The Senate’s ‘Lowest Common Denominator’ Health Debate

To anybody tuning in to C-Span this week, the Senate health care debate might seem like a spirited, if somewhat convoluted, discussion about the Affordable Care Act. In reality, it is a Goldilocks-like search by Republicans for a bill that can get the bare minimum number of votes needed for the party to claim victory.

On Wednesday, the Senate, including seven Republicans, voted down a bill that would have repealed some of the most important provisions of the A.C.A., or Obamacare, without a replacement. That bill would have left 32 million more people without insurance, according to the Congressional Budget Office. It was the second straight defeat for the majority leader, Mitch McConnell. On Tuesday night, the Senate failed to provide the votes needed to advance a repeal-and-replace bill that would have taken insurance away from 22 million.


Senator Lisa Murkowski of Alaska on Capitol Hill on Wednesday.

Tom Brenner/The New York Times

Up next, and hoping that the third time is a charm, Republicans are expected to offer a bill that they are calling “skinny repeal.” It would increase the number of uninsured people up to 15 million. If that legislation passes, the House could be asked to accept it, or it could be sent to a conference committee where Republican lawmakers from both chambers can try to hash out a compromise.

This is not how laws affecting the health of millions of people and an industry that accounts for about one-sixth of the American economy should be made. Yet, here we are. To senior Republicans like the health and human services secretary, Tom Price, this process is about getting to the “lowest common denominator,” not about improving health policy or providing people with better, more affordable medical care.

One of the central Republican criticisms of the A.C.A., which helped 20…

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