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The health care war’s ugly cultural underbelly

President Donald Trump discusses the failed attempt to

President Donald Trump discusses the failed attempt to replace and repeal the Affordable Care Act in the Roosevelt Room of the White House on July 18, 2017. Credit: EPA / Michael Reynolds

The fight that ground our governance to a halt was never just about health care. It was not only about expanding Medicaid or subsidizing policies for the poor or demanding that insurance actually insure people. It wasn’t about state exchanges, or coverage mandates or a system spiraling downward.

If the issue were really the Affordable Care Act, which at its core emerged from several Republican ideas, the vast majority of the nation, already getting coverage through employers or Medicare or Medicaid, would never have cared so much.

The battle the GOP started over Obamacare became a seven-year war of “us” against “them” over all manner of things, dividing people by color and ethnicity and religion, stopping the cultural elites, fighting to stop President Barack Obama, and battling for President Donald Trump. Repealing it was what Trump promised to do on Day One.

Now, with the breakdown of the GOP’s long-promised plan to repeal and replace Obamacare, the whole nasty scene is exposed.

The latest version of the GOP plan died Monday because of the ideological fault lines in the party. Two ultraconservative senators decided it was not mean enough to support. Several moderate GOP senators opposed it because it was unbearably harsh and would have cost tens of millions of people their coverage.

By Tuesday afternoon, the false promise that the Affordable Care Act could be repealed without passing a replacement was stillborn. That forced President Donald Trump to crow that he would just let the Affordable Care Act die on its own, deprive tens of millions of Americans of health care, and have the Democrats take the blame.

“I’m not going to own it,” Trump said. He does, and so do the Republicans. The latest polling shows that even among Trump voters and Republicans, it was a losing proposition.

However, the Senate, where 62 members represent the 31 states that took the Affordable Care Act’s Medicaid expansion, is not ending that expansion and taking away 14 million people’s coverage. Yet the Affordable Care Act really does have some problems. And the GOP really does have some good ideas about improving laws on health care.

Now the only way to make progress is by running the ball up the middle. The most conservative GOP members will not get the Obamacare killing they’d like. The most liberal Democrats will not get the single-payer universal health care they’d like. We’re not getting anywhere on any societal problem if we let the extreme wing of either party drive the process. This failure on health care is setting the table for failures to agree to a budget plan, rebuild this nation’s infrastructure, reform our tax code, protect our environment, improve our education system and create great jobs. This seven-year screaming match did not work under President Obama and will not work under President Trump.

Regardless of party, there is a majority of members in both houses of Congress that could find moderate solutions to health care and other problems. But that means focusing on policy, not politics. The latest culture war has ended with everyone losing. It’s time to call a truce, rebuild a bipartisan process and move forward.