There are currently 23 Republicans who are in districts that Hillary ClintonHillary Diane Rodham ClintonMcConnell: Taliban could take over Afghanistan by 'the end of the year' Hillary Clinton: There must be a 'global reckoning' with disinformation Pelosi's archbishop calls for Communion to be withheld from public figures supporting abortion rights MORE won in 2016. Of those, 14 of them very possibly signed their political death certificate yesterday, as they voted for the horrific abomination that is the Republican healthcare bill — or TrumpCare — which they and the president now fully own.

It is one thing to take a tough but principled vote on something you truly believe will help more people, like many Democrats did in 2010 as they all voted unanimously for the Affordable Care Act, but then went on to lose their seats.  It is another thing entirely, to put politics ahead of sound policy and vote for a bill that will actually endanger people’s lives, simply because you want to “check” off your list that you voted to repeal ObamaCare.  This is what the Republican Party did Thursday. And they should be hanging their heads in shame.


Republicans will spin like tops spewing talking points that unconvincingly try to insist that their bill will be better for American families. But if that were true, the bill would not be so "controversial" at least with Republicans, and you would have had every single Republican legislator vote for it. But when you have a bill that is adamantly opposed by AARP, every major patient advocacy group, the American Medical Association, the American Hospital Association, the American Academy of Pediatrics, and nurses, you should see a huge red flag.


Republicans voted on this with no new CBO score, making complete and foolish hypocrites out of themselves since many have blasted other legislation with no CBO score.  Ironically, the first version of TrumpCare that failed miserably actually had more protections in it, and even then it stripped away healthcare from 24 million people according to the CBO, and it increased deficits.

The TrumpCare bill that just passed presumably still takes away healthcare from 24 million people — if not more — and egregiously puts people with pre-existing conditions at huge risk because there is no full-on guarantee they will be covered.  Republicans and Donald TrumpDonald TrumpDemocrats, activists blast reported Trump DOJ effort to get journalists' phone records Arizona secretary of state gets security detail over death threats surrounding election audit Trump admin got phone records of WaPo reporters covering Russia probe: report MORE insist they will.  Trump goes further and insists there is a mandate in the bill that everyone with pre-existing conditions be covered.

There is not.

The now famed MacArthur amendment allows states to obtain a waiver so that they do not have to cover people with pre-existing conditions who have let their insurance lapse.  In order to get this waiver however, there needs to be a mechanism that will cover these Americans like high-risk pools.  Sounds good right?

Well it isn’t.  High risk pools have been tried before and the coverage can be prohibitive because it is so expensive.  To assuage nervous Republicans who did not want to be accused of hurting people with pre-existing conditions, a last-minute “sweetener” was added to help them swallow this bitter pill.  Now, there are $8 billion more dollars to fund the high-risk pools yet many healthcare experts say this is woefully inadequate.

So yes, Republicans can say people with pre-existing conditions will be covered.  But that will not be the case in real life.

There is a reason 20 Republicans did not vote for the TrumpCare death bill.  In addition to leaving people with pre-existing conditions out in the cold, this repulsive bill will defund Planned Parenthood, leaving millions more Americans who depend on Planned Parenthood clinics as their primary provider, without options.  TrumpCare also allows older Americans to be charged up to five times more than younger people, and it will allow states to opt out of covering “essential benefits” like pre-natal and maternity care (you hear that ladies?), and it will be ok for insurers to charge sick people more for coverage.

TrumpCare slashes Medicaid by $880 billion, likely drastically reducing benefits for its recipients.  States could also choose to receive a “block grant” that would likely result in a huge reduction of benefits for recipients and could also mean cutting school services for disabled children since schools rely on $4 billion in Medicaid money to support the needs of these kids.

And ironically, as TrumpCare puts sick, older and low-income Americans in danger, it gives massive tax cuts to wealthy Americans.

What is perhaps most astounding is the complete incompetence, ignorance, and worse, indifference that Mr. Trump has shown throughout this process.  He is on an obsessive mission to corral a “win” at all costs, even if it means that Americans will die in the process.  His massive ego is wounded from his huge losses in the first 100 days, he is smarting from the omnibus spending bill that was just passed with many Democratic priorities in it and very few of his, and he is out to prove that he is still a “winner.”

Trump has no clue what is in TrumpCare, musing to the Australian Prime Minister that they “have better healthcare than we do.”  Does he know Australia has socialized medicine and provides universal health care?  If he wants to work with Democrats on that, then bring it on Mr. Trump!

But he is just woefully un-interested in the details of governing or legislating.  And the exercise in TrumpCare these past few weeks have sadly betrayed a disdain with how any of it will have a real life impact on the well-being of Americans.

So Trump and Paul RyanPaul Davis RyanThe Hill's Morning Report - Presented by Emergent BioSolutions - Facebook upholds Trump ban; GOP leaders back Stefanik to replace Cheney Budowsky: Liz Cheney vs. conservatives in name only Cheney at donor retreat says Trump's actions 'a line that cannot be crossed': report MORE made Republicans take a politically perilous vote on a bill that will most likely not make it through the Senate anywhere near its current form.  In fact, passing it through the House was always the easy part.

They really should have thought twice about supporting a horrid and immoral bill that will put American lives at risk, repeal the Affordable Care Act which is more popular than Trump, and three times more popular than the members of Congress who voted for it.

Republicans should know that even if this version of TrumpCare doesn’t survive, those who voted for it will wear the scarlet “T” and will be targeted for a trouncing in the 2018 midterm elections.

Maria Cardona is a principal at the Dewey Square Group, a Democratic strategist and a CNN/CNN Español political commentator. Follower her on Twitter @MariaTCardona.

The views expressed by contributors are their own and are not the views of The Hill.