Around this time eight years ago, House Republicans had already passed a right-wing heath care bill intended to “repeal and replace” the Affordable Care Act, but Senate Republicans were struggling to keep their members in line. Alaska’s Lisa Murkowski, in particular, said she simply couldn’t get on board.

To win her over, GOP leaders came up with a variety of ideas intended to help Alaskans so they wouldn’t feel the punishments that Republicans were eager to impose on the rest of the country. The proposed carve-outs and schemes were even given memorable, albeit unflattering, nicknames: “Alaska Purchase,” “Klondike Kickback” and, my personal favorite, “Polar Payoff.”

The core of the party’s offer was simple: If Murkowski let Republicans repeal Obamacare, GOP leaders would agree to let Alaska keep Obamacare.

It didn’t work. Murkowski remained unconvinced, and she ultimately helped derail the gambit and rescue the country’s health care system......

This time, however, it did work. NBC News reported:

[Murkowski], who had expressed concerns throughout the process about the bill’s cuts to social safety net programs, was a key vote for Senate Majority Leader John Thune, R-S.D., to win over. ‘I struggled mightily with the impact on the most vulnerable in this country, when you look to Medicaid and SNAP,’ Murkowski told reporters after the vote, adding that she didn’t get ‘everything’ she wanted but ‘I had to look on balance.’

Even more striking, however, was something the Alaska Republican said after the dust settled on the dramatic vote: Murkowski said she hopes House Republicans make changes to the Senate’s version of the bill......

But that’s a difficult position to take seriously. For one thing, if she’d joined the bipartisan minority that opposed this bill, it wouldn’t have “killed” the legislation; it would’ve opened the door to a new round of negotiations in the Senate — where Murkowski could’ve exercised enormous influence. By giving up her leverage, she’s apparently hoping to see House members do the work she could’ve been involved in directly.

For another, Republican leaders fundamentally disagree with her entire vision of the process. Murkowski apparently believes it’ll be up to the House to “recognize that we’re not there yet,” but as far as the White House and GOP leaders are concerned, the negotiations are over. There’s nothing left to talk about. The bill is done. The House’s job is to approve it, as is, quickly and with as little fuss as possible.

If, as expected, House Republicans do as they’re told and approve the Senate version of the bill without changes, it means Murkowski will have made it possible to implement the most regressive piece of legislation in modern history — a bill she admits remains flawed and in need of changes — and that will further mean that she bears responsibility for the consequences the package imposes on the nation.