A Primetime Clash Over Health Care

Ordinarily, you debate to stave off defeat. But for Senators Lindsey Graham and Bill Cassidy on Monday night, the defeat came first.

By the time the two GOP senators stepped on CNN’s stage Monday night for a prime-time debate over their health-care proposal, they knew they had already lost.

A few hours earlier, Senator Susan Collins became the third Republican to formally reject the pair’s legislation to repeal and replace the Affordable Care Act, effectively killing its chances for passage through the Senate this week. Graham and Cassidy had hoped to use the forum to make a closing argument for their plan, and to line it up against Senator Bernie Sanders and his call for a single-payer, “Medicare-for-All” health-care system. Instead, the two senators found themselves defending a proposal that was no less hypothetical—and probably much less popular—than Sanders’s supposed liberal fantasy.

“We’re going to press on,” Graham said about his and Cassidy’s proposal, offering none of the optimism they had in recent days about its prospects. The South Carolinian said it was “okay to vote” on the plan even if it fell short, a signal that he hoped Senate Majority Leader Mitch McConnell would not abandon plans to bring it up for debate.

Graham and Cassidy dutifully defended their bill against attacks from Sanders and Senator Amy Klobuchar of Minnesota, arguing that its cuts to Medicaid put the program on a sustainable trajectory and that governors could be trusted to offer consumer protections that would no longer be federally guaranteed. “I trust governors,” Cassidy told a questioner during the town-hall format who asked about the bill’s provision allowing states the opt out of requiring insurers to charge the same rates to people with preexisting conditions. “I actually think that governors respond to the people that elected them. If they don’t, they don’t win next time,” Cassidy said.

It was Sanders, however, who took full advantage of the national audience to articulate a position on health care that was more nuanced than his critics—both Democrats and Republicans—often attribute to him. Some Democrats had feared the Vermont independent would allow Graham to goad him into a debate over single payer when the party needed him to focus on defeating the Republican repeal bill.

But Sanders appeared more agile than he did during some of his presidential primary debates with Hillary Clinton last year. He assailed the Graham-Cassidy while defending the strengths of Obamacare and talking up consensus Democratic proposals, including a gradual expansion of Medicare, a public-insurance option, and allowing Medicare to negotiate drug prices with pharmaceutical companies.

“The truth of the matter is the Affordable Care Act has done some very important things,” Sanders said. “Let’s not throw the baby out with the bathwater.” Echoing the Democratic Party line, he urged Republicans to “work together and improve the Affordable Care Act, not repeal it.” Sanders made a distinction between the “short-term” goal of improving the current system and his longer-term goal of Medicare-for-All, which he acknowledged had no chance of passing while the Republicans controlled Congress.

Graham and Cassidy appeared frustrated at times by his restraint. “Bernie is the most honest person in the Senate, because he believes in government-run health care from cradle to grave,” Graham said. The tone of the debate remained cordial throughout, with the senators often referring to each other by their first names. The four even tip-toed toward consensus at points, as Graham and Sanders laughingly agreed that insurance companies were making out too well under Obamacare, and Sanders and Cassidy agreed on the need to control drug prices. But once the senators began to dig a little deeper, the agreement quickly faded. When Sanders tried to get Cassidy to commit to backing his bill on allowing negotiated drug prices, the Louisiana Republican ignored him and called him “a socialist” instead.

Graham appeared deflated at the outset of the debate, but he mustered an emotional defense of his close friend Senator John McCain, who has come under heavy criticism from President Trump for opposing the last two GOP repeal efforts. “John McCain was willing to die for this country, and he can vote however he wants to,” Graham said after CNN’s Jake Tapper read an angry tweet Trump sent during the middle of the debate.

Klobuchar, who is one of more than a dozen Democrats discussed as possible presidential contenders in 2020, used the opportunity to introduce herself and to implore Republicans to return to bipartisan talks on fixes for Obamacare. Graham, however, was having none of it. “It’s not working, and it’s never going to work,” he said of the law. “I don’t see a solution other than just throwing money at insurance companies. I’m not going to do it. Do you hear me?” he added later.

Graham’s comments fit a theme for the 90-minute debate: As the Democrats tried to entice the Republicans with talk of negotiations and consensus, the Republicans recoiled toward repeal. Graham and Cassidy may reluctantly recognize their own plan is dead, but with the defeat still fresh, they weren’t ready to move on yet, either.