This past Friday, Sen. Elizabeth Warren was speaking to a packed theater of supporters in Los Angeles when she took a victory lap over the defeat of the American Health Care Act.
The Massachusetts lawmaker—already pegged by President Donald Trump as a possible 2020 opponent—complimented progressives for having successfully “fought back against the biggest assault on health care in the history of our country.”
“So how did that happen? We defeated the health care bill not because suddenly we grew a bunch of new Democrats, though, I’m all for that,” she joked. “It happened with democracy.”
She then instructed the audience: “Take the lesson on what happened with health care and that is: Show up. Man, show up.”
Less than a week later—after grassroots opponents of Trumpcare failed to show up in significant enough numbers to make a difference—House Republicans have passed an updated version of the American Health Care Act. They voted on the bill without a score from the Congressional Budget Office or new polling, but the revisions to the earlier bill were relatively minor to the overall structure. In fact, those changes will likely result in more harm to Americans’ ability to gain access to health care than what was in the original version, which was polling at 17 percent and which—according to the CBO—would have resulted in 24 million fewer people with insurance than under the status quo. Many GOP legislators refused to even acknowledge whether they had read the bill before voting on it. Some admitted they hadn’t.
But they did vote for it. Despite what the president, House Speaker Paul Ryan, and other congressional GOP leaders said at the time of the original version’s defeat—and despite what Warren told the crowd just last week—this bill was not dead. It was very much alive. And now it has a reasonable chance of passing, in some modified version, in the Republican-controlled Senate.
How did Republicans wrench victory from the jaws of defeat? How did Democrats do the opposite, and why were they so complacent to the renewed threat that had emerged in the past few weeks?
On the Republican end, the motivation appears to have been driven from the right. After the apparent death of the health care bill, the Republican base was rightfully disappointed with the failure of the president and their members of Congress to live up to their central campaign promise to repeal and replace Obamacare. In April, shortly after the bill was withdrawn, Trump experienced a 17-point drop in the number of Americans who thought he kept his promises. Notably, that included an 11-point drop among Republicans.
During Trump’s Rose Garden ceremony celebrating the passage of the bill on Thursday, both he and Vice President Mike Pence emphasized the importance of appearing to keep this particular promise. “At [the time of the ACA’s passage] Republicans in Congress promised the American people that law would not stand,” Pence said in introducing Trump. “Today, thanks to the perseverance, the determination, and the leadership of President Donald Trump and the support of all of those gathered here, we’ve taken a historic first step to repeal and replace Obamacare and finally give the American people the kind of health care they deserve.” In his own remarks, Trump emphasized that promise kept. “Make no mistake, this is a repeal and replace of Obamacare,” he said. “Make no mistake about it. Make no mistake.”
That’s what motivated Republicans more than anything else: a belief that they had to pass something. But how come the progressive insurgence that torpedoed the first effort failed this time around? As Warren’s remarks on Friday indicated, that insurgence had moved onto other things.
This entire revival process of Zombie Trumpcare took weeks, but it wasn’t until Wednesday—less than 24 hours before a final vote—that Republicans appeared to have the votes to pull it off. During this time, the party was essentially allowed to play possum by both the media—many of whom did not foresee how reluctant moderate Republicans would ultimately be made to come on board—and by Democratic leaders like Warren—who were still cheering the defeat of the first effort rather than realizing a new opposition needed to be activated.
What might that opposition have looked like?
“It’s not just about voting, it’s about doing all the things you can to make your voice heard. So join an organization, doing emails and phone calls,” Warren told the crowd in Los Angeles. “Do ’em every single day. It’s going to take all of us, but that’s how we’re going to make a change.”
Again, though, none of this rhetoric last week was directed specifically against the new health care effort. As Vox reported on Thursday, it wasn’t until Wednesday—the day before the vote—that activists at the left-wing group Indivisible even realized they needed to mobilize. “While some have been sounding the alarm about the bill’s chance at passage for more than a week,” Vox’s Jeff Stein wrote, “others had largely moved onto other priorities, thinking the fight over ACA might have already been won.”
According to Stein’s reporting, some liberals realized they had been asleep at the switch. “Everyone went drinking after the first one [AHCA] failed, and I think we got caught flat-footed,” one Democratic Party operative told Vox before the vote. “The grassroots moved on, and then Republicans moved fast. … We’re all now staring at the abyss.”
Others on the left blamed the media for not drawing attention to the Republican effort until it was too late.
“MoveOn and many other groups have been operating in Defcon 5 mode for a week. But most Americans, even progressive activists, weren’t aware of the danger. And the media environment that our members live in has made it seem like this moment was almost impossible,” Ben Wikler, Washington director of MoveOn.org, told Vox. “It would take all of five minutes to string together a series of quotes about how Trumpcare was dead in major front page and prime-time stories from the biggest news outlets,” he added.
Again, though, it wasn’t just the media playing into the hands of the Republican leadership by treating it as dead. It was would-be progressive leaders, as well.
On Monday, for example, Warren was still describing the effort to repeal Obamacare as having “failed.” Only on Tuesday, it seems, did she start treating the issue as a live one again on her Facebook page, linking to Jimmy Kimmel’s impassioned health care monologue. It was the same from other Democratic leaders. Bernie Sanders only started posting on his Facebook page about health care on Wednesday, also mentioning the Kimmel video. Joe Biden, meanwhile, tweeted his opposition only after the bill passed. Hillary Clinton sent out one tweet about the Kimmel video on Tuesday and then another crying shame at Republicans after the bill passed. Barack Obama, for his part, spent last week agreeing to give a $400,000 speech to a health care conference sponsored by an investment bank.
And then there was House Minority Leader Nancy Pelosi. On Thursday, she reportedly indicated that she was cool with Democrats failing to activate in time to stop the bill, and that it might have even been a strategy to force Republicans to take a toxic vote that would go nowhere in the Senate.
Progressive pundits agreed that Republicans would be shooting themselves in the foot with this vote. “If anything resembling the bill they have just passed is ever signed into law, it would amount to one of the greatest self-inflicted political wounds in American history,” wrote New York magazine’s Jonathan Chait. Writing for the New Republic, Brian Beutler similarly argued:
If Senate Republicans respond to [the new CBO] score by shelving the bill, it will underscore how reckless and cynical their House counterparts were being by voting blind. If, on the other hand, the bill somehow clears the Senate, becomes law, and people start dying, the politicians who passed it will have to choose between claiming they didn’t know how devastating and immediate the consequences would be, or admitting that they were lying the entire time.
Pelosi said something similar on Thursday: “House Republicans are deluding themselves into thinking that they can hide the truth or hide from their constituents when they take their votes.”
But are they? On Thursday, Republican leader after Republican leader was repeating talking points about Obamacare failing, while evading questions about the potential destructiveness of their own bill and outright lying about what it would do.
“It makes health care more affordable, it takes care of our most vulnerable, and shifts power from Washington back to the states and more importantly back to you the patient,” Ryan lied flatly during his Rose Garden appearance.
“We’re not taking a benefit away,” House Majority Leader Kevin McCarthy lied on CNN before he voted for a bill that will rip health care from millions, mostly through Medicaid cuts. “Nobody on Medicaid is going to be taken away.”
For his part, Trump exclaimed as vaguely as humanly possible how this was a “great plan” with “great features.”
Pelosi and progressive pundits don’t think these lies will prove sustainable if the bill passes the Senate and—in some not-so-distant future—people actually start dying because of lost health care coverage. But this is the Republican Party that has successfully turned what should be straightforward factual questions—whether or not man-made climate change is a real thing, whether or not we knew for a fact if Iraq had weapons of mass destruction, whether or not Hillary Clinton won the popular vote by millions of ballots—into ideological debates with two arguable sides. Its reward has been full control of the federal government. Does anyone really doubt the GOP can turn the question of whether Trumpcare is removing millions from health care and resulting in deaths into another such partisan battle if they choose to go forward with this bill?
At the Los Angeles event on Friday, there was another way that Warren expressed how the original bill had been killed because of grassroots pressure.
“I have to tell you, people sometimes say to me '[do] phone calls actually really matter?' During the health care debate, there were people in the United States Senate who were totally freaking out,” she said.
House Republicans were not freaked out enough on Thursday, apparently believing that facts won’t matter in the coming debate. As for the degree to which Senate Republicans are actually freaked? We’re about to find out.