What Went Down On Health Care This Week

It’s been hard to make reliable predictions about exactly how the health care debate will play out. The general rule has been that Republicans are never as close to passing a bill as they seem to be at their best moments, nor never as far from it as they seem to be at their worst ones. But whereas “skinny repeal” seemed to have a lot of momentum initially — with Heller indicating he would back it, for example — the news so far today has been more troubling for its prospects. Here’s a sampling:

• House Freedom Caucus chair Mark Meadows said there’s “not enough appetite” to pass “skinny repeal” in the House as currently constructed.
• South Dakota Sen. Mike Rounds said he wanted a guarantee that “skinny repeal” wouldn’t pass the House, or that its implementation would be delayed.
• Arizona Sen. John McCain said he’s still undecided on “skinny repeal.”
• And various provisions that were supposed to be in the “skinny repeal” bill keep getting nixed by the Senate parliamentarian, meaning they’d require 60 votes (or for the GOP to eliminate the legislative filibuster) to pass.

So … who knows. Fundamentally, however, McConnell is playing a game of three-card Monte with his caucus. Some members (like Heller) are willing to vote for “skinny repeal” only in order to avoid having to vote for something like AHCA or BCRA, while others (like Rounds) want to vote for “skinny repeal” only because they hope it turns into something like AHCA or BCRA after conference with the House. It might be a neat trick if McConnell pulls it off, but it was never going to be easy.