EDITORIAL: Now that Cassidy’s healthcare bill is dead, it’s on the Democrats to make the next move

Oct. 01--The health care bill is dead. Now, Democrats, you're on.

Senate Republicans, not for the first time, could not agree last week on the vexing subject of "repeal and replace" of the Affordable Care Act, or "Obamacare."

The last-ditch effort for repeal was one led in large part by a relatively junior senator, Bill Cassidy, of Louisiana, who proposed a far-reaching but inevitably somewhat confusing concept of devolving Medicaid and other popular programs to the states.

It became a tangle, not because of bad intentions from Cassidy or co-authors like the respected Lindsey Graham, of South Carolina, but from the sheer complexity of the American health care system -- changed in some ways by Obamacare, but still based on the interactions of so many actors: patients and doctors and hospitals and insurers and governments at the federal and state level. It's not one-sixth of the American economy for nothing.

Taking away, or simply seeming to endanger, the coverage gains under Obamacare is clearly a nonstarter politically. That couldn't get the GOP majority in the Senate to go along. But baked in the big Obamacare cake are costs, taxes and other moving parts -- particularly, high deductibles and premiums that are crippling for middle-class families. More than 40 percent of counties or parishes in the U.S. are down to single insurance provider, Cassidy pointed out Tuesday.

If Cassidycare did not make it -- and it didn't even come to a vote -- what comes next?

That's where Democrats come in.

Acting on Napoleon's dictum, don't interfere with the enemy destroying himself, they committed in a bloc to oppose the Republican repeal bills. That had the political result they desired, as only a few GOP defectors could stop any bill. Cassidy has all along expressed his frustration with Democrats' stand.

And in fairness, Democrats have been working with the GOP's Lamar Alexander, of Tennessee, on a bill yet to emerge from Alexander's health committee that would deal with some of Obamacare's problems. Under Senate rules, Cassidy noted earlier this summer, those provisions could not be part of his own bill.

Alexander, and Cassidy, earlier demonstrated their willingness to work outside party lines on the mental health issues in health care. Why not make that a model for a fix to problems with Obamacare?

It won't be the comprehensive "repeal and replace" that folks like Cassidy campaigned for. But for anything at all to pass the Senate, as the GOP's troubles lately demonstrate, Democrats must come to the table willing to give on some of their ideas.

The embrace of some form of national health insurance or "Medicare for all" by some Democrats is certainly a nonstarter politically at this time. A government that can't balance its books should hardly be expanding entitlements. If Democrats want to use health care as a club, while frustrations with Obamacare's problems grow in middle-class households across America, such an impractical ideological stand won't get any bill passed.

For political reasons, maybe, Obamacare amended still may not be palatable to Republicans, but if Democrats misplay their hand, specific relief to American families is endangered.

Democrats, you're on.

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