I’ve got a bad feeling about this. Silver lining, though: If the GOP chokes, we’re mere weeks away from the first major third-party effort in decades.
They’ve had seven years to forge a consensus on the Hill on what a Republican replacement plan should look like, including five months since they claimed total control of government. And the strategy right now, as we roll on towards March, is to put a bill on the floor and basically dare Republican critics to vote no.
Republican leaders are betting that the only way for Congress to repeal the Affordable Care Act is to set a bill in motion and gamble that fellow GOP lawmakers won’t dare to block it…
Advocates of the strategy hope that knife’s-edge math will be an asset rather than a liability. They are betting different groups of Republican lawmakers can be pacified with a handful of concessions, then will swallow hard and vote for a longstanding repeal pledge, first in the House, then in the Senate.
“You’re a Republican, you’ve been running to repeal Obamacare, they put a repeal bill in front of you… Are you going to be the Republican senator who prevents Obamacare repeal from being sent to a Republican president who is willing to sign it?” said Doug Badger, a longtime Republican leadership health policy adviser…
“The president’s going to be very pivotal in this,” said Rep. Dennis Ross (R., Fla.), a member of the House GOP whip team, which is charged with rounding up votes. “He’s got to go into these districts and give air cover to these members who are weak-kneed on some of these issues.”
A meeting Friday afternoon between President Trump and Ohio Gov. John Kasich, his former rival in the GOP primaries, had no set agenda. But Kasich came armed with one anyway: his hope to blunt drastic changes to the nation’s health-care system envisioned by some conservatives in Washington.
Over the next 45 minutes, according to Kasich and others briefed on the session, the governor made his pitch while the president eagerly called in several top aides and then got Health and Human Services Secretary Tom Price on the phone. At one point, senior adviser Jared Kushner reminded his father-in-law that House Republicans are sketching out a different approach to providing access to coverage. “Well, I like this better,” Trump replied, according to a Kasich adviser.
Kasich, remember, doesn’t support full repeal. He wants to scale back some of the benefits from ObamaCare and lower the income threshold for Medicaid eligibility under certain circumstances, but he’s nervous about any replacement that would lead to fewer people getting coverage. How’s Trump going to lead the charge publicly for the House plan if it’s not even the plan he prefers?
All it would take in the Senate is Collins, Murkowski, and one other Republican to defect and the party would be stuck. And there’s good reason to worry about that, notwithstanding the immense pressure on skittish GOPers to vote with their party once a bill hits the floor: Support for ObamaCare is climbing in some polls as the public contemplates the consequences of repeal; meanwhile, Trump’s approval, though not as dire as the worst polls suggests, is lukewarm. If you’re Collins, why not show the voters back home in your purple state how independent you are by holding out on repeal unless certain changes to the GOP plan are made? Remember, she and Bill Cassidy of Louisiana have introduced a bill that would essentially let blue states keep ObamaCare in place. If they hold out together for concessions on that point and Murkowski joins them, that’s all it would take to either stop repeal or force McConnell to find a Democratic vote somewhere. And that’ll be hard to come by, even from a red-stater like Joe Manchin, given the equally immense pressure from the left on Democrats to try to defeat the repeal effort at all costs.
And that’s just the Senate. In the House, the Freedom Caucus has vowed to oppose any repeal bill that doesn’t go at least as far as the 2015 bill vetoed by Obama — and that bill went pretty far, repealing the individual (and employer) mandate and phasing out subsidies over two years. A CBO score of the bill estimated that 18 million people would have lost coverage in the first year had it become law, a number that would obviously be vastly reduced once a GOP replacement system was implemented but maybe not reduced enough to please Trump, Kasich, and Collins. The Freedom Caucus easily has enough votes to defeat a repeal bill in the House if they vote as a bloc, though, which means that a bill that pleases Collins may be doomed in the other chamber. As usual with Republicans, they’re trying to thread a needle between moderates and conservatives. That hasn’t worked out so well in the context of immigration. It had better work out here, and soon.
Here’s the president discussing ObamaCare this morning and marveling at how complicated health-care reform is. Er, yeah.
TRUMP: “Nobody knew that health care could be so complicated.” https://t.co/LFr422VHbq
— Bradd Jaffy (@BraddJaffy) February 27, 2017