Before he crafted a bill to dramatically overhaul the health care system in American, Senate Majority Leader Mitch McConnell (R-Ky.) wrote a memoir in which he sharply criticized the way that President Barack Obama went about shaping and passing his own health care reform.

Those criticisms were unremarkable at the time ― the type of rhetorical pablum that conservatives often used to denounce the Affordable Care Act. But with McConnell now pushing through his own version of reform, they could create complications for him. Some of the same legislative processes that McConnell framed as anti-American, he is currently deploying.

Titled “The Long Game,” the 2016 memoir takes aim at Obamacare from a variety of fronts. But chief among McConnell’s complaints is Obama’s failure to find Republican support for the Affordable Care Act and the fast pace with which the bill was pushed through the Senate.

The first criticism is misleading, as McConnell makes clear it was his primary objective to ensure that Obama got no Republican votes even as he acknowledges that the White House did try. “I didn’t want a single Republican to vote for it. It had to be very obvious to the voters which party was responsible for this terrible policy, and I wanted a clear line of demarcation ― they were for this, and we were against it,” he wrote.

That McConnell succeeded in keeping Republicans at bay was used as proof that Obama’s chief legislative mission was doomed to failure. At one point in his memoir, McConnell imagines what he would have done had he been in charge and there was no bipartisan appetite for his own reform bill. And he concludes he would have done things quite differently. 

 I might have paused at this moment to consider what this meant. I might even have taken a look at the vote tallies of some of the most far-reaching legislation of the past century. Medicare and Medicaid were both approved with the support of about half the members of the minority. The Voting Rights Act of 1965 passed with the votes of thirty out of thirty-two members of the Republican minority ― all but two. Only six senators voted against the Social Security Act. And only eight voted against the Americans with Disabilities Act. In no case had those votes happened by throwing these bills together in a back room and dropping them on the floor with a stopwatch running. It happened through a laborious process of legislating, persuasion, and coalition-building. It took time and patience and hard work, and it guaranteed that every one of these laws had stability. So maybe we needed to rethink what the future was going to hold for a bill of this magnitude to be enacted with literally no support whatsoever from the minority party. The mess to come was inevitable. Anyone with a sense of the long term could see that. But Democrats plowed forward anyway.

McConnell is now in charge. And he’s not doing things differently at all. He has introduced an Obamacare repeal and replace bill that will end up with no bipartisan support. He will likely hold a vote on it without a single hearing. And that vote will come in a matter of days, even though, in his memoir, he said lambasted then Majority Leader Harry Reid (D-Nev.) for rushing Obamacare through the Senate chamber.

″[T]he whole thing started to feel absurd. One of the most major and far-reaching pieces of legislation in decades and this is how they wanted to approach it?” he wrote.

Asked if McConnell had a change of heart about the process surrounding Obamacare’s passage ― whether his criticisms were insincere ― a spokesman for the senator said he did not.  

“A change of heart about undoing the law that was passed that way? No, he still wants to undo it,” said Don Stewart. “We’re taking up legislation this week to undo it.”

And so they are. But the McConnell who wrote “The Long Game” may have still some quibbles with the McConnell now shepherding the repeal bill through the Senate. And if not quibbles, then some warnings. As he wrote at the time ― and as the passage of the ACA showed ― there are immense political risks when tackling big legislative projects in a polarized environment.

“Americans believe that on issues of great importance, one party shouldn’t be allowed to force its will on everyone else,” McConnell wrote. “Yet that’s exactly what the Democrats did, and for his part in it, Obama squandered a great deal of political capital.”

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