Blame and Spin. The GOP will try to pin the tail on the donkey.

Both Republicans and Democrats assert that they are looking out for the health of the public.

As Thad Guyer points out in the long comment below, Republicans have some real assets here.   Paul Ryan is out there talking and spinning.  Fox News has its talking points.  Rank and file Republican Members of Congress generally have the story down.  The wayward ones say healthcare is a privilege to pay for, or that emergency rooms provide perfectly good health care, or that "no one dies" from not having health care.

Off message.

But most Republicans are on message:   Obamacare is in a death spiral.  Insurance companies were abandoning the market.  It was too expensive.  It was unfair to young and healthy people. The insurance high risk pools will solve the pre-existing conditions problem. The states will have flexibility to make the Medicaid decision.  I am watching this get sold right now.   

Guyer might be right, but I am going to argue the opposite point. 

I will cite four reasons why I think Democrats will come out winners in this battle of blame and spin:

   1.  Trumpcare imbeds a lie that is easily refuted.  An undeniable consequence of Trumpcare is the reduction of taxes on prosperous American.  There is way, way less money raised--and spent.  Trumpcare is in fact less care, not more, but they are selling "more and better."   As Guyer notes, most members of the GOP, including Trump, just don't have it in them to try to sell the moral or financial value of people sick from chronic underrated disease.  In fact it is less care and by arguing it is more care they set the standard.  

Fox News celebrates the tax cuts

  2.  The states won't take this lying down.   The premise of the GOP sales job now, and the final words in Guyer's comment below, is that the GOP will successfully have washed their hands and the states will take the blame for people being pushed off Medicaid.  States will have "flexibility", sure, the flexibility to try to manage with most of $800 billion fewer dollars.  Governors are politicians.  They have ambitions.  They want to pass the blame just like the GOP.  Possibly a few red state governors will attempt to push thrift as a virtue and the value of real life incentives to get people to work harder so they can afford health care, but there will be examples of people pushed off Medicaid that will be politically toxic.  Most states will pass the blame right back. 

3.  Democrats have their story down.   The problem with Trumpcare is that it is less.  Less money.  Fewer people getting Medicaid.  Less help for pre-existing conditions.  They will not be at cross purposes with themselves and they will have the CBO and multiple individual instances to buttress their case.

4.  Trump.   Trump insists on taking credit.  Trump can sell but Trump has a self-destructive need to brand things.  Trump wants credit for Trumpcare; he wants to own it.  The GOP would love to hide behind "Obamacare was failing anyway" which would be a winning strategy, but Trump won't tolerate it.  He is the alpha male dog and he wants to pee on the fire hydrant, higher and stronger than Obama.  The GOP will own Trumpcare, with all its exceptions and problems, and hassles.

But Thad Guyer has been proven right many times.   Hear him out:

The Bipartisan Power of Political Bigotry"

UpClose hit the nail on the head: “I’ve got mine”. Moreover, Obama and Democrats sold the ACA on a broad principle of "affordable healthcare for all". The focus was never free or heavily subsidized insurance. Instead the ACA emphasis was on the middle class, small businesses owners, or those employed by small companies couldn't get affordable insurance. The ACA key word is "affordable”, and a focus on helping those who could pay "their fare share", not those who couldn't. The Medicaid component was for those who earned too much or who had no kids, i.e. the "working poor". While there are pockets of exceptions, the overwhelming majority of the poor and working poor don't vote Republican; they vote Democrat or they don’t vote at all.  

Republican Congressional candidates, like Greg Walden are fully aware of this, they just can't talk political bigotry in public: "Who cares about the Obamacare needy, a group that doesn’t vote Republican anyway". Political bigotry is not illegal, just shameful, and indeed just as vicious on the left ("deplorables") as on the right (“takers”). Individual economic interests almost always predominate over altruism. The ACA barely passed the 2010 Democratic Congress and got the final Democratic votes through crass and overt political payoffs to endangered Democrats, many of whom went on to lose their seats. Obamacare killed the Democrats because of big tax dollars and federal control (“death panels” and “bureaucrats not doctors” making your medical decisions). The young (a Democratic constituency) had to be forced by penalties to buy insurance; they weren't going to do it for altruism.

Obamacare made big promises it could not deliver. Keep your doctor, keep your present insurance, easy signup, insurance rates and thus health care costs and taxes will go down. Republicans were right in predicting these promises were too good to be true. The promise of coverage for your kids until age 26 was an easy one to keep—i.e., insure the healthiest demographic. But even Democrats would not have enacted the ACA had it been named the "Medicaid Expansion Act" or the "Federal Insurance for the Working Poor Act". 
 
Few Republicans will lose a seat for voting for the House Bill. It's just a bill, not a law, and if you read the WSJ or centrist analyses, it is far more defensible than Democrats claim. Repeal was never on the table for Trump and establishment Republicans. They did not threaten to kill it, but only to replace it with fewer mandates, less taxes and state control. The super majority of Republicans will keep their insurance with whatever the Republican Senate passes. 

Political bigotry will hold true to form: Republicans may lose a few votes by cutting out the poor and working poor; and they may lose a few by making insurance prohibitively expensive for the chronically ill and pre-existing conditions sufferers. Republicans will pick up some young and healthy independents who loved Sanders’ trashing of the ACA and demands for a single payor system. But Sanders people have little appetite for more half-measures they must be forced to buy.

The bottom line is that those who will be really hurt by Trumpcare are statistically few, politically inactive, disenfranchised, or just plain Democrats. For the few Republican voters who will be hurt, effective political spin is built into Trumpcare-- "Republicans gave the states the power to run the exchanges, to expand Medicaid with state money, and to create subsidized risk pools for pre-existing conditions-- if they want to. Blame them if they don’t." 

But the silent message of political bigotry is easily heard: Let the Democrats eat cake.