TrumpCare is doomed unless Republican leaders make fundamental changes

The American Health Care Act appears not long for this world. No one wants to vote for Trumpcare in its current form—not conservatives, not moderates, not anyone. Republicans might be complaining about the assumptions the Congressional Budget Office used to produce its atrocious score, released on Monday, and top leadership might be pretending like there’s nothing to see there. But rank-and-file do seem to recognize, as Arkansas Sen. Tom Cotton put it Tuesday morning, that the CBO score is “directionally correct.” More people will be uninsured; older, low-income people will be wholly priced out of the market; and premiums will still increase, albeit at a slightly slower pace on average.

Trade-offs in health care legislation are to be expected. But for what are they trading here? Tax cuts for the wealthy don’t appear to be enough this time around. This is a bad bill with no clear benefits for members to sell to their constituents. Members know that, and that’s why it has to change.

But how? GOP leadership is going to have to figure that out and soon.

Senate Republicans on Tuesday continued to take issue with the CBO’s calculation that 24 million people will lose insurance by 2026, saying it applies too much weight to the effect of Obamacare’s individual mandate. There’s a case for that—in the short term. But there two far more glaring and less dismissible problems in the eyes of would-be backers: The bill appears to go out of its way to destroy older, low-income people for sport, and it doesn’t lower premiums.