is a Republican one, based on the notion that individuals must be forced to take responsibility for their own well being, so that the tax payer won't have to. I'm sure other readers will recall...was it the Heritage Foundation that initially floated the plan?
Bruce L. Northwood (Salem, Oregon)
Take a good look at this photo but put on your sunglasses. The sunlight reflecting off of all those white faces is blinding and says all one needs to know about our republican controlled government.
chambolle (Bainbridge Island)
Mr. Northwood: Extra points for identifying the women involved in and celebrating the formulation of a tax reduction package for the rich, masquerading as a 'health care act,' that just happens to eliminate much necessary health care for the female half of the population, like family planning, prenatal and maternity care.

'GOP' now stands for 'Gruesome Old (White Man's) Party.' And thus it has been since the end of the Eisenhower administration.
short end (Outlander, Flyover Country)
Contrary to public opinion, the USA has the best health care in the world. bar none.....sadly it is also the most expensive.
Why is it so expensive? Because public opinion is manipulated to confuse health CARE with health INSURANCE. The concept of "pre-existing condition" is meaningless in the health CARE business....as "pre=existing condition" translated into english simply means "sick"....which is why we invented health CARE in the first place!!
Now, insurance is a financial instrument created to lessen the financial burden created by a certain defined risk.....Insurance makes absolutely NO attempt to control the cost of said risk......Insurance is very good at spreading the cost, whatever it is, amoung as large a pool of risk takers as possible.
The mandatory insurance that the public was manipulated into demanding is EXACTLY the reason why health CARE costs are skyrocketing.............
Repeal and DO NOT replace.
The Senators and their Lobbyist Pals are fooling you into believing something that isnt true.
As Ralph Nader said, "They are all laughing at you."
Ana (Brooklyn)
If you research it i think youll find health care costs are increasing at a steady pace, and what do you think will happen to the best health care in the world if no one in the us can afford the costs and govt funding is also cut?
Bucketomeat (The Zone)
Where can one obtain health CARE without health INSURANCE?
skysoldier (New jersey)
Best as we live longer, lead mobile meaningful lives into old age? Travel much? How about all those obese people in France, Norway and Ireland in their little three wheeled carts with their oxygen bottles? Right...zero. Rethink best healthcare in the world. A myth.
William O. Beeman (Minneapolis, Minnesota)
Republicans have timed the effects of their horrible bill so that the worst of them don't kick in until after 2020 presidential elections. This is a clear strategy to further deceive Trump voters into thinking that nothing bad is happening to them.

This further underscores the cruelty and greed that underlies this legislation. It is not, and never was about creating better health care for Americans.

Listening to Health Secretary Tom Price on television over the weekend made me nauseous. His lies and deception about the effects of Trumpcare reached to the nadir of blackheartedness and chicanery.

We have a passel of thieves and charlatans in the White House, and the rubes who voted for Trump don't seem to notice.
Dean Fox (California)
David Ogilvy, the advertising guru, is famous for saying, "Nothing kills a bad product faster than good advertising." Trump, Ryan, the GOP and the Trump/Ryan healthcare bill are all terrible products. The more we know about them, the less we believe anything they say.
Wesley Brooks (Upstate, NY)
The word is finally starting to get out about how the GOP has been taken over by the right wing enterprise created by the Koch family and their other major benefactors. It's not just Congress, either. Take a look at the names of the deputy secretaries and/or advisors in the Trump cabinet. Trump's tweets are probably the only thing he is doing that isn't being directed by the Kochtopus. We all know that he didn't nominate Neil Gorsuch, he only followed orders. The average American knows nothing about the far right's agenda, and if they did they clearly would not support it. As every politician since LBJ knows, cutting Social Security and Medicare is a non-starter, but yet it is at the top of the Koch playlist. And getting politicians to tell you they support something while they quietly take it away is the essence of the Koch playbook. The media needs to stay vigilant and keep exposing the power and influence of these right wing oligarchs that is destroying our democracy.
Garz (Mars)
Oh, Sarah, just watch!
Madam DeFarge (Boston)
Those smug old white men think everyone who votes is as gullible as their base.
Brette (Texas)
What kind of people celebrate knocking 24 million people off health insurance and sacking Medicaid? Savages?
Joy (Sacramento, CA)
Savages treat their people better than the GOP does. Savages don't kick the people who voted for them in the face.
Thomaspaine16 (new york)
God blessed the American people with many gifts, but he also gave them one major fault. We are the most stubburn people on Earth, and we refuse to admit when we are wrong. In this way the people who voted for Trump will never admit they are wrong about it , they will tie this into gun rights and fighting against abortions. The only thing that will really sway them is an economic downturn, thats when they face reality and vote accordingly.
skysoldier (New jersey)
So right. Americans can never admit a mistake.
John LeBaron (MA)
During his campaign, President Tump never uttered a word about how he envisioned creating a "beautiful" health care plan to cover everybody at lower cost and a higher standard of care. Nor did he say anything about the nuts and bolts of any other grandiosity he promised.

But we were too stupid to ask him for details or to give serious analysis to all that he proposed. Caveat emptor! We got exactly what our political laziness deserves and now we're living his dream and our nightmare.
Joy (Sacramento, CA)
"We were too stupid" ??? Speak for yourself. Us lefties were screaming for details, that were not forthcoming.
John LeBaron (MA)
By "we" I am referring to the American voting collective and I stand by my choice of words. Too many "lefties" did not bother to vote, even though I strongly suspect that you did, Joy. So did I.
CD-Ra (Chicago, IL)
The new Republican healthcare plan is a callous and inhumane act as perpetrated by a House claiming Christian values that Christ would never condone for the New Testament assures us that he spoke love, kindness and charity. "Vengeance is mine" saId the Lord, and yet a minority of the Freedom Caucus believe that option is theirs not God"s. Shame!
El Lucho (PGH)
"Far from unifying Republicans behind a strong president"
Ummmh, I can't figure out who you are talking about.
The problem with Trump and other Republicans is that they are selling the Brooklyn bridge. I do not consider that to be a strength.
How will everybody be covered when you are taking billions out of the system and allowing for people to be charged more, depending on age and existing health conditions?
This is pure math, very simple. For example, the expense of treating for maternal care remains the same, regardless of who pays for it. If you make it so that men do not contribute to this cost, then women have to bear the full cost.
The rational is the same for existing conditions:
You are not making Health Care cheaper, you are only redistributing the cost so that healthy and young people pay less and older and sick people pay more.
As I have not heard of any plans to actually reduce expenses, as the only thing being talked about is the billions of dollars taken out of the system, it follows that there will be less money left for patients.
A strong president and politicians would tell the people what the cost is.
PAN (NC)
Exactly right. The Extremist on the Right propose the most radical ideas and negotiate from there, peeling away lesser extremist Republicans until they have a one vote Majority to win. This results in a more extreme bill than starting with more center-right and peeling away enough support from those further and further to the right. That is how we lost the common sense moderate compromising middle.

Instead of maximum the size of centrists they maximize extremists.
Mitchell Zimmerman (Palo Alto, CA)
Can't you stop calling the GOP's anti-tax, anti-government, extreme-rightist group by its self-serving term, "Freedom Caucus"? The "freedom" they stand for is only the freedom of the most privileged top tenth of a percent to be free of taxes, free of reasonable regulation, free of the responsibility that is inherent in living in a free society. At least "so-called Freedom Caucus" would be helpful.
Dorota (Holmdel)
Even Marine Le Pen, and it is hard to say anything positive about her, believed in protecting France's social net.
Spencer Lewen (New York)
First, it is worth noting that a single instance of legislative process does not, in any way, establish a pattern. The notion that this method is a "template" by which the Republicans will ram down the throats of the American people any and all bills they so desire, amounts to biased speculation. I am cognizant of the fact this is an opinion column, but the author should take care to avoid exaggerating and projecting far beyond that which a reasonable, objective mind can foresee.

Second, and following from the first, that method of writing legislation is not as detrimental to actual policy as it is made out (unless, of course, you disagree with the policy, in which case it's the worst thing in the world). Compromises within factions must begin somewhere, and if they did not begin with the Freedom Caucus, they would begin with some other faction or even the moderates themselves. More importantly, however, that is how legislation is made in both parties. If you think for one second that it isn't the core of the Democratic party that produces legislation, and then compromises with its' moderates to produce a final legislation for vote, you're fooling yourself. If that's a bad methodology for Republicans, surely it's just a bad for Democrats?

Lastly, keep in mind that Health Insurance is predicated upon not providing health care. Insurance pools survive by not paying out for care. The ACA mandate is misguided policy from the beginning.
Doug Terry (Maryland, USA)
There isn't "unified party control" in Washington, DC. The factions of the Republican party, especially in the House, are at one another's throats, plain and simple. Just as the so called leadership feared Trump throughout 2016 and allowed him, without serious opposition, to rise to the nomination, they now fear the so called Freedom Caucus. One reason Paul Ryan and company fear them is fairly simple: a Speaker of the House may be voted out at any time and the far right has enough members to do it. This is legislation by intimidation and threat and no one has the nerve to seriously challenge it.

We live in a nation with a half dozen or more of these unchallenged pressure points. Another example: someone could bring Trump down to earth by threatening to withhold all support unless he moderates his actions, including his wild tweeting habit. Who? Again, the Republican leadership, if there is any, could be the agent, but a combination of moderate Republicans, Republican governors and centrist Democrats would have enough power to demand that Trump change his habits (at least in his outward actions) and develop a full plan for what he wants to do.

Right now, they are engaged in a dance to the death both for future Republican prospects and Trump's promises, which were never based on a factual understanding of what might be possible anyway, fantasy dressed up for campaign rallies. Unless the Freedom Caucus put on a leash, Republicans are headed downward at full speed.
Joy (Sacramento, CA)
They can't get downhill fast enough to suit me. But just when I think they've hit rock-bottom, they find ways to go even lower. These fine, so-called "Christians" are in for a big surprise on Judgement Day.
Joe (Bologna,Italy)
I agree with Mary Ann from Massachusetts. I know that the humanitarian arguments are compelling to most but not to all. I'd really like to know what the real cost of the current system is versus Obamacare or single payer. People being bankrupted due to inflated hospital bills, people using emergency rooms for relatively routine healthcare, postponement of minor illnesses until they come major and cost a bundle. Is there no equally compelling economic argument?
Thomaspaine16 (new york)
It's only a disaster for these congressmen if the people who vote for them think it's a disaster. Frankly i can't figure out republican voters. When FDR tried to get social security passed the republicans fought him with every trick in the book, it took him years to get it passed. The voters kept voting in the same republican congressman to fight against social security because they were told it would be bad for them, and they believed it. Is there one republican voter living off social security today who would want to give up that social security check?Don't think so. Yet there duly elected representatives fought like hell to stop social security. So if you can figure out Republican voters, go head, they continue to vote against their own self interests time and time again because they have been brain washed to be against anything the democrats are for. They have been told the democrats will take away their guns, they have been told the democrats will turn their children into little socialist cared for by the nanny state, this is just some of the propaganda constantly pumped into their brains. So if you think Republican voters are going to get the message you could be wrong. Republican voters, whether they be working poor or just getting by, will fight like hell even against the idea of Universal health care-they just don't get it, and because they don't get it, unfortunately neither will we.
Mark (USA)
To be fair, there is plenty of liberal propaganda out there as well. The merits of this bill can be debated, but one thing that is absolutely certain is that the president is not doing what he said he would do. In other words, there will be no Insurance for everybody, contrary to what he said. Insurance will not be cheaper or better, contrary to what he said. And Medicaid clearly won't be protected from cuts, also something he claimed.
JayK (CT)
Your example of Social Security is a perfect distillation of the irrationality of the typical GOP voter and what we face yet again with the ongoing battle for healthcare in this country.

Democrats were behind both Social Security AND Medicare, two programs which obviously none of them would be willing to give up, yet they still remain loyal to the GOP.

Republicans as a group just can't accept yes as an answer, unless it involves building a wall or a tax cut.
skysoldier (New jersey)
There's that false equivalency again. No, it's them.
PRosenwald (Brazil)
Look at the picture of the smug GOP leaders celebrating their hopefully Pyrrhic victory on the health care bill. See any non-white males or any females?

What we have seen is not only a "terrible way to write legislation" but another blatant example of the destruction of e pluribus unum in favor of the pictured country club elite.
adak (Ithaca, NY)
Looks like a reunion of an elite college fraternity.
JK (IL)
Yeah, there is one woman behind Pence and I remember seeing 2 others. But I agree. Doesn't matter, as the Senate committee includes no women senators. So, let's see. The republicans can afford to lose only 2 votes. Uh, there are 4 women senators, one of whom, Sen. Collins, from Maine, has insurance expertise. OF COURSE she wasn't included. Let's see how this vote goes. Regardless, 45 will blame the Dems if it fails. But then he may be impeached by then. We can only hope.
Joy (Sacramento, CA)
Frat boys on spring break. God help us!
NYer (NYC)
Were this plan to pass, and people start dying and going bankrupt even faster, the electoral comeuppance would be an amazing breakthrough for Single Payer. I'd rather that reason prevail, so people don't need to be dying to realize the GOP is the Profits at All Cost Party.

Perhaps the GOP think they will have a lock on future elections, since the electorate is becoming so easy to manipulate a percent here or there in swing districts. (Thanks Mike Farb.) With Psyops like Mercer backed Cambridge Analytical and the botnets and hackers in Russia. And now potential consolidation of Sinclair Media and other corporate medias, maybe Democracy and the Republic really are on the ropes.
Bob Laughlin (Denver)
Can we please do away with the charade that this so called president has a "Legislative Agenda". He does NOT.
He has some ill conceived promises he made to approx. 20% of the American electorate and he wants to say he kept his word to them, even when it is patently obvious that he is not capable by his very nature of keeping his word.
My only hope is that the republican party will be even more disorganized than the democrats, maybe we can get back to having a democracy if republicans are once again the minority party of no, instead of the majority party of no.
Frank (Fl)
Bob
This country has never been a democracy, it is a representative republic. Its basis is clearly stated in the Constitution. All true democracies fail in the long term. People will eventually elect despots. Hence our system.
Chris (California)
The most appalling factor in this disastrous bill passing is that Congress people did not even read it and had no shame in admitting this to reporters. Throw the bums out in 2018!
Jpriestly (Orlando, FL)
The Rose Garden photo-op is a sea of establishment male white faces pleased with their accomplishment. They really showed us what they are made of.
T3D (San Francisco)
I'm convinced that Paul Ryan underwent plastic surgery to paste that constant smirking grin on his mug as if he's accomplished anything noteworthy. Passing a conservative-style health insurance bill onto the Senate to create is nothing to be proud of.
thelifechaotic (TX)
Don't forget to make note of the fact that most of those male heads are gray or bald. This suggests that many of them are Baby Boomers who grew up expecting a "Father Knows Best" existence. The world moved past them and that's not how things turned out. They are angry about it and have been taking that anger out on the rest of us for decades. I've got two words for these guys - retire already.
Joy (Sacramento, CA)
Clearly we grew up in different America's. The Baby Boomers I know were out there protesting Viet Nam, social injustice and racism. We're already retired -- and now we're worried about how we're going to pay our medical bills.
Shar (Atlanta)
This attack on the middle and lower class disguised as a "healthcare bill" - what an Orwellian claim! - is nothing more than an enormous tax cut for the rich that is designed to set up another even bigger tax cut for the rich as part of the "tax overhaul" that Trump wants.

Inequality on a level never before seen in history is, apparently, not enough for Trump and his merry band of hypocritical bigots. More, more, more for the rich is their psalm, their mantra, their hearts' delight. The tragedy is that their unending lying ("Nobody dies from lack of access to healthcare") and fraud (Trump's "insurance for everybody" and "much lower numbers" claims) are simple for the intellectually lazy or completely disheartened voters who put them in power, the very same people who will be literally condemned to death by the GOP thirst to pander to wealth above all else.
dan anderson (Atlanta)
Take it for what it was, a "Pass the Buck" bill. "We can't solve this. Send it to the Senate. Blame them when it passes or fails. We aren't capable of doing this. Lets go get a beer."
Nancy (Washington State)
The republican plan to "save" social security and medicare is to make sure a good number of people die before fully utilizing it.
Janet (Key West)
These optics are insulting to any one with even a few cells of brain tissue. It is laughable if it weren't about life and death. It is a poor Karl Rove spectacle seen so frequently during Bush ll reigns.
Robert Murphy (Ventura, Ca.)
I will now vote against all Republicans even on the local level.
Profiling Trump by his own words about women he is literally a predator.
Poor Melania.
Trump's son, and grandchildren, Ryan's kids and wife need to be first in line to benefit from this "Tax cut pretending to be Healthcare".
Donald Green (MA)
"I will now vote against all Republicans even on the local level."

Perhaps you're just younger than me, but otherwise all I can say is, "What took you so long?".
marawa5986 (San Diego, CA)
Please, New York Times, finally wake up from the Trump stupor that he's in any way behaving like a real President. Trump cares nothing about Americans, or America, in any way. He cares nothing for trade (unless it benefits the Trump Organization or Ivanka's and Jared's businesses) or infrastructure (unless it affects his golf resorts). There is nothing in his first 100 + days in office that anyone can point to that will improve America or the lives of Americans; in fact,, it's the opposite. Each day he sinks to new lows. And, with the House passage of this AntiHealthCareAct, whose only purpose is to pay for close to $1 trillion in tax cuts for the rich, he's sunk to deliberately, recklessly and knowingly letting Americans die (while he golfs at his resorts on our dime). This is not a real presidency. Get over it and call it what it is; a nepotistic kleptocracy.
blackmamba (IL)
Where the liberal progressive socioeconomic populist political left cheers this Republican House vote as a looming legislative disaster, the conservative evangelical ethnic sectarian colored white supremacist political right sees victory in caste dividing bigotry trumping class unity. As long as the socioeconomic colored black and white poor can be divided by 'racial' caste rather than united by class the corporate plutocrat oligarchs will be victorious.

From George Wallace through Barry Goldwater until Ronald Reagan the Republican route to elective political victory was overtly and covertly paved with invoking the persistent threat of the heirs of darkly enslaved and Jim Crow Africans.
Dr. Pangloss (Xanadu)
We can say what we will here but until and unless the painful, sickening truth filters down to Breitbart, Infowars and Fox "news" his supporters will continue to celebrate the naked emperor while festering in their rage and despair until demographic decline rids us of the worst excesses of what ironically bills itself as the Grand Old Party.
Lucy Hanson (Richmond VA)
the resistance to hard right has already started in Virginia. There is a movement to vote against that reptile Brat from the Richmond area. I for one will do just that. the sooner he is gone the better.
Bill (Madison, Ct)
The Orwellian language of Trump and the republicans just gets more and more outlandish. Up is down, black is white, night is day.
Mford (ATL)
That photo of Trump and Price and Ryan and ALL the other white dudes will go down in history. Have so many cruel, narrow-minded, myopic, greed-driven elected officials ever gathered for such a pic in American history? It's really amazing, and sickening. I wish (political) ills on the lot of them!
Lev Davidovitch (Peoples Republic of California)
a pox on their houses.
mike scanlon (ann arbor)
The lucky among the poor will die quickly. Many of the less fortunate poor will wish they had.
BRussell (Tampa)
The cuts to Medicaid will impact the quality of nursing home care that many e.g. especially aging relatives and the disabled, often need that is not covered by insurance or Medicare. Everyone gets sick and no one gets out of life alive and rarely gracefully.

Life is tough enough without Republicans making it seem insane
klm (atlanta)
That vid of Trump and his jokers in the Rose Garden is worth a thousand words and attack ads. See ya, Republicans!
Nancy (Upstate NY)
Elise Stefanik, NY 21, has refused to have a real town hall. She has had one small event packed with pre-chosen supporters. We set up a town hall in Glens Falls, NY, and she refused to come.
She voted YES on this travesty of a bill. Stefanik usually gets about 5 positive comments on her generally pointless Facebook posts. She posted about her YES vote on Trumpcare on FB and at last look, had 1009 and 1051 comments, 99.9% of them negative. I keep asking her how she will run for 2018 when she is hiding under her desk? She hasn't answered me yet. Sad.
Chris Parel (Northern Virginia)
Premeditated morbidity & premature death = premeditated murder. We're now just haggling over the price...
Hawkeye (Cincinnati)
Is it really, simply about greed? Is it? I talk about this a lot, do the Members actually accept gifts, payments for votes? What else would motivate them to create such chaos? Ideology can only carry you so far I would think, unless such Ideology is so filled with hate and spite for others, you would do anything not to stray, like a cult or Religion, it's just what it's members do.

I am a government for the "Common Good" person, not some selfish, greed driven Ideologue who simply wants to hurt my fellow citizens.

I do not understand how you can live with yourself and consciously destroy lives out of spite........
Richard Wells (Seattle)
All you really have to do is contemplate the monochromatic representation.
Pat (Texas)
It reminds me of something Rush Limbaugh said years ago, "You don't need to be female to know exactly how it feels to give birth!"

Yes, folks, they really believe that wealthy-white-male is some kind of template for the ideal legislator.
Paul King (USA)
Everyone heard very clearly the lunatic nonsense, vitriol and hateful, divisive words of Donald Trump… not for a few weeks.

For over 16 FULL MONTHS of our endless campaign.

Somehow, stopping him as if our very lives depended on it didn't sink in. Now, your child with a pre-existing condition proves it did.

"Hillary Clinton, oh well, I just don't care for her."

Realty: in American presidential elections you get A or B.
Get it? And the results really do have GRAVE consequences.
(as in someone you care about may end in their grave)

2018.

2020.

Correct. The. Mistake.

Seriously, get it?
usworker (Phoenix, Az)
The PERFECT republican health insurance policy?? - Is they dead yet?

The PERFECT republican choke the American people movement from lower to middle to upper class......

Let's wrap retirement / health care/ social net programs around the word .. CHOICE

In every instance where we the people have had benefits taken those benefits taken were wrapped around the 'nice sounding words' of CHOICE ... in reality it was the magic words used by republican politicians and corporation ceo's and boards to reduce corporate funded/supported benefits to line their pockets ................
jnyc (New York City)
A bunch of white, privileged men grinning, smirking, and applauding over taking away health care for those less fortunate so they can die younger, and be unable to care for their families -- hurray for them.
Nat (98368)
A picture is worth a thousand words. As an old white guy, I can assure you that I would not buy a used car from one of these guys. I hope their "victory" gets them all tossed out at the first opportunity.
tom carney (manhattan Beach)
"Vulnerable Republicans who voted yes this time, like Darrell Issa of California, could find it harder to do so six months from now."
Lets work to make it impossible for Darrell Issa and many of his co-ignoramuses to vote at all in the U.S. Congress. They have defaced this institution of Democracy long enough. Out with them.
James Threadgill (Houston, Texas)
Healthcare is for rich people, you silly girl. Just ask any Republican. I believe the consensus is "let them die." That is what they have chanted when the opportunity arose. The GOP has always been uncaring but now they are seditious, traitorous, and anti-American.
Pam Dixon (Bethesda, MD)
I can't get past the photo accompanying the article. Look at all those smug old white men. How is it they represent this diverse nation?
Pharmer2 (Houston)
When will newspapers stop calling it the "Freedom Caucus" and start calling them what they are...the Koch Network.
Joe (Chicago)
Look at all the soulless people. Where do they all come from?
Big Text (Dallas)
(Destroy) America First!
Doremus Jessup (On the move)
Only the republicans and Trump could perceive this abominable legislation as a win and a success. They have simply told millions of Americans to go to hell because they don't care. The rich will prosper and everyone else won't. Such is the world and the perception of today's Republican Party.
Kevin O'Keefe (NYC)
The War on the Poor continues and it looks like anything these Repubs can get done in this session will benefit only the 1%. Warren Buffet and others have pointed this out, disregarding their own self-interests. But these foot soldiers only do the bidding of their masters. It's incredible to see the opposition on this one- doctors, patients, insurance, poor, middle class, and yet they are able to ramrod it through the house. The timing is awful. The damages will be real and it will only boomerang back to haunt then in 18 months.
Thehousedog (Seattle)
This bill hurts Trumps base, those older, rural, white Americans. If they end up getting sick and have no health insurance, is that what they mean by making America great again? The smart people have already left the building; y'all are now left to yourselves; good luck!
Harley Leiber (233 SE 22nd Ave Portland,OR)
With no leadership from the WH the health care package sailed through as RyanCare with a few added tidbits...What a shameful process to watch much less participate in.
BRussell (Tampa)
It is despiriting that Republicans are incapaple of doing anything good for Americans, more likely harm and evil. Obama knew healthcare would be appreciated by most Americans and accrpted the politucal blowback knowing once he got the ball rolling most voters would open their eyes. He unselfishly wanted to make life better. The Republicans seem to have group sociopathy. To them the answer to everything is tax cuts for the wealthy and pass the ball to the states, which cannot find a way to fix potholes.

If you are not part of the solution you are part of the problem.

The Republicans are part of the problem. Truman called them the "do nothing party". Times have not changed.

How can a party be collectively so selfish, shortsighted and incomptent with such frightening consistency.
Duncan Lennox (Canada)
"House Republicans rode up Pennsylvania Avenue to celebrate with President Trump in the Rose Garden."

I counted 31 people (disgusting people) in the photo of which only one was a female. Not surprising for the party of NO. The mystery is "Why are thee ANY female supporters of the GOP ?? Do women GOP voters not care about their own healthcare & bodies or those of their daughters , sisters , mothers , aunts or female friends ??

The answer is that they were raised/steeped in the Never-Vote-Democrat no matter what culture. Anyone who sees Trump as being mentally well & not a conman or the GOP ,which is defunding Planned Parenthood & taking healthcare away from citizens so that the 2% can get a $880 billion tax cut , is in this group of unable to Think Critically. e.g.. The 46% of American adults that (per 8 separate Gallup polls) say that the earth is 7000 yrs old & that evolution did not happen.
Mark S. (New York, NY)
Regarding your question "Do women GOP voters not care about their own bodies....."

I asked my sister a similar question (my Republican sister) and received a blank stare. My only possible answer is that her contempt for the prior administration as well as her downright hatred of Hillary Clinton took precedence over their puritanical attitude towards women's rights. She and I have two other sisters and it just boggles my mind.
Kevin (Red Bank N.J.)
All this goes to show a few things. One Trump is a lair and just flips on anything he said to get his ego stroked even with a bad bill. Two, Republicans only care about the rich. Three, the tax reform that comes next will finally destroy the middle class, with the most benefit going to the 1%.
Megan (Santa Barbara)
The irony is that if Trump could think his way out of a paper bag, he could have moved to the LEFT to acquire votes, pleased more Americans, helped more Americans, and actually IMPROVED Obamacare.

He ran on claims to be a disrupter and his own man, but had no ability to move laterally or creatively. He caved to the most rigid within his own party. Some maverick.
Gabrielle (USA)
"Mr. Trump's supporters might say a deal on health care was needed to get victories on what he really cares about, trade and infrastructure..."? Seriously?? Trump voters are intellectually vacant enough to throw away their health care - however flawed the system - on some "deals" a con artist with multiple bankruptcies promises to put together? Do we, as a country, really deserve to be ruled by the ignorant minority?
RM (Winnipeg Canada)
"Do we, as a country, really deserve to be ruled by the ignorant minority?"

It was you, as a country, who voted for this guy.

As Clint Eastwood said in Unforgiven, "Deserve's got nothin' to do with it."
Al Vyssotsky (Queens)
My big question is whether the President will challenge Congress on any legislation they may send to him. So far, he seems amenable to signing anything Congress might put in front of him, even if it contradicts his campaign promises. Trump did not campaign as a right wing demagogue, but so far it appears he will govern as one. If he finds himself unable to stand up to the Freedom Caucus on anything, he will continue to lose the people who elected him.
Cleo (Austin)
This is just Obamacare all over again. Just repeal. Then legislate some reforms such as allowing folks to shop for insurance and drugs from anywhere in the world. All but the globalist rich are walled off from this huge benefit of globalisms. We pay the costs of globalism (lowered wages due to either immigration or outsourcing) but are denied the benefits (lower costs and more choices) that would compensate from those costs.
Doremus Jessup (On the move)
In Trump's rapidly filling swamp, it's not the cream that is floating to the top. The republicans finally managed to show everyone how totally useless and uncaring they are. Hopefully there will be retribution.
MIMA (heartsny)
It's exhausting. Let's hear more stories of real people behind the scenes with "pre-existing conditions". They need to get out there, one right after another.

Obviously when we hear a bozo Congressman say "everyone gets taken care of regardless" the presence of the public needs to be in his face.

On the other hand, when Jimmy Kimmel goes on nation wide TV and pleads a case for those afflicted like his son, and hours later our "leaders" are getting on buses, going down the street for a Rose Garden Party with their President, to celebrate the potential death of those with heart conditions, as Kimmel's child, we really have to wonder.

With Donald Trump at the helm, it's starting to be norm not not be shocked everyday at stupidity, cruelty, and selfishness.

Let us hope we don't just turn our backs on it all, throw up our arms, and get hopeless to a point we don't pay attention.
Ron Epstein (NYC)
Trump knows that his voters don't care about health, only about winning.
After all he is the best example of this twisted
Mindset.
tomreel (Norfolk, VA)
Where's Waldo? Or to be gender specific, where's Wanda? In the photo as cropped for this column, I can find one woman - second from the right near Vice President Pence. There might be another one directly behind Tom Price. Can't tell. Were most women excluded from this exercise or did they just demonstrate the good sense not to be front-and-center in anything this unseemly?

White men with really good health insurance are applauding their plundering of the vulnerable (present and future) for the benefit of proving they can pass something - anything! - in the House, regardless of its cruelty. Despite the Bravos, we must hope and pray there are no Encores!
VMG (NJ)
What bothers me more then the GOP's ridiculous excuse for a healthcare plan are the 62 million people that voted for Trump. The Republican party doesn't represent the average working class and never did. The Trump voters that thought that they were getting something new will soon realize that they gave the keys to the hen house to a bunch of wolves with the head of the pack the worst of them all.
Eroom (Indianapolis)
For weeks we have been reading and hearing about Le Pen in France who is almost always described as "far right." In the interest of accuracy and consistency it is time to begin referring to American Republicans as "far right" as well. In many ways, their agenda is more far right than Le Pen's!
Tim (Baltimore)
Trump has a simple plan for his constituents. They are already dying off at an alarming rate. Just amplify that for long enough, and the problem will be solved. You don't need to buy votes from the dead.
TMK (New York, NY)
This is an entirely good bill, one that won't just pass Senate, but also overwhelmingly win voter-approval. Which will solve whatever legislative issues Professor Binder moans over.

Make no mistake about it: President Trump wins battles to win wars. While the Democrats, thanks to Obama, make a habit of climbing high moral ground where none exists, only to find themselves repeatedly on top of some remote ragged hill, devoid of human votes. It's a stark truth that must be more than delicious to Trump and co. They're looking at decades of one party rule to remake America as they wish, constitutional amendments included. From MAGA to MGGA (GOP), who would have thunk.

Meanwhile all the Democrats can offer in return, are sorry chants when they lose, not to mention the usual barrage of tired name-calling opinions, all soothsaying that because of the GOP, sky-falling is imminent. Game, set, and match in three sets folks. You're rooting for this. Shrug.
Laird Middleton (Colorado)
I don't think you are fully "getting" Donald Trump. He isn't worried about keeping promises or his legacy as a President. Health care bill passing = legislation on huge tax cuts = HUGE estate tax savings for his heirs + HUGE income tax savings for Trump.
Wake up and smell the coffee and stop wondering Trump would break pledges when breaking pledges is in his DNA and is his MO. There is only one question to ask when it comes to Trumpian motives and that is, "how does this benefit Donald Trump?"
SLBvt (Vt.)
Forget clashing ideologies.

The GOP committed legislative and fiscal malpractice by shoving this through:
---without many Repub. even reading it
---without any knowledge of the fiscal repercussions (no CBO score) on our
economy
---without any knowledge of how many newly jobless healthcare workers
will now be swelling the unemployment rolls
---without concrete knowledge of the health repercussions of millions of
Americans
And our tax dollars are paying the salaries of these so-called legislators.
M. P. Prabhakaran (New York)
Republicans are behaving like freshmen in college who did well in the midterm exam. I am waiting to see the blush on their faces when the result of the final exam comes. Bu then, shameless fellows don't blush, even when blunders they made stare them in the face. Has anyone seen President Trump blush, let alone apologize, when his words and actions turn out to be stupid?
CN (University of Pennsylvania)
This administration is emotionally terrorizing millions of people in this country, and millions of others have been groomed to abandon all reason at the alter of worship of their leader and Party. While this is what one might expect of a despotic regime, it should never, ever happen in a democracy. Fighting back, en masse, relentlessly, is both a moral and a mortal imperative at this critical time in our national history.
Bob Jones (Dallas)
The Democrats should be thankful Republicans repealed it. Now you don't have to defend this horrible law any longer. Obamacare was the single biggest gift to the GOP since Jimmy Carter. The Obama legacy is now complete. There is no legacy and the GOP has more political power at all levels in more than 70 years.
John (Baldwin, NY)
Why does no one point out the elephant in the room? That is, that this president has no idea what he is doing.
Frank (Colorado)
Fortunately, I had good, job-provided private insurance until I age-qualified for Medicare. After seven years on Medicare and several serious medical issues, I can say that I am quite satisfied with our single-payer, Medicare system. I sincerely hope that someday soon all of our citizens can experience the satisfaction and comfort of Medicare for all. Is it perfect? Of course not, but I am confident that I and my family will not bear an unreasonable financial burden of aging. After all, Donald promised he would not touch Medicare, right?
Nora_01 (New England)
Over three months into the Trump administration, does anyone with half a brain believe anything the man says?
Charlotte (pt. reyes station)
I am waiting for the front page article that compares the health insurance that members of congress and their families receive and the one they are proposing for the American people.
TH Williams (Washington, DC)
Gut the Medicaid program and increase healthcare costs for older people? That's no way to run an airline. Toying with people's health care will only inflame a vast range of voters. Most older people have younger people, their children, that will quickly learn who must contribute more if Mom or Dad can't pay their doctor's bills.
Chris (Berlin)
Nothing has happened relative to Trump Care or the ACA.
All the House Republicans did was to kick the can down the road so that Trump and Ryan could declare a 'victory'.
Like every other bill, it's on track to becoming a different bill out of the Senate.
Basically the Republicans in the House failed to produce anything workable and they're asking the Senate to have a go at it.
But then again, Trumpcare/AHCA is a massive tax cut (almost 1 trillion) to the wealthy in barely veiled stealth.
It has little to do with the supplying, the delivery of healthcare to the masses.

Regrettably, we are only having this discussion now because Obama and the Democrats failed to deliver real health care, single-payer or Medicare for all, in 2009.
SAD.
John (Baldwin, NY)
Not for lack of trying. They were lucky to get what they did considering they got absolutely no help from Republicans, as usual.
jonathan (decatur)
Chris, since the Dems never campaigned on single-payer and there were not the votes there, your comment is not based on fact. Second, the fact the Dems passed the ACA (Obamacare) does not mean the GOP has to repeal it. They could work to improve it. Do not blame the Dems for the GOP's obsession with getting rid of Obamacare.
James SD (Airport)
Everyone will get sick or injured at some point. Health care is very expensive, in this country particularly, because we allow pricing for drugs and services to be whatever the "market" bears, and patients have no choice in what needs to be done, and there's no transparency about pricing so we could choose another drug or provider. So, insurance needs to cover everyone, and everyone needs to participate in it's financing. There are ways to bring down costs (marginal caps on drug prices, No fee for service billing, etc), keep insurance companies participating ( allow states to form regional group markets so small states don't end up with 1 provider), etc in the ACA. Or, with single payer to eliminate 30+ percent in profit and admin costs. But this plan is just a tax cut for the wealthy, so the budget later can give another tax cut to the wealthy that's 'revenue neutral'. It's a fraud. It's freedom of choice, a la Paul Ryan. Freedom to not buy what you can't afford, and pay the price another, more painful way.
g (Edison, Nj)
The Republican House and Senate should stop trying to pass any national health care legislation, but stop allocating any funds towards ACA subsidies.

Allow the ACA to continue on its merry way.

Wait til no insurance company is willing to extend insurance in a few states.

Then, when the American people are fully aware of how disastrous the ACA is, we can revisit new legislation.

It is obvious that the public does not realize what will become of the ACA without continuing mass infusions of money (AKA more taxes for everyone).
Observer (Backwoods California)
Do you seriously think the fact that Trump promised no changes to Medicare during the campaign means he wouldn't sign a bill that, for example, made it means tested? Have you not learned by now that the only thing he cares about is "winning"?
Juvenal451 (USA)
Health care is as much national defense as, well, national defense.
Mary (Atl)
... and what concessions were made when the Dems shoved the ACA down our neck. Is our memory so short that we forget that most of us now pay more for less?

The ACA is a disaster. I believe it was created to be a disaster. But, can't we fix healthcare in the country without hurting 90% of the population? No one can afford to see their doctors or seek care. Least of all those in the middle class - although the middle class is now subsidized in the exchanges (a family of 4 making $94,000 is middle class in my mind, and they are subsidized).

The ACA drove changes to our system that most here no nothing about. It excellerated the mergers of private doctor offices with local integrated delivery networks. Now, a simple doctor's visit costs 2x or more, because you pay for the deliver network - we are subsidizing hospitals and clinics. And those merged entities are making a profit, a big one that is not under the ACA regulations. Yes, they will get penalized for patients that re-enter a hospital with the same issue they had (if 30 days or less), but they also get bonuses if patients don't re-enter - meaning they are sent to rehab nursing homes where care is bleak at best.

The ACA created all kinds of third party players that have nothing to do with providing care. The media rejoices at these 'fake' industries as it increased jobs exponentially, but at what cost? Healthcare has not improved, ERs are still filled with non-paying patients. No one is fixing the system.
John (Baldwin, NY)
So tell your congresspeople to pass universal healthcare.
Asher Fried (Croton on Hudson NY)
The main problem with Trumpcare is that first and foremost it is a tax and soending cut bill. no inout was sought from health care professionals and thise with a stake and the responsibility for providing care. nor were economists who specialize in health care cost issues brought in board. The bill was drafted and voted on without the concern for understanding the factors underlyning our expensive healthcare system or with a concern for improving and broading care and reducing cost. in fact, the promise that Trumpcare will reduce premiums is a Trumpian bait and switch lie: comprehensive health policies equivalent to Obamacare will cost more; lower premiums will buy substandard, now prohibited policies.
Steve Shackley (Albuquerque, NM)
"But Senate Republicans have already said that they will likely write their own, more centrist bill, possibly including provisions objectionable to the Freedom Caucus." They may be Senate Republicans, but they are still Republicans in the majority. The GOP only, that's only cares about the 1% of America that is their donor base. The health care "plan" that comes out of the Senate will be mainly a tax cut for the rich, the rest of America can eat cake. I said it here on this date. Watch for it.
John (Baldwin, NY)
Not exactly a "stick your neck way out", Nostradamus prediction, is it?
Steve Shackley (Albuquerque, NM)
True, but so many seem clueless even in face of the obvious.
KAN (Newton, MA)
Don't you worry about Republican unity! It is assured by a few million reasons per campaign, donated by the people who will benefit most richly from this and every other bill which will really be more of the same, a no-tax-on-them bill. In the Republican gerrymandered districts the only "immense electoral risks" are challenges from the even farther right, readily threatened by those same reasons if one doesn't obey the paymasters.

The get-it-done-before-the-CBO-scores-it fast track is only a terrible way to write legislation if the intent of the legislation has anything to do with what is claimed. It does not. As you say, few Republicans are interested in trade or infrastructure. Even fewer are interested an actually providing health care for American "takers." As this bill shows us, even the most transparent facade for a tax giveaway to the rich is perfectly acceptable. Its Republican architects and their Republican followers will be amply rewarded, assuring continued unity. The House Freedom Caucus is not the determining factor. It is merely an intermediary. The millions of reasons per campaign are what make the determining factor.
wally (maryland)
This was a wealth care, not a health care bill. The centerpoint of this bill and the previous version is to reverse about a Trillion dollars in taxes supporting Obamacare. Perhaps never before in history has the House passed a bill that so explicitly rewards the wealthy and takes away so much from the majority, especially the poor. Many will die if the bill is ultimately passed and put into effect. Studies indicate there will be 24,000 additional deaths per year if 20 million lose health coverage.

What this tells us is more than about healthcare. We it demonstrates is we have now reached a point of economic inequality which also fosters so much political inequality that members of Congress on average are willing to sacrifice the lives of 55 constituents per district per year to secure tax cuts for the 1% averaging $37,240 per year.
polymath (British Columbia)
"With the health care vote, the House G.O.P. has made the rest of its agenda harder to achieve."

Wait — why is hampering the G.O.P. agenda a problem?
Tony Reardon (California)
From a Republican perspective, we have a huge surplus of sick and/or old and/or poor folk who do nothing to expand the wealth and comfort of our upper class.

Making them go away as much and as soon as possible, without spending any of that wealth to do it, is the obvious preference.

Making as many disposal methods as possible,both disguised and legal, is the way to assuage appearances and consciences (if there are any), and to avoid a legitimate rebellious backlash.
Bill Keating (Long Island, NY)
Why is it that there is a hard-right, but never a hard-left?

This health bill will never pass the Senate. But the current health care plan simply does not work on the numbers. The New York insurer created to help the poorest, Health Republic, established with the help of federal loans, went bankrupt in its second year, taking with it the unpaid loans. Many insurers did not participate in the exchange, citing sure losses. The insurers in the exchange requested a whopping 17 percent average increase in premiums for this year.

Health care must be reformed by acting against cost, not against spend. Health care providers and drug companies pull huge numbers out of thin air and the insurance companies pay them and pass on the increases in premium increases.

When Canadians are paying less than Americans for drugs designed, manufactured and distributed in the United States, you know that there is unjust enrichment afoot.

The current struggle in Congress shows the federal government at its worst. Legislators looking for cheap and quick political gains instead of continuing the long and difficult process of arriving at health care that works.
R0204 (St. Louis)
Here is the fundamental problem, Republicans are already spinning the Bill that it does not cut Medicare (which it does) and that people with pre-existing conditions are not going to be hurt (which they will). The Senate will rewrite the Bill, but it may not be enough. The vast majority of Trump supporters don't care what the NY Times says about the Bill, the vast majority will be getting their information from Fox which will parrot the Republican line.

The Con-Man in Chief does not know what is in the Bill, he just is selling it like so many trump university diplomas. By the time it all hits the fan, he will be onto something else and selling a new scheme.

I heard a woman on 60 Minutes last night who voted for trump and then her husband was deported after 18 years here. He checked in with Immigration every year, but that did not matter. She said she should have read the fine-print of trumps promises. I fear not enough people will read the fine print of this draconian Bill and will hurt themselves again.
John (Baldwin, NY)
You are correct on the FOX news thing. The Bubble.
Stan Continople (Brooklyn)
If the "Freedom Caucus" is loathe to spend a dime on preserving a human life then I don't give a bridge or a highway much hope, even if was to their own front doors. Trump himself would rather use the myopic Chris Christie approach, propping up other programs with infrastructure funds and then claiming fiscal responsibility.
joanne (Pennsylvania)
As republicans have done the past 8 years, the administration is making no secret of its top priority: jealously get rid of whatever Barack Obama did.
Everything Mr. Trump does is purposefully flashy to the point of absurdity.

"He feels vulnerable when other people have access to facts and when he can be measured against something objective," said Michael D'Antonio---who authored the powerful book "The Truth About Trump."
"His favorite thing is to game a system or defy a norm and if he can't do that, he doesn't feel as powerful."

Contempt for the media is an every day occurrence. And Republicans, with their lies about their healthcare bill, are showing their contempt as well.
They were fully complicit in helping Trump feel powerful about their failed health bill. Now they hear the Cook Report dooming their chances two years from now. It is quite profoundly "a disaster wrapped in victory."
bob miller (Durango Colorado)
The only issue Trump cares about is cutting his own taxes - primarily business rate cut and eliminate the estate tax. From his viewpoint, the import of the healthcare bill is solely to cut taxes - he has lied repeatedly to accomplish this goal. He does think this is a great bill - because it cuts taxes for the wealthy by reducing the government’s cost of healthcare for the old, sick and poor.
MK Timme (Los Angeles)
This healthcare bill has been decried as part of the R fight against 'entitlements' -- not a neutral frame-- the language is straight from the GOP propaganda playbook. While fighting 'entitlements' (implied: for the unworthy poor) the R bill builds in generous new entitlements for the wealthy and for corporations. Why is this never reported in tandem? Why give them cover and obscure this through naive, simplistic reporting? It is a huge story. All people (especially Republicans) need to understand that this is a core motivation behind most GOP legislation, so why not speak plainly - or even elucidate the backstory - about why this is so?
Dr.D (Silicon Valley)
Perhaps a data bank could be created where deaths by diseases that could have been treated if diagnosed early, but were not because the "victim" (should have been designated "patient") could not afford health "Insurance". That death count advertised daily in local media. This war between health and wealth has a very real casualty list and the republican Paul Ryan, (Ayn Rand wannabe) can issue signed photographs of the beer party at the white house and a they can split the picture with what the greatest transfer of wealth from middle and lower income people to the most wealthy in the country 1%. Maybe the poor should begin listening the the drum beat of the NRA "Only a good guy with a gun can stop a bad guy with a gun." What is their suggestion for hoards of the incredibly wealthy and purchasers of the congress, senate, and media who are dooming the poor and nearly poor to early death? "Access" is not the same as obtainable. "Access" to guns is what the far right scream they have a right to and that the patriotic thing to do is to "The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants" says Jefferson. Isn't the first thing we are promised in the Declaration of Independence the "...right to LIFE, liberty..." does that apply to the tree of life? Republican better hope the dots don't get connected or it could be really bad, sick (tho quote our president.
chris87654 (STL MO)
As a fiscal conservative (who understands that our country lacks with healthcare), I'm curious about the cost of this premature "Mission Accomplished" photo-op in the Rose Garden.
L Negron (Hudson Valley)
I honestly don't know how these men and women who voted for this sham bill can sleep at night.

If their government tried to ram similar health coverage down their throats, they would all but walk out.

How dare they, when we pay their salaries, blatantly lie that their proposal is better than what ACA offers? Toxic Trump is not my president. Not from day one and now that I've heard, seen and read what he does and not do, I was right all along.

God help us all.
Bob Adams (New York)
It is important to note that their salary is pretty unimportant to them. They are making far more than that from donors.
Heidi (Upstate NY)
Yet another huge tax cut for the top, funded by stealing the benefits of average Americans. This one really supports GOP = Get Old People.
Rich Stern (Colorado)
I am thrilled the House voted on this bill. They have made the 2018 so much easier by willingly painting on their own targets.
Andy W (Chicago, Il)
Tax cuts for the richest, greatly increased costs for the poorest. Mission accomplished, GOP style.
wcdessertgirl (New York)
This is what compassionate conservatism looks like? Kristoff wrote an article in Jan 2016 about compassionate conservatism. He made an interesting and prescient point; that the Republicans, who dominate Congress and many state governments, would have a greater impact on social policy, such as healthcare, education, job training, addiction services, and "whether lead continues to poison American children," than the president, even assuming that HRC or Sanders would be POTUS. And now that Trump is president, those words take on even deeper meaning as we can see that the GOP is running the show. The White House is being relegated to a place for photo ops, so Trump can get his required ego-stroking, while Ryan and his gang try destroy every single last safety net in our society.

My husband and I paid more than 10K in health insurance premiums, not including our children's premiums. All we got in exchange was a few PCP visits and a raise in our premiums. How does this plan help make the cost of healthcare cheaper, if insurance companies can now charge even more for even less coverage? No matter, I will sleep better knowing that even though we could be easily left bankrupt by an unexpected illness, all the men in this picture are getting a tax cut. That's what really matters.
tuttavia (connecticut)
so much for health care for we the people...trapped between the "pass it then read it" Ds and the "screw it, let the senate do it" Rs...

what we got here is dereliction, starts with d and rhymes with t and that spells trouble in the land of the free (tranquillitas animi, meredith willson).

how much more of this are we willing to take? we'll certainly be tested in the coming months and if we expect anything different it's shame on us.

step one: to stem the tide of immediate threat, Ds and media ought to stop the easy lifting of bashing trump and get to the real work of taking back the house in'18...hint: H(R)Cs blame gaming and DNC chair perez's fulminations will only make the job harder, and as long as they and the tiring nancy peolsi and ossifying schumer consume all the oxyygen, the party will suffocate.

step two: time for us to get smart about citizenship, sure it confers rights but is has obligations, too...vigilance, call it informed oversight, starts with self education (ok restore civics to the curriculum as well) but, most important, we have to act as if we were the employers, not the "average americans" our hires call us to keep us in line at the company store...TERM LIMITS, as soon as we can get them will set us on our way to recovery from a nearly tenured lot of no-dealers, toward the citizen lawmakers, new-dealers, if you will, who will rather "promote the general Welfare" (see the preamble) than serve the special interest.
B. Rothman (NYC)
May they choke to death on this piece of trash masquerading as legislation and may they take their President and their fellow Congressmen and Congresswomen down with them. Their actions and words are beyond reprehensible and if passed in the Senate they will have been complicit in murdering thousands by denying them healthcare. That is the reality behind their lying language.
against rhetoric (iowa)
I hope they actually fall upon one another.
Bob Jones (Dallas)
You must be talking about the original Obamacare. You should be angry at Obama and the Democrats who sold the country a bill of goods that has turned into the single biggest gift to the GOP since Jimmy Carter. Think about that next time Obama gives a 400k speech to his Wall st pals.
Christy (Blaine, WA)
Listening to Tom Price and other Republican talking heads on the Sunday shows, I was struck by the alternative reality the GOP seems to be living in -- patients on Medicaid will be better served by an $880 billion cut in Medicaid; premiums and deductibles will go down even though all projections are that they will rise; everyone will have "access" to health care (only those who can afford it of course and those who can't?????) and health care will be "back where it belongs," under the control of patients and their doctors (ignoring, of course, the insurance company middlemen). It seems as if these Republicans all took a course in "disinformation" from Trump (and maybe the Russians?). So what are they going to say when the CBO comes out with its assessment? Probably lie some more and say the CBO is wrong.
Big Text (Dallas)
Those are called "lies." The public generally accepts them at face value.
LenK (New York)
Yes, they are definitely and deliberating practicing disinformation. I would not be surprised if someone is tutoring them in this dark art.
Joy (Sacramento, CA)
they'll just change the subject.
George Deitz (California)
How many third rails can the GOP step on before the voters have had enough?

Medicare, Social Security, and Medicaid, Planned Parenthood, the environment, science, the arts, even national monuments. They have alienated the old, sick, poor, and women, and all the rest of us human beings who care about these things. But these groups vote,

What do Trumpites care about? When will even the staunchest Trumpite have had enough with these GOP grotesqueries in the House, and the GOP cadavers in the Senate, and that thing in the White House, whose only goal is to retain power as long as possible and make gobs of money for themselves and their cronies? What's the red line for Trumpites? When will their ox be gored sufficiently? Will they ever have buyer's remorse?
Big Text (Dallas)
Republicans are ALL rugged individualists who need no help from anyone. If someone challenges them to a debate, they let their firearm do the talking. Hope that helps!
Carl (Trumbull, CT)
TrumpKare is not a “Death Panel”, TrumpKare is a DEATH SENTENCE…!!!
Steve (New York)
Billionaire Boys Club tax cuts funded by gutting health care.
Maggie Moehringer (Albany, NY)
America... where rich white christian men feel morally obligated to take away poor people's health care...
damon walton (clarksville, tn)
Sadly, the GOP will walk over the sick, elderly, and the poor's dead bodies to hand one of the largest tax cuts in American history to the wealthiest among us. A well written tax cut hidden in poorly written healthcare plan.
Hypatia (California)
"Vulnerable Republicans who voted yes this time . . ." Remember how Sara Palin issued that lovely map listing Democrat candidates inside rifle crosshairs? I wonder how Darrell Issa and the rest of the craven contemptibles feel now that the same attitude applies to them.
chris87654 (STL MO)
Another of Trump's premature "Mission Accomplished" moments...
PogoWasRight (florida)
One of the biggest things Democrats must have learned at the passage of this bill, is that the Republicans blame some kind of failure of Obamacare on Barack Obama. Obama is, of course Black. Republican have, now and always, disliked that color, especially as a skin color.
Big Text (Dallas)
They also despise black ink!
MegaDucks (America)
Republicans today are driven by:

(1) A hatred for the first Black (yes there is racism involved - don't be naive) President. This loathing evidently exists in a large swath of them.

Obama - the uppity diverse fellow who despite their vicious efforts to destroy him over his 8 years remained electable, likeable, and a somewhat effective and good President for the People throughout - he didn't really fail! what psychological torment and frustration!

Bringing down any Obama accomplishment of any sort energizes them and this added boost to their energy makes them all the more dangerous to modern non-RWA rational us!

(2) A base chock full of Right Wing Authoritarian, often fundamentalist religious, often christofascists, often hyper-militarists who demand that they legislate us back into a time when their ilk ruled people's lives.

Because they have to satisfy their base in some significant way makes them all the more dangerous to modern non-RWA rational us!

(3) An ideology designed to create Plutocracy, Corporatism, elitism, a concentration of privilege, wealth, and power in basically "peaceful" sociopaths - the likes the World has never seen.

They 1st must dissolve our privacy and egalitarian leaning institutions and protections and then perform a metamorphosis to create the orderly but master-servant like utopia they swoon over in novels they read.

Most of their loyal soldiers don't recognize they'll be low servants. Very dangerous soldiers!

VOTE or we are doomed!
Phyliss Dalmatian (Wichita, Kansas)
Yes, it SHOULD be a disaster. However, among His " uneducated " fans, this will be Obamas' fault, still. The silver lining: they will be most severely affected. Darwin.
Granny kate (Ky)
The picture with this commentary shows gleeful, smiling white men - oh, but look closely and you might find two while female faces. As long as these Republicans get their 'win', they do not care how they got there or who it hurts. After all, they think they are derserving "winners" and the undeserving masses - the poor, the weak, the disabled Americans, already the losers in life - take another hit. Did good "Christian " Pence lead the prayer of thanks?
Psst (overhere)
Well heeled clowns clapping like trained seals. Our government is an embarrassment.
MoneyRules (NJ)
Trump voters can choose between Healthcare, and paying for Fox News on cable. We, the Liberal Elite, have stopped caring.
John Brews ✅__[•¥•]__✅ (Reno, NV)
The struggle within the Republican House has shown there is a moderate group among them. Unfortunately, it also has shown they will not stand and be counted, but will capitulate to the hard right, and the GOP leadership expects them to fall in line because the ideologues will not yield. So the tail wags the dog.
James DeVries (Pontoise, France)
It's like when somebody comes back from Malaysia and hands you, the unaccustomed tongue, a gaily coloured, cellophane-wrapped piece of Durian candy for the first time.

Never had Durian candy? You haven't lived!

If you are patient, you get used to the taste (as apart from the smell) of Durian candy, even come to appreciate it.

The counterpart candy proposed by the soulless Republican House is, however, under the shiny wrapper, really poison!

Never had AHCA? You won't live!
Douglas McNeill (Chesapeake, VA)
"Vulnerable Republicans who voted yes this time, like Darrell Issa of California, could find it harder to do so six months from now."

All Rep. Issa's troubles will disappear when he disappears from the halls of Congress in 2019...

Mr. Issa, that's not your car alarm that is going off--it's the warning from your primitive midbrain of a predator stalking you on the savanna.
Betsy S (<br/>)
Silly you. You think that Donald Trump "cares" about anything beyond winning.
H Mansfield (Florida)
My heart went out to the real President last night. His speech at the "Profiles in Courage" event and the presentation of its award seems to have only partially covered up a deep sadness for our beloved country that so many now feel. This young man, his family, close friends and those who support him, have been thwarted, obstructed and insulted relentlessly every day for over eight years. If a calm, thoughtful leadership for eight years in the face of this daily hateful barrage does not in itself take a carload of courage and self control, nothing could. But the final insult resides in the systematic, robot-like destruction of his legacy. A blatantly arrogant billionaire kleptocracy, is now being led by a Reality TV character who is hell bent on undermining anything with President Obama's name attached to it. Sheer schoolyard spite prevails, while these vultures systematically and gleefully destroy what remains of our fragile democracy one outrage at a time. As beautifully demonstrated in the photo, they applaud loudly while doing it.
Maureen (Boston)
That picture should be shown constantly, everywhere. Particularly to American women who vote for men who hate them. Truly hate them.
[email protected] (Los Angeles)
what would Ed Brooke do?
Defiant9 (Columbia, SC)
The old saying 'you reap what you sow' or maybe it's the other way around, just like Trumpcare that's bad backward and forward. The GOP is laying bare the philosophy that takes from the poor to give to the rich. Eventually we are all poorer for it.

It's starting to rip away at the soul of the country. We have problems that can be dealt with through thoughtful engagement, not shotgun weddings.
Our strength will show cracks soon if this continues. We can only engage our representatives to be better. Until the next election when you can shout out 'you're mad as hell' as loud as you want.
Gary Hanson (Kansas City)
Republicans in the House of Representatives are a sorry bunch of human beings.
NanaK (Delaware)
The Rose Garden "Gaggle of Greedy Grifters" puts me in mind of the image of Dickens' OLIVER asking for more watery gruel while the opulently obese orphanage board members feast on a table of gastronomic excess.
Phyliss Dalmatian (Wichita, Kansas)
The Freedom Caucus. Freedom to get sick, THEN die. Quickly.
Red's Insight (USA)
Inhuman, indecent, unmoral, greedy Republican's, lead by the sleaziest President in the world. Your time will come....
Chaz (Austin)
40 people in picture. 38 white men and 2 white women.

Freedom (Caucus) just another word for nothing is worth the acknowledgement of basic quality of life needs of your fellow man.

This comes from a 50+ white male that is generally right of center. But I don't know what center even means anymore.
Ann O. Dyne (Unglaciated Indiana)
That Republicans lied and skewered their voters is not really news.
The only 'news' around this charade is 'did Trump* drink some beer?' and 'what beer was provided?'.
1st Armored Division 1971-1973 (KY)
The sick voting against the sick. This is what the Republican party has become.
Mary (Durham NC)
This bill is simply another one of Trumps great lies. Of course this time the Republicans in the house joyfully joined in --just lie and hope the people are too dumb to get it. The Trump library should be named the lying 45th. As to Price -- he sullies the good reputation of physicians nationwide.
Adam Stoler (Bronx)
Trump is an empty vessel; what flows in @ 8 AM Monday flows out by 8:02 AM Monday
He is worthless as s leader of his own agenda ( which is ?)much less the leader of a major ( for now) political party.
As to that party, let's see the celebrations on the day after the 2018 midterm elections.
The Democrats lost 63 seats in 2010 when the ACA was not nearly as unpopular. Even given their high handed gerrymandering the GOP will likely lose control of the House. At 17% , the first LESS draconian bill was to say he least wildly unpopular

Normalizing this group of thugs by saying they have an agenda is ignoring the basic facts:
They don't know how to govern
They don't want to govern
They are unwilling to learn how to govern
Any fool that shuts down discussion of his personal taxes such as 45 has about as much chance of passing tax reform as Marie LePen has of winning the election Ooops....

These angry old white men are clueless.
The "mandate" never was and now has turned into an angry rallying cry that will swamp the minority who voted the freak in.

Then maybe something can be achieved: like impeachment of the crook we call POTUS and all the greedy bad apples in the bunch. ALl of them.
Steve C (Bowie, MD)
"Everybody" no longer has even a minimal part in the Trump agenda. He and his rubber-stampers have changed it to "nobody." It's a fraud President backed up by a fraud Republican Congress.
David Henry (Concord)
The only issue, as always with the GOP, is whether the rubes will believe the madness.
Hugh Massengill (Eugene)
I do wonder what America would look like if it adopted Oregon's vote by mail system. From the time of its inception in Oregon, the state has been pretty Democratic. It works to help the poor.
I also wonder what America would look like without the racist electoral college. Certainly George W. Bush wouldn't have been able to create ISIS, and Trump wouldn't be able to run amok as Putin's stooge.
Wealth is defended by greedy, weak minded people, who are in reality creating the architecture for the demise of American Democracy itself.
Hugh Massengill, Eugene Oregon
Aaron Kowalski (Indianapolis IN)
DEMOCRATIC LAWMAKERS - Again....why are there no Ads put out by the DNCC speaking to America in layman's terms telling them EXACTLY what this bill will do?
David (California)
The Republicans have now fully embraced the concept of death panels (State governments) which have been authorized to throw sick people overboard.
Jon (Detroit)
All those people who voted for Trump on a wing and a prayer saying things like " Whats the worst that could happen?" now know. Republicans could lie to you. They can do real damage to 1/5 of our economy. They could make fools out of you and lie and lie and lie. Hillary was the lesser of two evils. Here's a broom. Don't forget to sweep up when your done cleaning up this mess.
Richard A. Petro (Connecticut)
Really, does ANYONE care if the Republicans are devoured by the "snake" on the "Gadsden Flag"?
The more awful things they do, the better chance that those who were duped into voting for them come to their senses and start "throwing the bums out" next year.
The only problem being, with "Twitler" in charge, will we even make it that far?
Mixilplix (Santa Monica)
I mean honestly, do we really need the Republican party anymore?
Ruby (NYC)
This is all good news for us popular voters and let's hope the Republicans "stay the course". Vive la Résistance!
Disillusioned (NJ)
How about a little Where's Waldo with the photo? Find the minority in the picture. Good luck! (the one woman doesn't count).
James Murphy (Providence Forge, Virginia)
Take health care coverage away from the Republican bums in Congress and then see how they would vote. They absolutely do not represent the people.
Kris (CT)
Republicans will wrap a shiny ribbon around anything and call it a gift. Unfortunately, their supporters may not know that until they unwrap this one and taste the poison.
Richard (Madison)
Another photo full of white men with Paul Ryan, Mike Pence, and Donald Trump sporting their nauseating fake smiles and lots of mandatory clapping for, what exactly? A "victory" on health care? If this is their standard, then passing a bill eliminating all national parks will count as a victory for conservation.
Carla (Brooklyn)
Everything about this administration is a disaster.
When you read that EPA is being filled with industry
polluters for example.
Thtump has no idea what he's doing and could care
less. But he is being manipulated by dangerous
ideologues. I felt so happy that France did not cave
to white supremacists, then I wake up and read
the news here. Very depressing,
Wilson (Milford N.H.)
When you campaign on lies, make promises you can't deliver, and saddle up to a political philosophy of nihilism you're going to get just what you are seeing.
[email protected] (Los Angeles)
please look carefully at the celebratory photo accompanying this piece.

these are the guys who pushed the books out of your arms in high school, then tripped you at he top of the stairs. these are the guys who made sure you didn't get into their frat or eating club in college. these are the fellows who made sure you couldn't join their country clubs or didn't think you would be a good fit in their bank or co-op.

just look at their self satisfied smirks. you have seen that look before.

look again: does this crowd look like America to you?
Steve (Los Angeles)
I just wonder how this new bill would play out with a 55 year old farmer, working a 2000 acre farm, climbing down from his tractor and sitting down to lunch and learning from his wife of 33 years that she has breast cancer? What are the first questions that jump into mind? How are we going to pay for the healthcare insurance next year after this year's insurance policy expires? Who is going to insure us with my wife's preexisting healthcare problem? What's it going to cost? Who is going to insure us of the next 12 years until my wife qualifies for Medicare? This isn't fair. We've been healthy all our lives and lived a healthy lifestyle.
GarrettClay (San Carlos, CA)
A healthy lifestyle? I think not, there are more and higher concentrations of toxic and carcinogenic compounds on a farm than in most cities. I wouldn't go near a farm in summer.
Julie R (Washington/Michigan)
I can answer that for you. I live in a deeply red Christian rural community that overwhelmingly went for Trump. My daughter married into a family run dairy farm. Nearly all the farmers here have wives that work outside the home, often with good insurance so many aren't affected by Trumpcare. Those that are will never admit it. At least once a week one of these Christian Trump voters pens a letter to the editor saying though they "held their noses" to vote for Trump, they have no regrets because Neil Gorsuch is going to "save the unborn babies" therefore suffering inflicted upon the masses was worth the price of admission. Trust me. They have no regrets.
GERARD (Williamstown, NJ)
He'll care until the screaming heads on Fox tell him the politically correct liberals are going to teach mandatory homosexuality in his public schools, and he'll be right back to saving "real America" by next November.
Elizabeth (Roslyn, New York)
We got President Trump because of Republican party infighting. I mean come on, 17 candidates and we wound up with this?
Fast forward, and anyone who thinks that Trump gives a hoot about policy is a fool. Sure the people around him do but not Trump. He just wants a win.
Regarding the AHCA, do not underestimate McConnell's hatred of Obama. He will do what he must to make sure Obamacare is wiped away entirely and does not care what the end result will be because he has the Republican tool box of voter suppression and gerrymandering to assure future wins.
The fractious Republicans do not really have to do anything. They can squabble all they want and devise any legislation they finally agree on because they own the whole thing. They will lie and cheat and get votes.
The only one who cares about the optics is Trump. He really hates "fake news" bad press.
Meungkahn (California)
Another theory, perhaps fantasy. Both Trump and Ryan dislike the self righteous Freedom Caucus. After all, they burned and embarrassed Trump on the first run at this bill and, he doesn't enjoy humble pie. Bothe Trump and Ryan have to know the current bill is going nowhere in the Senate and by Senate rules will require 60 votes/democratic support. To obtain Democratic support will require a much more palatable solution to HC. If it obtains Democratic support in the Senate, it will obtain the same in the house of representatives. Hence, Trump and Ryan have performed an end run around the Freedom Caucus and found a new model with which to write and pass legislation.
Lyn (St Geo, Ut)
A win at all costs, a win on the backs on the poor and the elderly. Some win, not. Paul Ryan said it was a rescue mission, must be a rescue mission for the rich, taking money from the poor and giving it to the rich.
David A. Lee (Ottawa KS 66067)
This absurd mockery of legislation didn't even make it to the proverbial legal sausage shop. It was sent straight from the abattoir to the Senate table. The methods involved in Obamacare seem classical and clean compared to this empty act of cruelty and vengeance.
Ian MacFarlane (Philadelphia PA)
There really is a disconnect between the men seen in the Rose Garden and the rest of America I know. They appear smug, well-dressed and eluding confidence, but in what I cannot fathom.
These guys are not my neighbors and do not in any way share the neighborhood I share.
This is approaching Ancient Rome and isn't very comfortable.
Ian MacFarlane (Philadelphia PA)
"eluding" is incorrect, "effusing" is the word.
Tabula Rasa (Monterey Bay)
The price increases for cost of care will be felt before the mid term elections. That will translate to voter turmoil and district hand wringing by entrenched encumbents. Tap dancing on teflon the end result.
pg (long island, ny)
Thoughtful and informative essay.

Some thoughts to keep in mind:
1. Carping and demolishing laws is easy. Creating workable legislative solutions is hard work. The GOP circus about the AHCA is a tragic example of poor effort and workmanship on this point.
2. Ad hominem attacks are frequently the resort of the inept. This charade illustrates how focusing on destruction of a useful piece of social legislation because of its namesake can lead to the lemming effect.
3. Winning battles and losing wars is not a smart strategy. But then, the GOP seems unable to see the forest for the trees.
4. Businesses that forget who their ultimate customers are and fail to attend to their wants and needs have short life expectancies. For the greater good, I trust the voters will visit this lesson on those who voted for this ill considered, poorly crafted and disingenuous piece of legislation.
Nan Socolow (West Palm Beach, FL)
This overwhelmingly unpopular bill was rushed through Congress and now, hopefully, will be refused by the Senate and sent back to the House in durance vile for further input from the corrupt GOP congressmen. Surely the bill will not pass the Senate as is - increasing premiums for older and sicker Americans, depriving millions of low-income Americans insurance coverage mandated by President Obama in his Affordable Care Act. Unified party control does not exist between President Trump and his party. Trump is unfit to govern. Celebrating the passing of this Trump health-care bill in Congress with the 45th President in the Rose Garden was oh, so premature! We're looking at a disaster, a catastrophe, not a happy event to celebrate in the Rose Garden.
Andy (Salt Lake City, UT)
Bingo. Prof. Binder nailed the argument I've been trying to make all week. She's a good step ahead of me. I didn't foresee the slight on the White House represented by the Freedom Caucus compromise. All the same, good analysis.

I'm beginning to hedge my bets though. There's 548 days until midterm elections [Who's counting?] and the public has the collective memory of a gnat. I'm not sure anyone can predict the fallout just yet. All we know is the outcome is in all probability unfavorable to Republicans right now. We should have a much clearer picture once the Freedom Caucus responds to the Senate health care revision. Are we witnessing sustained civil war or just hard bargaining?

The fact of the matter is though: The G.O.P. was not ready to govern and it shows. They don't show any encouraging signs of pulling it together either. The only question is whether the collective public will notice, care, and act.
ChesBay (Maryland)
I was delighted to see the Dems running ads, already, against the House members who voted for this travesty of a bill. Voters will have to be reminded again, and again, that Republicans are not interested in making their lives more comfortable.
ChesBay (Maryland)
ChesBay--OR, more secure.
mdalrymple4 (iowa)
America will come out of these four years damaged beyond repair. Not even Obama could fix it. I am middle class, retired. I have been very poor at times in my life, but didnt complain about paying taxes because that is what kept our country going. What in the H is wrong with these rich republicans that they cannot fathom paying for the things taxes provide that they come to take for granted - like roads, bridges, SS and Medicare. Arent they happy they can pay instead of always being the charity case. We pay quite a bit in taxes as we have no deductions. We dont complain, we dont try to cheat, we realize how lucky we are to be comfortable financially at this stage of life. Republicans only care about tax cuts and or profits for the rich and all of their bills point that way, be it healthcare, military spending, prisons, etc. Why are they so greedy? Why do the poor people believe that someone like Trump, who has cheated everyone and everything his whole life would suddenly care about them? When will they realize they have been duped? Maybe when their SS check has become a voucher to pay for meager insurance, once the republicans dismantle the remaining products (SS, Medicare, Medicaid) that the kind hearted Democrats fought for years to give them.
Michjas (Phoenix)
About 20 million Americans have been added to the insurance rolls by the ACA. That's one in 16 Americans. Almost all of the 20 million are Democrats, who would vote Democrat regardless.. With respect to preexisting conditions the Republicans are maneuvering for favor. So it's hard to see how the prospects of the ACA are going to make a decisive difference in 2018. There just aren't enough people who stand to be affected in a fundamental way.

Those who lack insurance or have substandard insurance far outweigh those affected by Obamacare and Trumpcare. They're the ones whose votes could make a difference. But, sad to say, they are not being helped by anybody..
Rob (<br/>)
That is not accurate that almost all of 20 million people who have added to the insurance rolls are Democrats. As with most federal programs they disproportionately help the South and Midwest/red states (you know the real takers). It has also disproportionately helped the non college educated (again actually Republican). That is not to say Democrats did not benefit from this bill but I am willing to bet it is a lot closer mix of beneficiaraires than you think of in terms Republican and Democrats and most of importantly Independents.
Bryan (Washington)
Donald Trump said many things during his campaign, contradicting himself time-and-time again. He will continue to do so. Donald Trump needs to "win" and for him, every move he makes is about; a personal win. Be it this perverted Trumpcare legislation or Executive Orders which are clearly unconstitutional. He simply looks for a win. In the end, Trump needs to win, no matter the longer-term consequences for his political party. We now know the pattern. Does the GOP?
PR (Canada)
If only there was a master negotiator to help the competing factions navigate their way to a reasonable solution, it would be so easy. SO easy. Oh, wait... America, it looks like your last, best hope for maintaining a society that sort-of resembles a first world country is the work of previous generations and the sheer ineptitude of your current leadership. Nice work.
arp (east lansing, mi)
I am transfixed by the photo accompanying this opinion piece online. The whiteness of the faces is blinding. Aside from a few smirks [Ryan, as always,, and...Dr. Price (sic)], nobody looks very happy. They look like the Rotary Club of some town in Mike Pence's former Indiana district, but in better suits. The stuff that nightmares are made of. Maybe they are contemplating the ritual creamed chicken lunch made with certified non-organic ingredients. But let's remember that a lot of people voted for these guys [I can only see one woman, but who's counting?], candidates who said they were going to deprive these voters of healthcare the voters depended on. What water were these voters drinking? Water certified as drinkable by the coal and herbicide industries? The pre-existing condition for many Americans is being delusional.
Jack (Austin)
I'm pretty sure this is an intelligent and useful analysis.

But it's gotten to the point where I'm not in the mood. Get back to me when the Democrats have started to sing the praises of that 3.8% investment tax in terms of the American social contract and as a pretty good example of trickle down economics in action. Get back to me when they have started to explain the principles of insurance in ways that will cause most Midwesterners of, for example, African-American or Northern European heritage to enthusiastically nod their heads in understanding and agreement.

I can't speak for everyone but that's the sort of thing I mean when I say the Democrats need to learn to fight for their values, aspirations, and accomplishments. I don't mean "double down on the use of "white male" as a snarl word."
EJW (Colorado)
As a special education teacher, this bill is beyond a disaster. What this will do to families with special needs children or adult children will be beyond repair. Schools often bill Medicaid for therapy services children receive in their districts. Almost gone now. This is just one aspect of the bill. The lack of a pre-existing condition clause is horrid. I cannot put into words the amount of loathing I feel for Trump and Ryan. If I were the Pope, I would excommunicate Ryan from the Catholic Church.
joanne (Pennsylvania)
No victory here. Only perceptions of it. Even the least political among us realize this president is not doing what he promised to do.
That was that health care would be for everyone, and at a very low cost.

He didn't even know what was in the bill. Lawmakers said he didn't want to know. And they were shocked he lacked policy astuteness on almost every issue of governance. His fund of general information merely an empty void.

Yet they perpetuated the idea he was a great deal maker to massage his ego, and restrain his vengeance toward them. His famously repulsive penchant for retribution/payback/reprisal.

They caved, and became cave men. Sacrificing it all to give him a victory party as victims of self-delusion, effectively sealing their own fate.
Kay Johnson (Colorado)
Lying is the New Fake Patriotism over at the GOP.
That picture says it all. Where is America in that bunch of hypocrites? Expect a fight Congressmen.
annpatricia23 (rockland county ny)
This is not about healthcare. It is not about heath. It is not about care. If this is not irony then what is?
Lawrence Lundgren (Linköping, Sweden)
@ annpatricia23 - Just taking a last look at comments and I really like that, I think I used "the Republican absence-of-healthcare bill in a comment.

It sure is about irony!

Only-NeverInSweden.blogspot.com
Dual citizen US SE

Written after just finishing a translation for a Swedish cancer researcher responsible for the database that makes possible extraordinary research on prostate-cancer patients and the identification and management of post-treatment symptoms for the ever increasing percentage of survivors.

That gang of Republicans has no idea what goes into the research that probably will someday keep many of them alive thanks to their government provided care.
Mary Ann (Massachusetts)
I wish the New York Times would start educating the populace as to exactly why a single-payer system would be the most efficient and cost-effective that we could have. Describe why Medicare has the lowest overhead for instance.

It's true that the republicans need a good bashing for what they have done. But every columnist in every newspaper is describing the same thing, in different words, why they have put themselves in jeopardy.

Please begin something constructive and educate and re-educate why a single payer system would work best for everyone.
Stan Continople (Brooklyn)
Clinton already had a health care debacle during her husband's presidency and she was loathe to touch the subject in 2016, lest she remind everyone of the fact. Like everything else she proposed during the election, she was happy to nibble around the edges of Obama's policies, and her reticence pushed single payer further into the future, just to satisfy her own ambitions. Now, Sanders on the other hand...
heysus (Mount Vernon, WA)
Unfortunately, this would be like preaching to the choir. Most of the NYTimes readers are aware of single payer health care. It's those who voted for his idiocy who don't know and do not read, either the Times or anything.
Roger Farwell (Baltimore, MD)
I wish everyone could recommend this comment a thousand times.
skeptonomist (Tennessee)
Is there disunity in the Republican party about deregulation and tax cuts for the rich? Are any legislators likely to be primaried on these issues? With a nominal victory on health care out of the way (the House voted to kill the evil socialist Obamacare!) they can leave it to die in the Senate and get on with their real objectives.
JO (Atlanta, GA)
Tom Price in an interview yesterday said this bill will "bring new resources to Medicare and Medicaid" - but it's a $880B cut. These people are shameless liars.
PogoWasRight (florida)
Correction: They ARE liars, but certainly not shameless...."blatant" might be a better word for them.....
Kathy K (Bedford, MA)
How can that be since Medicare is supposed to be a different fund?

The Republicans knew that once the ACA was implemented, American voters would not give it up. They tried for years to kill Social Security and Medicare. If they are successful in this repeal, Medicare will be next. A voucher of $3000/yr to people over 65 will be useless in this "free market" approach to health insurance.
Bruce G. (Boston)
By "resources" he meant "tools", namely, the ability to cut benefits.
Rob Porter (PA)
The House bill is a classic Trumpian business move---propose something completely outrageous, then "let" the other side talk you down to what's only a clear win for you. They get to show their negotiating prowess, and you get to show how willing you are to "compromise." The House bill was coldly calibrated for this purpose. The Senate will now water down the most egregious positions of the House bill but still leave us with a lunatic-right plan that looks palatable only in comparison.
Kayleigh73 (Raleigh)
The Republican representatives showed their true colors when they passed a bill on which the ink wasn't was even dry to show their contempt for the health of others. A special load of censure goes to Rep. Fred Upton who professed his care for his constituents and then turned on them days later. May the Bird of Paradise fly up his nose.
James (Waltham, MA)
The Republicans have just made a colossal strategic blunder with their creation and passage of their version of healthcare legislation. It has virtually no chance of becoming law and it is reviled by a vast majority of Americans. Astoundingly, they went on to demonstrate their child-like behavior by throwing themselves a beer party at the White House.

This laughable public relations disaster is reinforcing a wave of opposition that will ultimately flush them out of office. Long before then, the President will be hobbled, if not impeached, by his nefarious dealings with the Russians.

Nice going Republicans! You just made my job of opposing you a little easier.
ibeetb (nj)
Again....why are there no Ads put out by the DNCC speaking to America in layman's terms telling them EXACTLY what this bill will do?
Jonathan (Black Belt, AL)
I went to bed that 2d Tuesday last November knowing the nation was in for disaster. Disaster for the Republican Party is a minor footnote to that. I'm not sure we will last long enough to see them tumble down. Evil triumphant, disaster for all.
Alexandra (Seoul, ROK)
"Instead, most expect that the House bill would skewer the president’s electoral base, since it would be especially harmful to older white Americans and rural, white working-class families."

Only a fool would not have seen that coming.
Ruth (RI)
The "fools" that believed his campaign promise of a ' "beautiful replacement of Obamacare in which the government would take care of everybody..." put him in office - they didn't see it coming. Don the superlative Con.
Steve (Los Angeles)
Thank God they didn't elect that liar, "Hillary". They still don't know what is going on. Hillary called them deplorables. Really, they were "clueless."
jimfaye (Ellijay, GA)
Even the trees in a forest know that they all need to help each other in any way they can so they can all stay healthy and alive! Humans are stupider than trees!
Rich Moore (Raleigh NC)
Legislate in haste, repent at leisure. Here in NC we had our infamous HB2 "potty bill", passed into law within 24 hours and still not fully resolved more than a year later.
Graham Ashton (massachussetts)
What is next? Strip the sick and uninsured of the right to vote.
Richard (Madison)
Don't give them any ideas!
james jordan (Falls church, Va)
Professor Binder,
Thank you for this piece. For the uninitiated in the process, it is a good reminder that the real health INSURANCE policy will be written by a House/Senate conference and it may not be possible to write a private health policy that will offer affordable health insurance for most Americans.

I have been disturbed to read that the major rationale for replacing Obamacare is that it is collapsing on its own because insurance providers can leave a market on their own and use this power of "market extortion" to get their way politically. As a result, I have concluded that the health insurance debate is really just a political means for members of the Congress to reciprocate in their extortion of financial contributions from the private insurance companies to support their campaigns for office at all levels of government: Federal, State, and Municipal. So, I have concluded that the health security of many Americans is simply impossible under our current system.

The "beautiful replacement" might be a medicare-for-all or a single payer system as proposed by Senator Sanders. If I recall correctly, this is what most American's wanted before we enacted Obamacare. Remember the problem is the rising cost of healthcare, not a problem that can be solved by a polyglot of health insurance providers who don't even need to compete for a market.
JW (Colorado)
Very true Mr. Jordan, very true. But then.. we who live here are already slaves and pawns of the monied interests. "Land of the brave, land of the free".. what a joke. I've never been more discouraged and ashamed. I grieve for my children and grandchildren. I hope they can find someplace better eventually, some country with a conscious, a heart, and an educated, sensible electorate.
edmele (MN)
There is no rational way to discuss this HC bill. None of it makes sense. It is, pure and simple, a gift to the 1%. Even Buffett says it is a disaster. Furthermore, it is obvious that the Republican group who patched this monstrosity together have no idea of the almost certain unintended consequences of a bill that no one has read, that has not been vetted by the CBO and promises what it can't achieve. They are spinning lies to defend it. It won't take long before the examples of how it will (won't) cover the sick and the elderly will begin to enlighten the public.
josie (Chicago)
This is not a health care bill, it is a tax cut bill. As such, the policy never mattered.
Tom Beeler (Wolfeboro NH)
For Republicans politics is a zero sum game: for me to win you have to lose. I get my taxes cut, you lose your healthcare.

Zero sum games work both ways. I can't wait for 2018.
Eddie Brennan (Shelter Island)
It seems many American voters accepted the stump speech promises made by candidate Trump. Taken at his word, it portrayed what some might have regarded as a utopian vision for the future. When viewed without skepticism, it probably sounded ambitious and generous. These people will have that gullibility come crashing down upon them once the final bill goes back to the house and is signed into law. It is a tragic thing that the very health of good citizens will be the price of the president's high stakes hucksterism.
Tom W (IL)
The promises Trump made are meaningless. He never really thought he would win and other then the ability to say that he won, I don't believe he wants to be there. So what he said during the campaign, just like anything he says, doesn't matter.
Queens Grl (NYC)
He has said he misses his old life.......and judging by the looks of it he really hasn't left it behind. Still jetting off to one of his clubs to play golf on the week-ends and promises to do more of the same come summer. Only difference? We the American taxpayer now gets to pay for it. The midterms can't come soon enough. 2018 GOP Down in Flames.
Annette (Maryland)
The GOP wasn't together in the election--how can they expect to be now? A party that for two election cycles in a row puts such an improbable slate of candidates in front of voters in the primaries has a long no way to go. All parties have divisions but Republicans have at least three factions so as soon as two agree, the third is scowling with its arms crossed.

Maybe voters elected a weak governing party for a reason--because they don't trust a strong one?
Michael Roush (Wake Forest, North Carolina)
"The bill established a template: devise legislation based on Freedom Caucus priorities, then add just enough concessions to bring in the minimal number of centrists needed to pass —"

The passage of the house bill demonstrated that the centrist were looking for nothing more than a fig leaf when it comes to protecting people with pre-existing conditions.

The Kaiser Family Foundation estimates that $25 billion a year will be needed to maintain high risk pool viability. The bill provides $138 billion over 10 years after the Upton Amendment passed adding the addition $8 billion to the original amount.

These numbers should be sufficient to alert people to how little the so-called moderates really care about those with pre-existing conditions.
brucekingsleymd (phoenix az)
His actions and words show that all Mr. Trump cares about, if not Mr. Trump and his family's personal interest, is "winning." He cares not a tweet what he is winning, he just has to win.

The law can do nothing about the latter, but the former is well addressed.
Ms. Pea (Seattle)
Trump and Ryan knew the Senate would change their bill. They just wanted a "win," something for Trump to take credit for and crow about. But, they knew very well that their bill would either be ignored, pushed aside or changed into something completely unrecognizable. The cynicism of politics at its' worst. Trump must view the Senate as the clean-up chamber, where he can send his dirty linen to be washed and pressed and made ready for the public. This isn't leadership, or artful deal making, or negotiation expertise on the part of Trump. This is cowardice and laziness. The Republicans should be ashamed of themselves for pushing this bill through when most of them, including Trump himself, didn't even read it. Instead they preen and pose in the Rose Garden like they've accomplished something great. Disgusting.
hen3ry (New York)
As with so many of the pictures taken during this session of Congress and with this president I see white rich males congratulating themselves on their ability to deprive the rest of us of what they take for granted: access to top notch medical care subsidized in part by us because we pay their salaries. Disgraceful. They take from us but they don't return anything. If they were an investment we'd say they weren't worth the time or the money spent on them. Every vote that has been taken during this session of Congress has been a vote against the majority of Americans who are neither rich nor influential. The shame of this is that the people who voted for the GOP and Trump don't realize this even though both have made it perfectly clear that our concerns are not their concerns.

Some of these people have made use of the very things they want to deprive us of. One of them received benefits after his father died when he was young. Others can't be bothered to read 140 pages before they vote yes on a bill that would hurt their poorer constituents. Many of them simply do not understand what it's like to be less than rich, to worry about paying next month's bills, whether or not the job will be there. They will live and die with wonderful government benefits that they don't want us receiving. And they will tell us that we're lazy or dependent if we need something to tide us over during a bad time.

Welcome to the Untied States of America courtesy of the GOP.
GarrettClay (San Carlos, CA)
You got one very important thing wrong. We may be paying their salaries, but that is a pittance compared to their real income. That comes from corporations before, after and while they are in office. They are doing the work their underwriters want done. And doing it well. That's the source of those smiles. You and I are a mere annoyance. They work for corporations.
MarkAntney (Here)
We had to destroy HealthCare Coverage in order to Save it.
Carrie (ABQ)
I'm not certain that Trump's skewering his own base matters much to them. They are a cult now, and they will happily and ignorantly go down with their ship.
A.H. (Delaware)
They are like wresting fans. They know it's all fake and don't care. They will keep buying tickets, cheering, and beer guzzling their way to an early grave.
Plennie Wingo (Weinfelden, Switzerland)
However, let's not forget that these detestable cowards managed to insert language into this horrid bill at the last moment that exempts them from it. They should be forced to eat their own cooking. Hopefully many will lose their seats and their loathsome careers as obliging sheep over this.
BlueHaven (Ann Arbor, MI)
The nation, and those few sane and conscientious members of Government, must decide if we go down the rabbit hole with Donald Trump. Friday's celebration was all about trickery and optics. This is not normal and we can not accept this farce.
Bob (Seattle)
Observing how Trump is dealing with the issue of national health care is helping me fill the voids in understanding his reported ill-repute in past business dealings, Trump U, casinos, development projects etc.

With health care it seems to have begun in the campaign: coverage for everyone at "a fraction of the cost"... That's the "get everybody believing" stage.

Now, in defense of the newly house approved TrumpCare he's indicating that this is step one of a multi-step process - one that HAD to be taken to enable progress to the (totally undetermined) stage two.

I can guess that as whatever stage two is, there will be a stage three which may or may not "deliver the goods" on his promise of universal coverage at a fraction of the cost... Health care issues are so complex they can't possibly be solved immediately and all at once.

Any and all negative aspects of further changes in our health care will be blamed on the Democrats - and all we have to do to get to the end point is trust him and support his initiatives...

We're witnesses to one of his greatest cons ever. And I am beginning to understand why past business partners had difficulty dealing with him.
Randall Johnson (Seattle)
The next step is subsidies for funerals.
Ella (Washington State)
There are OMB rules against using Govt funds for alcohol. Who was the crony that bought the beer?
Alexander Bain (Los Angeles)
Trump's only agenda is Trump. The House right-wingers cannot undermine this agenda. Trump plainly doesn't care what's in the bill so long as it cuts taxes on wealthy people like Trump. This is the right-wing agenda too. It is a complete misreading of the situation to say that the House Freedom Caucus is undermining Trump. They are working together fist and glove.
Rick (Vermont)
"There’s another problem with outside-in deal making: It results in bills that can’t pass the Senate."

That isn't necessarily a bad thing (in particular in this case).
Jim LoMonaco (CT)
Looking at the pictures of the crew McConnell has assembled to "write" the Senate version of the Republican "wealth care" group I doubt that the end product will be all that different from the Freedom Caucus version.

The Republican focus on tax cuts and tax cuts alone means the 99% (aka the rest of us) are in line for some serious damage.
AnnaJoy (18705)
Thank you for "wealth care".
James Phillips (Lexington, MA)
The Republican health-care bill is predominantly a tax-cut bill. Watch the Senate version to see if the tax cut remains, among all the noise about its being a different bill.
JAB (Bayport.NY)
Senator McConnell may support a conservative health care bill. He obstructed Obama at every turn. Trump is fooling his supporters by following a very rigid conservative agenda. He is using the presidency to fleece the public and enrich is family.
John Laumer (Pennsylvania USA)
This "Disaster" can be read several ways. Was Trump mislead by the "Feedom Caucus?" (Does the President's constant need for narcissistic supply make him easily duped?) Or, did Trump collude with the extreme right to give his "base" some more red meat? (Again, anything to provide that needed attention.) Maybe three dimensional chess game underway to 'punish' Senators in 2018...many of whom were more reluctant than House members to support Trump. Or, finally, is this simply a shared values driven crusade against those less fortunate, or non-white?
Randall Johnson (Seattle)
Trump colluded with the Russians. Why not, the Freedom Caucus?
B. Rothman (NYC)
This President doesn't give a d--m about what the bill says so long as it makes him "look good," "appear to be a leader" etc. He's all about appearances and how he can capitalize, literally "make money on" whatever is in the news about him.

When things get slow or negative, count on The Donald to use the Armed Forces to generate support for the nation and therefore for him as President, no matter how loathesome and unnecessary the action he takes.
Mark Thomason (Clawson, Mich)
"Far from unifying Republicans behind a strong president"

Republicans did their very best to prevent Trump from becoming their candidate, and he reciprocated that feeling. They said he was not a real Republican, and they were right.

He was no Jeb! or Little Marco or Huckabee or Cruz. He beat all of them, and made a pass at a primary challenge to Ryan along the way.

Trump is not Ryan. He's not Bernie either, of course, but he's not Ryan. It is important not to push them together, but rather to pull them apart. It can be done.

Trump is also not a "strong President." He's lost. He has not even hired help. He's firing what little help he's got. Don't push him into the arms of Ryan as the only guy with a "plan" who will talk to him.
JAS (W. Springfield, VA)
The extreme right wing of the Republican party's Repeal of Obamacare vote is text book example of short winning a battle but losing the war. They allowed Trump's sports minded view of a win as that in a game of baseball. He was desperate after the 100 day failure to achieve any legislative victory to get something immediately. This anti health care position will prove disastrous to them as the public's support for it is caculated at 17%. It will be tied up in the Senate, returned to the House and months will go by without space for Tax Reform. Then there is the mid-term elections and House seats open for the public to vent their anger.
Epaminondas (Santa Clara, CA)
Mitch McConnell shut the moderates out of the writing of the Senate health care bill. Expect something in line with what the Freedom Caucus wants.
David Henry (Concord)
How do you know at this early date whether this is true?

Everyone can still say whatever he wants, and vote yes or now, so for now I don't buy into your fatalism.
Jay Lagemann (Chilmark, MA)
I wouldn't count on the Republicans in the Senate the not cave in. The GOP that I grew up with has been totally highjacked by the Far Right.
Jerry (New York)
It's an excellent bill. As we close the borders we'll need to find another helpless and desperate group to dump fry oil and serve wax-paper wrapped patties. The millions who voted for Trump are an excellent candidate group.
tony b (sarasota)
How re-assuring that the self proclaimed fiscally responsible republicans rushed through a bill for political purposes when they don't even know the costs. Throw these clowns out in the mid terms.
klirhed (London)
Probably the main loser in this sad affair will be the Republican Party -- possibly as early as 2018 -- and most surely Trump in 2020.
Looking at the victory of Macron last night, I cannot but admire the French for having tossed out a damaged-goods two-party system. Isn't it the right time for America to get rid of the horrible octopuses called Republican and Democratic parties, who presented two most unsavory candidates in 2016?
Blue state (Here)
One gets the sense that the beer party in the Rose Garden was the most important part of this bill passage.
Suzanne (Indiana)
And it wasn't even good beer.
T3D (San Francisco)
The House version must have been written during a hellacious beer bash.
James Lee (Arlington, Texas)
The split between House and Senate Republicans over this bill represents an alternative risk which Professor Binder ignores, probably because the threat targets the American people, rather than the GOP. Senate Republicans will almost certainly re-write the House bill, modifying some of the more objectionable sections just enough to dampen popular outrage over the reform.

Senate leaders can then present the new version of the bill as a far more compassionate replacement for Obamacare. Many in the mainstream media may then focus on the differences between the House and Senate bills, implicitly stressing how much better the latter is. The probability that the Senate version will still cost millions of Americans their insurance and will provide inadequate guarantees for people with pre-existing conditions, these minor defects will receive little attention amidst the relief that the House monstrosity has been replaced.

I am not suggesting a coordinated conspiracy to achieve this outcome. The Freedom Caucus in the House would probably reject the revised bill, but those Republicans who opposed the original bill, perhaps accompanied by a small number of Democrats, would vote for the modified version, the Democrats in order to avoid a harsher reform.

I hope this analysis is overly pessimistic, but I fear not.
David A. Lee (Ottawa KS 66067)
Whatever they intended to do, something like what you predict will almost certainly happen. If the Senate touches this at all, they will try to dress it up as compassionate, etc., even if, as it almost certainly will, a new version castrates some or many beneficial aspects of Obamacare. This is one of the most vicious, cynical things a sitting President and a House have ever contrived to do.
Joyce Vining Morgan (<br/>)
Why are we discussing this as though it were about health care? It's about wealth care, tax cuts for the wealthy. Republicans were clear that they needed to get this done under the aegis of repealing/replacing the ACA, so that they could make even deeper cuts when addressing the tax code.
Paula Hire (Ocean Springs, MS)
Warren Buffet said this "healthcare bill" was about tax cuts for guys like him.....article in yesterdays paper. And, apparently, the repubs want to move on to redoing the taxes so they can give the 1%ers even more tax cuts.
The Republicans have sold the American people a bill of goods for years, i.e. we are the fiscally responsible party, yet they created both (near) bank failures, first in the 1980's when they deregulated the S & L's, costing taxpayers 2 Billion dollars, then again in the late 90's and 2000, with more deregulation of lending institutions that created the housing bubble and near total collapse of our economy; and now, they are going after the Dodd/Frank regulations that were put in place following that near collapse. This will set the stage for the cycle to begin again.
Oh, one more thing, the Middle East conflicts, now @ 16 yrs and counting, started by a Republican president with false information. How many trillions has this cost us both in treasure and another generation of young Americans.
Rant Over.
Chanzo (UK)
"Warren Buffet said this "healthcare bill" was about tax cuts for guys like him.....article in yesterdays paper."

Thanks - I missed that one:

Forget Taxes, Warren Buffett Says. The Real Problem Is Health Care.
https://www.nytimes.com/2017/05/08/business/dealbook/09dealbook-sorkin-w...

see also:

The House Health Care Disaster Is Really About Taxes
https://www.nytimes.com/2017/05/06/opinion/sunday/the-house-health-care-...
Michael B (CT)
The entire health care debate is borderline silly. The fact is that in a progressive, rights-based free democracy, health care for every citizen is a no-brainer. Why is the U.S. the only such nation that declines to do so? It's simply one factor: the gigantic insurance company-big pharma conglomerate will not allow it, period. Corporatism has replaced democratic capitalism. Ugly has replaced pure. The sole focus is for insurance companies to rake in premiums as much as possible, and pay out coverages as little as possible. Check the five-year histories of the stocks of the major health insurance companies. The only things healthy are the profit margins.
Tanya Dobbs (Upper Black Eddy, PA)
Who wants to provide healthcare to a sick populace...Letting industry take over governing they will cut any and all restrictions that don't allow them to make tons of money. Pollute the air, criss cross the country with new pipelines, this time gas and tar sands. Let the old ones rot in the ground and pollute our water. Let children, especially poor children breathe in toxic chemicals by putting refineries where they live..they are poor so they have no say. Let agricultural companies poison us and our food with their chemicals. Cut science, we have no time for facts, we need jobs. Can you see that its counter intuitive to provide healthcare.
Lawrence Lundgren (Linköping, Sweden)
@ Michael B CT - Michael in order for our fellow American future voters to fully understand the answer to your question, I have, in the comment just above yours, noted that the Times should be giving us a series on Universal Health Care, which could in the process show the striking difference between the financing of US health care and that in other countries.
Larry L.
Ed (Stamford Ct)
Make everyone pay out of pocket for health care. That would solve the cost problem. :)
GTM (Austin TX)
Moderate Republican and Democrat politicians have been handed a gift for their election / re-election in this harsh, mean-spirited bill. The Senate will either write their own HC bill or amend this House-passed bill to a point where the Freedom Caucus will not vote for it's passage. As such, the GOP HC "repeal and replace" efforts will come to naught. Moderates and liberals should take the time and effort to explain to middle- and rural America exactly what has happened / will happen with this GOP bill and welcome these American voters back to the center, where American politics has historically resided.
Tanya Dobbs (Upper Black Eddy, PA)
"Moderates and liberals should take the time and effort to explain to the middle-and rural America exactly what has happened/will happen with this GOP bill...." What we really need is an all out blitz in the news explaining the DETAILS of this supposed healthcare bill. As you'll see if you read the article attached is an article explaining how little reporting has actually been done on how this bill will radically impact the most vulnerable...the poor, children, elderly, women. We can't just mention the bill and criticize it and the Republicans. NYT show us why, explain in detail the damage this bill will cause. https://www.mediamatters.org/research/2017/05/05/ahca-even-worse-youve-r...
manfred marcus (Bolivia)
Food for thought...except that there is no true thought on the republican side, where the needs and interests of the majority of folks in the U.S. are being thrashed; so petty, when compared to any and all healthcare insurance available in other industrialized countries. First, there is no justice, when there is dereliction of governmental duty in serving its constituents. Second, no compassion, as these millionaires in congress display such a social distance, unable or unwilling, to put themselves in the 'shoes' of the sick, the poor and elderly. All these ideological shenanigans are cruel, and so unnecessary, and so hypocritical, given our 'oh so honorable' congress men and women who take their own health care for granted. This is a capitalistic society, shooting its own foot to irrelevancy, by allowing a rising inequality, and it's inequities. That Trump and Ryan and Price are pitiful, indeed; but why the complicity of the rest, supposedly with a conscience to deal with?
TRo (New York)
The analysis of how and why the House ultimately approved a bill that undermines their constituencies and which has so little chance of approval in the Senate will linger for sometime. Perhaps the accompanying photograph offers at least one clue; why, after all, do we continue elect and re-elect so many old men?
John (Boston)
Trump doesn't HAVE a legislative agenda. An agenda requires thinking about something before it happens. That is not something Donald J Trump does.

Trump was willing to discard his "promises" on health care, because they meant nothing when he said them. Nothing Trump says has meaning past the moment.

Think of Donald J Trump as a performance artist. It may save your sanity.
Bruce G. (Boston)
While we are at it, let's call Sean Hannity what he is: a performance artist.

(Those are not my words, by the way. Those are Hannity's. So, in fact, his show is the original, ultimate FAKE NEWS.)
Joy (Sacramento, CA)
pretty crappy performance artist -- he can't control the smirk that keeps creeping across his face.
The Iconoclast (Oregon)
Like "Mission Accomplished" the GOP will be wrapped in shame. At least those capable of experiencing shame.

On the other hand I'm confident that many Republicans are praying this falls apart in the senate.
PogoWasRight (florida)
Let the GOP celebrate.....it won't last long. The bill will not be enacted as required by the Constitution. Of course, with Trump leading, they may not understand the process, and it could become law in their eyes.
marian (Philadelphia)
Let's make it clear the so called repeal of the ACA is all about giving a huge tax cut to the very wealthy at the expense of the poor and elderly.
The blatant erosion of anything decent associated with the federal government since DT became POTUS is nothing short of stunning and disgusting. He has managed in a few short months to dismantle any trust we had in our government.
I know the GOP wants to dismantle Medicare as the ultimate goal. How do I know that?- because DT said he didn't want to touch Medicare and Social Security during his campaign and I know that anything that comes out of his mouth is a lie. In fact, whatever DT says, I know the exact opposite is true- so I assume the next targets will be Medicare and Social Security.
Eliza Brewster (N.E. Pa.)
That "small window" has slammed shut. It didn't take long for the Republican Party to show it's true colors. And our president cheering them on. All those rosy campaign promises trampled in the dust by the raw greed of the GOP , salivating for their giant tax cut.
Greek Goddess (Indianapolis, In)
It is even tougher to govern when your goal is not to govern, but to "win," in the Trumpian sense that your will prevails over all else. Republicans are acting out the worst of human impulses on a grand acale because Trump's influence is emboldening and enabling them. As they ride to and fro on their magic bus imagining what "winners" they are, they are oblivious to the gathering storm of their constituents' will, which is the ultimate determinant of who truly wins.
cphnton (usa)
Maybe Trump should ask his NBF, Malcolm Turnbull of Australia, about Australian health care.
Trump has no idea, much less core beliefs, he just wants to be seen as a winner and his misplaced belief in the House GOP will hopefully get through to his supporters as they loose coverage and their illusions.
Mike Wilson (Danbury, CT)
Have the conservatives come to realize we have a president devoid of any affinity with anything other than that which he thinks promotes his own personal brand? I keep wondering who is the biggest sucker in this con, Trump, the people or the conservatives.
Elizabeth (NYC)
Well, the Freedom Caucus may just save us all it seems. You go, guys: stick to your far-right guns and hold out for the really extreme stuff.

Either your obstruction will completely block meaningful legislation, or it will contaminate anything that passes to the point where "moderate" Republicans face constituent wrath. Not to mention dying in the Senate.

Those of us who care about our fellow Americans and the future of our country can only hope.
Cathy (Hopewell Junction)
"There's another problem with outside-in deal making; it cannot pass the Senate."

That is a feature not a bug. The House is counting on their own bill to save seats in the primaries, and hoping against hope that the Senate, which faces the whole state, and not a gerry-mandered district will save their bacon and kill it. They want all of the glory and none of the blame.

The problem is that the Senate has nothing in its pocket that will solve the problem of health care. We have split the market into too many segments - care for the elderly, care for the poor, mandate business polices, and everyone else.
All the other pools have participation mandates, even if no one wants to see it. People pay for other's illness in corporate premiums - they just don't see
the payment, so they don't realize how much it costs them. The remaining market either has to be pooled with the elderly, the business class or the poor, and it needs a mandate, or it just isn't going to be cheap enough to work.

But the Senate will be focused on managing the optics, not solving the problem. And my family runs the risk of going broke, along with tens of millions of others, before we can help pay off the incredible school loans mandated by FAFSA. Before we can build a retirement. Before we can pay off our home.

And the nation will blame us for being stupid enough to not plan for devastating illness.
ed connor (camp springs, md)
Good points, Cathy.
You can file for bankruptcy if your medical bills are too large, but FAFSA school loans are not dischargable in bankruptcy.
Looks like the overfed health insurers are calling the tune for the R's. while the overpriced universities are doing so for the D's.
No wonder the primary voters of both parties largely rejected the establishment candidates.
Jim Demers (Brooklyn)
The bill is a "tax cuts for the rich" bill, nothing more. (The loss of health insurance for tens of millions of Americans is merely collateral damage.) We can only hope that the image of dozens of rich white men - Trump being the richest of the bunch - celebrating this obscenity will make a lasting impression on the minds of the electorate. Trump fans will remain willfully oblivious, but the majority can't be quite that gullible.
Crossing Overhead (In The Air)
This had to be done. Medicare/ Medicaid, also found with other entitlement programs need to be cut back if we are stay solvent.

It's the reality of our situation as a country.
Lyn (St Geo, Ut)
Reality for whom?? The rich??
Leigh (Boston)
Gee, no other options? How about restoring tax rates to what they were during Eisenhower's term? How about dumping some useless corporate welfare for the military? How about making corporations pay their taxes? How about getting out of all these wars?
Lawrence Lundgren (Linköping, Sweden)
Professor Binder, you note correctly that "The bill he championed in the Rose Garden runs completely counter to his promises..." But then you write as if you believed that "...what he really cares about (are) trade and infrastructure." Trump certainly does not "care about" infrastructure but neither does he really care about anything except the economic welfare of himself and his family.

A review of 100s of recent comments on the various articles on Republican absence-of-health-care proposals shows that Times commenters overwhelmingly favor what I consistently refer to as Universal Health Care (UHC), that is care that provides what Swedish national health care offers, whatever name you want to give it.

I mention this because a couple of days ago one commenter was up in arms against all commenters who consistently refer to universal health care as single-payer health care, giving examples of the several different varieties of UHC available in Europe. Comments were closed so I reply here by suggesting that the Times should provide a "Universal Health Care Series" explaining how UHC works in 4 or 5 countries and, of critical importance, giving the data for each showing why the USA is so far down in all lists based on evaluations of the effectiveness and cost-efficiency of health care from national perspective.

Only-NeverInSweden.blogspot.com
Dual citizen US SE
ghsalb (Albany NY)
"...suggesting that the Times should provide a "Universal Health Care Series" explaining how UHC works in 4 or 5 countries." Great idea, sorely needed; I would absolutely read that. For openers, do Australia (cf Trump's TV remark: "Australia has better health care than we do" (can't make this stuff up)).
JBC (Indianapolis)
"Unified party control rarely lasts long in American politics."

Unified party control is a misnomer we need to retire because it presumes that a majority is synonymous with unified block voting.

While this sometimes does occur, individual politicians are not automatons who vote the party preference on every single bill. A majority, particularly a slim one, is not a guaranteed voting block ... ever. Therefore, control of Congress also is a fleeting illusion even when you hold the majority in both chambers.
Vicky (Columbus, Ohio)
On Medicare: if Trump campaigned against rolling back Medicare, it's now in great danger of just that. Look at how he's "fixing" healthcare for everybody else.
G. Slocum (Akron)
If anyone really thinks that Trump will protect Medicare and Social Security from the hard right, he hasn't been paying attention. "Beautiful healthcare," "better, less expensive," "coverage for everyone?" The hard right has been trying to dismantle the New Deal for 80 years, and Trump is right there with them. Remember when he said that the minimum wage was too high?
Bimberg (Guatemala)
"Unified party control rarely lasts long in American politics"

It's debatable whether there is currently any unified party control. What unity exists is on the subject of what the Republican party is against, not what it is for. (One can't go far wrong by assuming that the agenda will, however, always be to give more to those who already have the most.)

Given their gerrymandering, their own television propaganda channel, their multiplicity of think tanks, their access to large amounts of campaign funds from the very rich, and the willingness of their poorer supporters to vote against their best interests, there is every prospect that even a divided Republican party can survive in power, even if diminished.
mike (mi)
We cannot bring back the past, especially a past that only existed in our minds.
Conservatives tend to look backwards to a time when men were men, the poor and the "others" knew their place, and women had specific roles and expected behaviors. A time when the resources of the country allowed self determination, rugged individualism, and unending growth and expansion.
Now we are 350 million plus, living in fixed borders with a global economy and technical progress eliminating blue collar jobs faster than outsourcing.
Conservative ideology would have us believe that the old ways will deliver us from our ills. The "magic of markets" will save us. Competition, choice, entrepreneurs, will lift all boats.
We need to balance the common good against the capitalist drive for wealth accumulation. Health care and education are two areas where market forces only enrich the few at the expense of the many.
It is not 1955 anymore and our government should provide for the common good even as it protects the rights of the "job creators".
Konstanze Plett (Bremen, Germany)
Republican/Trump health care law, if it gets through in this version or another, won't interfere with the mid-term elections since most provisions will become effective only in 2020. Hence those who will be deprived of Medicaid and unable to buy health care insurance won't feel it yet in the fall of 2018.
Dan Welch (East Lyme, CT)
Since when has the White House and the GOP leadership been about more than a PR campaign, a soundbite, and retaining power? The idea of public service, and courage to first seriously learn and consider the complexities of issues like health care, income inequality, and the genuine suffering of significant numbers of people is simply foreign to them.
Wm Conelly (Warwick, England)
Democracy ain't about one or two 'corporations' or a couple of offshore 'contributors' controlling what 'news' people are exposed to and, therefore, what choices they make. The number of Reps in the US House of Representatives needs to rise from 435 (locked in place in 1911, after the 1910 census) to reflect the Country's population growth in the last ONE HUNDRED AND SIX YEARS and, thereby, offset some of the 'single player power' that Big Money has accumulated.

Democracy means rule by the people. A significant surge of fresh water every two years will 'flush the swamp' and get things moving properly again. What's properly mean? It means getting The House of Reps needs out of the right lane on The Road to Serfdom. Our Reps need to accurately define problems, fully and openly discuss those problems, from as many angles as possible, and then VOTE the Country's way forward, not manipulate it.
Scott (Buffalo, NY)
I predict about 50 to 60 House seats will flip to the Democrats. Then the real Russia investigation can occur. Healthcare can be saved, because the Senate will punt this. Obama said to have courage and fight for what is right.
Lyn (St Geo, Ut)
I hope your are right.
alan haigh (carmel, ny)
Until it became completely polluted with the traumatized culture of the former Dixiecrats, Republicans stood strongly for a privatized system of universal health care.

Eisenhower and Nixon would not recognize the heartless and artless party it has become- or rather it would see today's Democratic party as its incarnation- and that is really the problem with the current national debate on healthcare.

The Democratic party should be debating with the Republicans about the relative merits of a privatized system compared to extending Medicare to all citizens. We should be looking at the statistics available by comparing systems that are in place in other countries instead of throwing away literally trillions of dollars for a health care system based on ideology, and serving entrenched interests rather than based on legitimate information (such as a comparison to the efficiency of the Canadian system).

The South lost the Civil War to defend a flawed ideology built Jim Crow on a flawed ideology, now they are destroying our nation with a flawed ideology.
Lyn (St Geo, Ut)
Nixon was for putting profit into healthcare.
DS (MA)
I sincerely hope that Trump supporters are the ones who most feel the terrible impact of this legislation. They deserve to get exactly what they voted for.

I also hope that the Rose Garden image becomes an iconic symbol--the smugness and self-congratulatory arrogance that befits Trump and the Republican Party.
Jazzmandel (Chicago)
Considering the human costs to be exacted by this bill or the one likely to be fashioned from it by the GOP senate, and the betrayal of his base's interests eagerly endorsed by the president, it seems shallow to focus on the political problems the Republican party has created for itself. I understand that's Ms. Binder's specialty, but I can't work up any interest in the party's plight when it's goals in so many areas is to dismantle government protections and services to the American populace.
Frank Correnti (Pittsburgh PA)
It's quite clear that if your nuclear family does not include someone similar to those posed in the Rose Garden, or thereabouts, and preferably that person being head of household, don't look for much welcome in this land that is increasingly not meant for you and me, brothers and sisters.

It's quite clear that only the best and brightest from other lands are welcome as potential naturalized citizens. The assumption is that the more highly paid and higher status higher tech jobs, or are they positions, are going to come from persons outside this country. Maybe I should be hanging in the yard at Carnegie Mellon where the fine4 ladies stroll and the gentlemen confer, rather than at the gym which to my mind is more diverse and thus more inclusive.

People, baby boomers mostly, of my generation see good health as a blessing that is neither earned by following the scriptures nor as a penalty for failing to observe some standard of behavior. Of course there are many whose view is constrained to include only those perceptions that have passed through a filter which also has been fitted only to some and not to all.

May the good Lord continue to grant us the open eyes and the unrestricted minds to continue to appreciate the whole of what we have.
Ami (Portland Oregon)
The Republicans have demonstrated that they plan to govern by a combination of cruelty, dysfunction, and greed. But as long as they erase the legacy of the first black president and manage to stomp out the New Deal and Great Society policies that have frustrated them for so long everything is going smoothly.

Never mind the fact that our infrastructure is failing, we've been at war for two decades and aren't taking care of our veterans, and we're falling behind in education and technology. So long as the 1% get their prescious tax breaks all is well with the grand ol'party.
EricR (Tucson)
Ami
Agree with most everything but have one bone to pick. The VA, at it's worst, is no worse than the health care industry at large, and usually better. I, like many vets, have had some problems at the VA, experienced serious frustration with them at times, but in general have received great care. I'm currently scrambling to get out of the veteran's choice program and back into the VA for cardiac care, my experience on the outside has been horrific. On the outside my various prescriptions would cost, at the least, over $1000.00/month, the VA charges me between $5 and $11 per script, with an annual cap of $700 (might be $750, not sure). I can renew them on the web and get them delivered at home, no extra charge. It can be hard to get an initial consult with a specialist, thus my visit to an outside cardiologist. But once in the system, things flow smoothly. Wait times to see the doctor are minutes, not hours as I experienced outside.
In late January I collapsed while waiting for an eye appt. They had a rapid response team on me in less than 60 seconds, I was in the ER in 3 minutes, literally.
As flawed as it may be, the VA is far superior to general medical care in this country, unless of course you're one of those who can pay whatever it costs. Unlike on the "outside", nobody at the VA has ever looked me in the eye and lied straight to my face, or ignored my conditions and concerns for their own convenience, as did my "outside" cardiologist. We're all a bit imperfect.
Kris (Ohio)
It's true - the biggest problem in the VA is waiting for access. Just because one is a veteran, one does not automatically qualify for services. This was a political decision, and could be changed by Congress; more resources would be needed. One could argue more resources are needed already, again, up to Congress. But consider that a non-vet who seeks an appointment in the regular healthcare "system" might have to wait months if new to a practice (this has happened to members of my family - not making it up). There is a physician shortage in this country which is only going to get worse.
totyson (Sheboygan, WI)
EricR:
I agree with you 100%. The horror stories out there about the VA and its third-world treatment of our honored veterans is an anecdotally-driven fiction used by the GOOP and its operatives as a cudgel to attack the Democratic Party.
A. Stanton Jackson (Delaware)
Trump/Pence/Ryan are so narrowly focused, they fail to understand 130 million Americans have pre-existing illnesses that crosses party lines and district boundaries. The 218 GOP house members that voted for this bill of genocide have no idea that they have ignited a fire that will blaze-up around their political careers. They have turned the swamp into quicksand and cast 130 million people into it to give tax cuts to people that don't need them. Never has so few done such irreparable hart to so many. These are cruel and heartless people that fail to understand the meaning of protect and serve.
Harpo (Toronto)
Trump's remarks at his party in the Rose Garden explain it clearly: he can't get over that he's President. Really. President And all these political people congratulate him when he does what they want. What could be better? Whatever he promised was necessary so that he could be President. That's all.
Susan (Maine)
Is this is called legislating, the GOP made the best argument ever against experience. And they will return from recess to a failing grade from the CBO.

Surely even THIS House which has shown it is tone-deaf to how they actions look in the public eye (think middle of the night passage of bill to gut their own ethics oversight as their first action)---knows that the better this bill is known, the more it appears as a shoddily done fraud mascarading as a health plan but really robbing Medicaid and the electorate to give possibly the largest wealth transfer to the rich.

(Surely even the GOP doesn't think that the public will accept "Gut and Destroy" under the Repeal and Replace slogan?)

Whatever--the consequences will be felt immediately as the insurance markets roil for all of us--resulting in our paying for their market insecurity beginning with next year's premium announcements.
GNewsom (USA)
You need to stop with the divisive "harmful to older white Americans and rural, white working-class families." The Obamacare replacement is harmful to older Americans, all working-class or poor families, of ANY color or background. It is just that the while Americans who are harmed most seemed to support Trump the most.
Sera Stephen (The Village)
When you look at all this insanity on human terms, it springs into high relief.

A gang of kleptocrats is leading the country with the sole intention of self enrichment.

Their supporters, who can only be described as victims of Stockholm syndrome, see 'winning' as the goal, with complete apathy about what is being 'won'.

The majority of Americans, the people who favor Hillary Clinton, Women's biological rights, solar and wind power, and single payer health care, have no effective voice.

The answer must lie in organization of the majority into a functioning political force. Either in the congress, or on the streets, as we did in 1974. Otherwise we face imminent disaster. It's that near.
Melvin Baker (Maryland)
With each passing day, week the GOP is seeing it's ability to actually repeal & replace the ACA slip away.

This inability or unwillingness to do so will be seen in the 2018 midterms when voters will show Congress how important their vote was last week.

The GOP will feel the sting of last week for years to come.
Christine McM (Massachusetts)
"An emboldened Congress, dominated by the right, might start aggressively pursuing conservatives’ quest to roll back entitlements like Medicare, something the president campaigned against."

Oh yes, get ready for that! Why should the elderly be spared, given how easy it was to wrench health coverage from the middle class via this "pact with the devil" deal?

Why should anybody be spared? Donald Trump is proving that he's too lazy to master policy details, too eager to get back out on the trail to hear cheers at his rallies, and too cynical to care. The Master of Deception will find a way to paint the health bill as the greatest thing of all time, and his supporters will believe, even when they discover they can't afford their healthcare premiums.

Last night I watched former President Obama give a speech accepting this year's Profile in Courage Award at the Kennedy Center. The first words out of his mouth were, "cynicism is dominating this country."

How right he is. A society whose leaders are dominated by simple greed and lust for power and wealth--and willing to go to any lengths to achieve it-- often spells the beginning of the end.
Katherine Cagle (Winston-Salem, NC)
I am lucky enough to have employer sponsored health care but I can't rest easy about that with the Republicans on a tear. We are all at risk with the exception of the very rich who can afford to buy their own insurance. Our state is already threatening to stop insuring state retirees except for those already insured. That, along with our pension, is one of the perks that made me generally satisfied with my relatively low salary. What will happen to all of us -- the middle class and the poor? I shudder to think about it.
E (<br/>)
Even those of us who have employer provided healthcare have benefitted from Obamacare, whether it was birth control or being able to keep our college grads covered until age 26 as they look for jobs with health coverage.
Phauger (ca)
This country is far from the beginning: that happened in the 18th century - or 1980's with Reagan. We are well into the end.
sdavidc9 (Cornwall)
The modern Republican Party wants get rid of the New Deal, as opposed to the RINOs who wanted the New Deal to be less expensive and rely more on nongovernment action. The most conservative Republicans are fairly honest about it and would like to do it quickly. The others avoid thinking about things clearly or in terms of principles (although they can fake it when necessary).

Until Republicans can discuss and come to a deal on whether they want to phase out the New Deal or just run it more frugally and downsize it a little. they will not be able to govern. The best solution would be for the frugal side to become conservative Democrats and then get the Democratic Party to split. The phase-out Republicans could then become Libertarians, and things would be much clearer.
Rainflowers (Nashville)
We need the "New Deal" more than ever now. Democrats will not vote to dismantle it, and republicans will become more and more unpopular as they push to dismantle the only safety net left in this God Forsaken Country.
Sandra Garratt (Palm Springs, California)
The GOP is clearly not a "conservative"party at all...they are now extremely radical and they should be described as the extreme radicals that they are. There is nothing even vaguely American about their so-called values & ideas....I see them as actively anti-American. They are the US version of the Taliban and we should be afraid of these religious poseurs who seek to be in charge of running our government and imposing their particular cult rules & traditions on to all the American people. Scary stuff and we should all be very concerned...render onto Caesar etc etc. These people worship only one God and that God is the all mighty dollar. Time to label the GOP party correctly.