On July 13, the Senate Republican leadership announced its revised proposal to “repeal and replace” the Affordable Care Act (ACA). The new plan tweaked the first two Republican health-care-overhaul bills but retained their substantial cuts to Medicaid funding and to the already-meager subsidies ACA gave low-income workers to help defray the costs of private health-care plans.

Luckily, it now appears that the Senate will not pass even this version of the bill. To explain why, the media has focused on divisions within the Republican Party, in particular between the remnants of the libertarian Tea Party and the more mainstream congresspeople facing tough reelection campaigns. The Republicans’ failure, however, also reflects the deep division within the American capitalist class over federal health-care policy.

On one side, the Chamber of Commerce supports Mitch McConnell’s new bill, arguing that it will repeal taxes and mandates on employers, give employers greater flexibility in reshaping employment-based health insurance, and lower the cost of individual insurance policies by granting state governments greater autonomy. However, organizations representing hospitals and health insurers continue to defend the ACA, which provides them with huge tax subsidies. Both the Coalition to Protect America’s Health Care, an organization consisting of the largest hospital chains, and American Health Insurance Plans, the insurance industry’s main lobby, have condemned the Republican bill.