See now why Rand Paul was trying yesterday to slow this process down, even if it required a silly stunt to do so? A year ago, fiscal conservatives in Congress would have had no difficulty stoking suspicions among the base that Ryan’s plan to fix ObamaCare involved a whole new entitlement program in the guise of “reform.” A year later, with Trump seemingly behind the Ryan plan, all of that grassroots leverage is gone. To mobilize any significant chunk of the right against a Trump/Ryan proposal, Paul and his allies need time.
And soon time will be up.
At a closed-door meeting with Republicans on Thursday, Speaker Paul Ryan said he plans for the House to hold a vote on the leadership’s Obamacare alternative in three weeks, sources in the room told POLITICO. The White House and the Senate support the House GOP leadership’s effort, Ryan added — comments many in the room took as a warning for the far right to get in line…
“We’re all working off the same piece of paper, the same plan,” Ryan said at a Thursday news conference when asked about conservative opposition. “We are in sync — the House, the Senate and the Trump administration, because this law is collapsing.”…
Privately, senior Republican lawmakers and staff are more blunt. They say they have no problem steamrolling conservatives by daring them to vote against an Obamacare repeal that their constituents have demanded for years.
“Conservatives are going to be in a box,” said one senior Republican lawmaker. Trump, the source predicted, eventually will “go out front and … tell the conservatives … they’re either for this or for keeping Obamacare.”
Yup, that’s what the Journal reported a week ago. The strategy in Congress right now to build Republican consensus is to … admit that there isn’t Republican consensus and then to have the leadership slap a bill on the table and dare dissenters to vote against it. No one’s afraid of defying Ryan but everyone’s afraid of defying Trump, which is why Ryan is emphasizing that he and the White House are “in sync.” Not just rhetorically, either: Mike Pence is in Wisconsin today to show White House solidarity with Ryan at an event to promote the coming health-care reform and Trump’s HHS chief Tom Price has been meeting with conservative dissenters like Rand Paul and Mark Meadows to try to sell them on the new plan. Whether it’s true that Trump is fully onboard or not, though, is known only to Trump — and his opinions on this subject have been known to shift. That may be weighing on Paul’s mind too. If he can get a chunk of grassroots Republicans upset about the Ryan bill, then in theory Trump might react by shifting towards a more conservative position himself. This isn’t ObamaCare, after all, where the president was the loudest, most committed supporter. This is RyanCare or PriceCare, if you prefer, with Trump expected to take the hand-off from them and then sell it, whether he backs it root, stem, and branch or not.
Can a bill that calls for subsidizing insurance via refundable tax credits, available even to those who don’t pay federal income tax, make it through a Republican House and Senate, though? The House leadership is probably right that they can steamroll the Freedom Caucus. House members face the voters every two years in small elections where they’re vulnerable to a grassroots backlash; if Meadows drums up 30 votes against the bill and Trump turns around and calls for primarying the Freedom Caucus holdouts, they’ve got a problem politically. The Senate is a different animal, and right now there’s a math problem in the Senate. A few days ago, Paul, Mike Lee, and Ted Cruz each tweeted a statement that they’d vote no on any bill that doesn’t go as far as the 2015 ObamaCare repeal bill, and that one went pretty far — ending the mandate and the law’s Medicaid expansion and phasing out subsidies. We’ll see what Ryan comes up with, but if the three of them are serious about that, McConnell will start in the Senate with … 49 votes, with more defections possible on other grounds from centrists like Lisa Murkowski and Susan Collins. Even worse for McConnell and Trump, Lee and Paul are freshly reelected. They won’t have to worry about facing voters again until 2022, which means they’re as free as can be to vote no on repeal if they like. (Cruz is up for reelection next year and isn’t about to thwart ObamaCare repeal against Trump’s wishes, so he’ll probably cave.) All of that being so, does Ryan end up caving and replacing the refundable tax credits that are (probably) in the new bill with non-refundable ones, available only to people who’ve paid some federal income tax? And if he does that, does McConnell suddenly lose Murkowski and Collins?
Here’s what Paul is up against in trying to engineer a revolt of the base against a Trump/Ryan plan on grounds that it’s not conservative enough:
Perceptions that Trump is conservative are rising on the right, and among Republicans generally who watched his not-very-fiscally-conservative speech on Tuesday night, 91 percent felt “very positive” about what they heard. On top of that, Trump himself has famously said that maximizing coverage, not just access to coverage, is important to him in reforming health insurance, although he did seem to back away from that a bit on Tuesday night. How would he react to Paul’s idea to replace refundable tax credits with non-refundable ones once he realizes that that’ll mean fewer people will be able to afford private insurance? And once Trump reacts badly to it, how will the pro-Trump Republican base react? Paul’s not going to win this PR war if — if — Trump really does end up on Ryan’s side here. Which means if he’s planning to vote no because of the tax-credits issue, he’ll have to do it as a matter of principle, not because the grassroots is clamoring for someone to stand up to the RINOs in D.C.
Here he is this week on Fox Business talking about “ObamaCare Lite.” He’s still looking for the House bill inside the Capitol, by the way.