Senator Joe Manchin (D-WV) is in a horrendous political position of dead incumbent walking. He is a Democrat in West Virginia with an election coming up in 2018. West Virgnia has steadily been going Republican for a generation and it went heavily for Trump in 2016. It is also heavily dependent on Medicaid and the Exchanges because it is a state with a lot of very poor people in it with high health needs.
Earlier this month, Senator Manchin made his comments on the ACA:
Instead of repealing the Affordable Care Act, Congress should work together to fix the parts of the law that don’t work, Sen. Joe Manchin, D-W.Va., told reporters Wednesday.
Manchin said Congress should work on the law “piece by piece,” instead of repealing the entire thing….
This is straight out of the Mend don’t End messaging playbook and I think this also works with a general Democratic defense of the law. LGM has a good preview:
As with all other issues, the default position of the Democratic caucus should be “no.” Make it clear that there will be no initial negotiations on a replacement plan. Hope that the tensions within the Republican caucus either cause the effort to collapse on itself, or results in repeal-and-replace. The longer this drags out, the better the chances of preserving the ACA. Obstruct. Delay. Vote no.
If the Republicans were to offer cosmetic changes to the ACA — slightly less generous subsidies and more rentier skimming for Medicaid, say, but preserving the basic structure of the ACA and making it worse in ways that could be fairly easily fixed by the next Democratic Congress — this would be one of the few instances in which the bad politics of collaborating with Republicans would be substantively beneficial enough to be worth it. But I think this will be a moot point. This would be the smart political play for Republicans, and I suspect McConnell would go along — but I don’t think Ryan will.
The ACA needs a technical correction bill. If Manchin is on board with cosmetic changes that make the bill slightly worse (Copper plan for instance) while getting a host of technical corrections in place (family glitch is the big one) at the trade-off of more Health Savings Account tax breaks, that would be great. I don’t know if that is where Manchin wants to go. But if the most vulnerable Democratic incumbent is on the Repair rather than Repeal kicker, this is good news for caucus unity.