Senator John McCain, now in the twilight of his career, delivered a speech Tuesday on the Senate floor so fraught with drama that it felt like it was out of a movie. Here was a legendary figure, a war hero and a former presidential candidate now stricken with an aggressive cancer who flew, at real risk to his health, across the country to deliver a message to his colleagues about how Washington had lost its way. Bipartisan comity had given way to win-at-all-costs partisanship, he warned. Nor did McCain spare his own party. He lamented that Republican leadership had run roughshod over norms in order to ram through a flawed healthcare reform bill—“a shell of a bill,” as he called it.

“We’re getting nothing done,” the Arizona senator complained. “All we’ve really done this year is confirm Neil Gorsuch to the Supreme Court. Our healthcare insurance system is a mess. We all know it, those who support Obamacare and those who oppose it. Something has to be done. We Republicans have looked for a way to end it and replace it with something else without paying a terrible political price. We haven’t found it yet, and I’m not sure we will.... We’ve tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it’s better than nothing, asking us to swallow our doubts and force it past a unified opposition.” He concluded, “I don’t think that is going to work in the end. And it probably shouldn’t.”

If this were a movie, there would be only one logical ending. Bucking his own party, putting country above politics, the weathered old maverick would cast the deciding “no” vote and stop the flawed bill in its tracks—likely killing the Republican health care effort altogether. But McCain had already cast a critical “yes” vote to open debate on repealing Obamacare. “I voted for the motion to proceed to allow debate to continue and amendments to be offered,” he said. “I will not vote for the bill as it is today.” Hours later, he did precisely the opposite, voting in favor of the Better Care Reconciliation Act, which nonetheless failed.

This movie ended with the film reel unspooling all over the floor.

It’s hardly news that McCain’s soaring speeches are belied by his own actions. Still, the yawning gap between McCain’s votes and his criticism of the GOP health care effort is a microcosm of the core problem: The Republican Party is so intellectually bankrupt that they are pushing ahead with a plan that they themselves know is terrible, merely so they can put a point on the scoreboard. This did not happen overnight, and it’s showing no signs of abating. Rather, it’s only getting worse under Trump, and there’s no telling what damage they will do together before voters get wise to it.


How did the Republicans end up with such a mess? Don’t accept McCain’s account that “both sides have let this happen.” The fact is, while Obamacare was passed with only Democratic votes, it was the work of a party that takes policy seriously, that openly debated every aspect of the Affordable Care Act for months before it passed, that allowed the bill to be scrutinized by the Congressional Budget Office, that held town halls and public hearings. Trumpcare, by contrast, is being jammed through what Vox’s Dylan Scott calls “an unprecedentedly opaque process” with “no final text” and “no Congressional Budget Office score.” If Republicans pass anything, it’ll most likely be a stripped-down version of earlier Senate proposals: the so-called “skinny repeal,” which would eliminate the individual and employer insurance mandates, and possibly end the medical-device tax.

In the event of a “skinny repeal,” explained The Intercept’s Ryan Grim and David Dayen, “the real action would occur in that House-Senate conference negotiation, where the leadership teams of both Republican caucuses would hash out the final bill.... And then the so-called moderates, with no chance to pass an amendment, would be told to vote for the bill out of party solidarity, to keep the seven-year promise of repealing Obamacare.” In other words, “skinny repeal” would mean that Senate Republicans were browbeaten into supporting a transformative bill without having any real input and without a sense of what the bill’s impact will be. In this scenario, Obamacare will be overturned in the worst possible way, with a backdoor deal between House Speaker Paul Ryan and Senate Majority Leader Mitch McConnell.

The prospect of something so dangerous as “skinny repeal” passing into law is a reminder that the real danger is not bipartisan polarization but rather asymmetric extremism on the part of the Republicans.

Ever since the Affordable Care Act became law, the GOP has promised to repeal and replace it when they returned to power. Killing Obamacare, through which 20 million Americans gained insurance, became the operating principle of the minority party. House Republicans, after winning the chamber in 2011, voted more than 50 times to that effect. Meanwhile, most Republican candidates for Congress and the White House, including Donald Trump, have campaigned on repealing the ACA. Few of them put forth their own comprehensive proposal for health care reform, which made them perfectly qualified to be elected GOP officials: Republicans in Congress had nearly the entirety of Barack Obama’s presidency to come up with an alternative, but never did.

The dishonesty of Republicans on health care and other issues, from voter fraud to abortion, allowed the party to be taken over by a shameless charlatan, an interloper who won the party’s nomination and presidency by promising voters the sky. Trump said he’d preserve popular social programs, make sure everyone has health coverage, and bring down insurance rates. When the Republicans unexpectedly found themselves in control of the whole federal government after the last election, they suddenly realized they had to make good on these impossible promises.

Trump’s incompetence and the GOP Congress’ infighting have led to a stalled government and a wholesale desperation for a victory of any kind. The president’s indifference to policy means he’ll accept any bill that can barrel through Congress, by hook or by crook, and Ryan and McConnell know they need to keep the “repeal and replace” promise or suffer the wrath of Republican voters in next year’s primaries (they’re also, of course, eager to cut healthcare spending to help finance tax cuts for the rich). The end result is that the Republican Party may well pass the most domestically destructive law the nation has seen in at least a generation—and with only a handful of people even knowing its contents before Trump signs it.

In the coming weeks, the Republicans may decide to deprive more than 20 million people of health insurance. That these Americans’ hopes rest on a couple of supposedly moderate GOP senators reveals the depth of rot in the Republican Party—and it is rotting more by the day.