Moderate mini-drama: It’s time for a little game theory on AHCA

Prediction: There will be some AHCA mini-drama with a key moderate who hesitates or refuses to sign on. The purpose of the mini-drama is to elevate that person to a key role. That moderate will extract some shiny-object concession such as a showy opioid treatment fund or ornamental consideration for medically-fragile children that don’t address the core difficulties of AHCA.

The strategic function of the mini-drama is threefold: (1) to make AHCA look slightly less hideous-ideally with a maximum of conservative grumbling-without actually fixing its deeper problems, which will remain in the final Senate version; (2) to help McConnell and the moderates quickly coordinate their bargaining, and (3) to provide a dignified political path for moderates to sign onto a bill they publicly criticized when the House passed something very similar barely a month ago.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

11 thoughts on “Moderate mini-drama: It’s time for a little game theory on AHCA”

  1. Further prediction: the "concession", if it has any effect whatsoever, will be removed in conference.

  2. I think it was Harry Reid who said of Republican "moderates," "They are always there when you don't need them."

    1. I believe this was said specifically with respect to the late Arlen Specter

  3. McConnell is also counting on outrage fatigue. It's less bad than AHCA, maybe people won't take to the streets.

    My uninformed guess is that he will get away with this and Trump will sign something close to the Senate bill into law. But the victory will be Pyrrhic. Delaying the Medicaid cuts won't make those who will lose coverage any less fearful and angry. Trump and McConnell have turned Chuck Schumer, an archetypal backroom wheeler-dealer, into an implacable opponent. There are millions of Schumers out there now. What do Democrats stand for? Repealing Turtlecare.

    1. I have a great deal of difficulty understanding how McConnell's thinking works, but I suspect that he is counting on a certain tribalism among American voters. He is after all from Kentucky, a state that by a very substantial margin elected as governor a man who had campaigned on eliminating the very popular healthcare system, Kynect. One must always be cautious of what shows up in the news, but it does appear that an awful lot of the people who stood to lose their healthcare thought Gov. Bevin wouldn't actually carry through, or that it wouldn't affect them. There's an awful lot of willful blindness involved-the sort of mentality one sees in a 15-year-old who is trying to decide whether he really wants to wear a helmet for his very first try at skateboarding a halfpipe.

      There's also the fact that pushing the actual cuts down the road gets people used to the idea. "That's old news" is one of the most effective dismissive phrases one can use on an American.

      I think, however, that the Democrats need to get serious about their messaging. Phrasing is important. "Trumpcare" works since Trump will hate the idea of his name being on something that unpopular. "McConnellcare" attaches it to someone who lends himself to looking like a villain. I'd also like to see Democrats try a phrase like "the kick-you-to-the-curb approach to healthcare."

      Point about Schumer very well taken. Good to see him taking a strong public stand.

      1. The "old news" line will work fine on the hapless bothsideserist respectable American media. I beg to disagree on the losers from Trumpcare (I still like my Turtlecare, but it's not going to catch on). You will lose Medicaid five years ahead .. four years … three years … Mind you, the Democrats will spend a lot of energy quarrelling over the best language with which to attack the bill: mean (Obama, Schumer) or murderous (Sanders, Clinton).

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