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The House Republicans’ zombie health care overhaul bill rose from the dead once more Wednesday night, with moderates and conservatives coming to a tentative agreement on draft language. Immediately, though, it became clear that the new bill faces even tougher odds than the one that was already laid low in the House and that caused no shortage of political damage to Republicans.
All of which raises a vexing question: Why are they doing this to themselves again?
After all, their first effort to repeal and replace the Affordable Care Act went up in dramatic flames in an embarrassing fashion, raising questions about Speaker Paul Ryan’s ability to manage his caucus, President Donald Trump’s ability to inspire votes, and the viability of the rest of the GOP agenda. It left the Freedom Caucus wounded and at war with the president, while moderates had to suffer an outpouring of intense opposition back home.
Since then, Obamacare has only grown more popular and the pathway to its demise more narrow in the Senate. One Republican lawmaker told The Huffington Post that the chances of ultimately succeeding with repeal and replace stood at 25 percent. And that, he acknowledged, was being generous.
Congressional Republicans could conceivably look at these odds and decide that it’s in their self-interest to run away ― that the risk of incurring more humiliations, of reminding voters of their political fecklessness, is simply too great. And yet, since the first attempt fell apart, they’ve repeatedly returned to the subject.  

“I think in their campaign and since the election, they have shown they are not risk-averse,” John Brabender, a longtime Republican operative, said of GOP lawmakers.
Those involved in actually crafting a health care bill say they recognize the politics are tricky, if not potentially self-damaging. And because of that they’ve sought to tamp down expectations that something will pass. A senior GOP aide told HuffPost on Wednesday that there was no current agreement to whip votes for the latest measure, let alone any indication the party would have the necessary 216 votes.
But aides also insist they have to continue to look for a path forward, in large part because the primary political concern for GOP lawmakers right now originates within their own party and not outside it. Virtually all elected Republicans in Congress pledged to repeal and replace Obamacare during their campaigns ― more or less every day since it became law. To abandon it after one attempt at passage (and a meek three-week effort at that, without even a vote) would be to risk alienating their core voters.
“At that point, your base collapses,” former National Republican Congressional Committee Chairman Tom Davis said before March’s planned health care vote was pulled because of lack of support. “All these people out in those town meetings [protesting repeal and replace] won’t vote for Republicans anyway.”
And so, the party is pursuing the repeal of Obamacare out of a desire to ― at a minimum ― show it is still in pursuit. This is true of both the White House, where Trump is reportedly obsessed with scoring legislative victories before his first 100 days in office; among outside groups, which worry that any health care failure will beget failures on other conservative priorities (mainly tax reform); and on Capitol Hill, where lawmakers are feeling an acute need right now to convince voters that they remain committed to their seven-year legislative objective.

All these people out in those town meetings [protesting repeal and replace] won’t vote for Republicans anyway.
Tom Davis, former National Republican Congressional Committee chairman


The most recent attempt was launched by Rep. Mark Meadows (R-N.C.), chairman of the conservative Freedom Caucus, and Rep. Tom MacArthur (R-N.J.), co-chair of the moderate House Tuesday Group.
“They want to be viewed as constructive,” one plugged-in GOP lobbyist said of those recent talks. “The actual vote-getting part is not their problem. It’s good PR. Neither side [conservatives nor moderates] actually speak for any significant bloc of votes.”
As long as the bill appears to still be alive, it gives Republicans running for re-election something to point to, the thinking goes. This has been the GOP’s electoral formula for seven years already, so perhaps it can be played on the base through the next election, too.
But the politics of Obamacare are shifting in ways that make this calculus more complex. Many people who benefit from the Affordable Care Act happen to be the type of low-income voters that flocked to Trump’s candidacy. And recent polls strongly suggest that Republicans writ large are growing more favorable to the law, now that its namesake is no longer in office. A Public Policy Polling survey from Wednesday showed 27 percent of Republicans supporting it and, more remarkably, just 51 percent opposing it.
House aides insist these studies don’t fully capture the political dynamics in which they’re operating. One of the reasons, they argue, that they must continue trying for repeal is precisely because the law is failing in many rural districts ― the type usually represented by Republican lawmakers.
“It is not working for a lot of their people,” explained another senior GOP aide, “and they need help.”
The problem, though, is that the kind of help needed in rural communities ― greater subsidies, a more generous Medicaid expansion ― are the opposite of what the GOP plan would do. And the proposals the party currently is pursuing have the public and its own members spooked. That apprehension is best reflected in the Senate, where even a conservative like Tom Cotton has pledged to protect the Medicaid expansion in his home state of Arkansas. But it’s also the underlying context of Trump’s routine insistence that he’d prefer to let Obamacare collapse on its own so that Democrats will shoulder the blame and be in a worse negotiating position.
Not every Republican subscribes to this theory. In fact, many believe the “let-it-collapse” approach would backfire dramatically.
“When I hear people say ‘let it fall apart and implode,’ do they really think they will have the political willpower to let that happen?” asked former Rep. Jack Kingston (R-Ga.). “Imagine the news stories. It will focus on how the callous, mean, son-of-a-bitch Republicans aren’t willing to fund whatever. And so and so will be without health care. There is no way Republicans are going to sit back and let this fall apart.”
But for all his fear of the politics of inaction on health care, Kingston also recognizes the complexities of acting on it. When he was running for a Senate seat in Georgia in 2014, he was criticized within his own party for suggesting Republicans might consider keeping elements of Obamacare in place rather than taking the entire bill apart. His former colleagues have gradually moved closer to that position. But they aren’t yet ready to fully say goodbye to the concept of repeal and replace. And so, Kingston predicts, they might just do the most congressional thing possible: pass something ― anything ― and let it collapse in the Senate.
“I think the way to get it out of the way is to get something to the floor and then blame it on the Senate,” he said. “They just have to.”
Any piece of paper will do.
 
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