A Vote of Conscience and Courage

This week, these senators will face a career-defining choice.

It is not an easy one for many of them. Republicans have spent years promising to repeal Obamacare. Now the Senate is nearing a decision on whether to do so. Opposing the bill risks marking any Republican as a traitor to the party.

By late Monday, enough Republicans were nonetheless expressing skepticism about the bill to put its success in serious doubt. Susan Collins of Maine, Rand Paul of Kentucky and Dean Heller of Nevada have all distanced themselves from the bill. But we’ve seen a version of this story before. House Republicans also expressed serious doubts — only to wilt after party leaders made superficial changes to the bill. The Senate bill remains alive until it’s dead.

In the meantime, I hope that each senator takes some time away from the daily swirl of Capitol Hill to think back to the reasons they entered politics. I hope they understand that this bill is a test of conscience and of courage.

A “yes” vote is still the politically easy vote for any Republican. But it is also a vote that will come back to haunt many senators when they reflect on their careers — and when more objective observers pass historical judgment on those careers.

There is little precedent for a bill like this one. That’s why Mitch McConnell kept it secret for as long as possible. Americans have often fought bitterly about how large our safety net should be and about the precise forms it should take. But once the country commits to a fundamentally more generous, decent safety net, it becomes an accepted part of society. Poverty, disease and misfortune that had been accepted as normal became rejected as cruel.

Once we stopped allowing 10-year-olds to work in factories and fields, we didn’t go back on it. Once we outlawed 80-hour workweeks at miserly pay, we didn’t reinstate them. Once we made health insurance and Social Security a universal part of old age, we didn’t repeal them.

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Senator Susan Collins of Maine, a Republican, after a vote on Capitol Hill this month.

Credit
Al Drago for The New York Times

The Senate health care bill would be a reversal on that scale.

Yes, Obamacare is flawed, and it needs to be improved. But the Senate bill would not fix those flaws. It would instead take away health insurance from millions of Americans — middle class and poor, disabled and sick, young and old — largely to finance tax cuts for the wealthy. Ultimately, the bill would lead many Americans to lose medical care on which they now depend.

I hope the senators will listen to some of these people’s stories. The most affecting that I’ve read recently is about Justin Martin, who has overcome cerebral palsy to become a thriving student at Kenyon College. As the HuffPost’s Jonathan Cohn reported, Martin depends on Medicaid to pay for a wheelchair that helps him get around and for health care aides who help him in the bathroom.

When history comes to judge today’s senators, do they want to have made life harder on Justin Martin?

I hope the senators will also take the time to ask themselves why virtually no health care expert supports the bill. Conservative health care experts have blasted it, along with liberal and moderate experts. The Congressional Budget Office says it will do terrible damage. Groups representing doctors, nurses, hospitals and retirees oppose the bill. So do advocates for the treatment of cancer, heart disease, lung disease, multiple sclerosis, cystic fibrosis and, yes, cerebral palsy.

I hope the senators will watch a two-minute video created by doctors around the country. In it, each one looks into the camera and explains how the bill would damage medical care. “This bill would dramatically affect my patients,” said Dr. Gregory Lam of Circleville, Ohio, “and my ability to care for them.”

I hope the senators grasp the weight of the decision they face, for the country and for themselves.

It takes only three Republican senators to prevent millions of their fellow citizens from being harmed. Which of them has the courage to make the right choice over the easy one?

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