Senate sounds ready to gut new House health-care bill -- if it passes the House at all

Doesn’t really matter. This is a game of hot potato at this point. The Freedom Caucus took the blame, fairly or not, for tanking the original House health-care bill last month. Now they’ve hatched an amendment that makes the bill more palatable to conservatives, letting states waive the federal mandates for Essential Health Benefits and community rating subject to certain conditions, but which does little to make it more appealing to Republican moderates. The stuff that would make it more palatable to them, like rolling back planned cuts to Medicaid, isn’t in the new version and would only spook House conservatives all over again if it were. In fact, if anything, because it gives states the power to let insurers charge people with preexisting conditions higher premiums under some circumstances, the new bill is arguably a heavier lift for moderates than the original bill was. (And possibly will prove even less appealing to voters.) But from the conservative point of view, that’s okay. The Freedom Caucus amendment achieves its core goal of flipping the hot potato from the right over to the moderates, who’ll now take the blame among Trump’s base if they vote no and the bill fails and will take the blame from everyone else if they vote yes and it passes.

If they end up signing off, it’ll only toss the hot potato to a third player — the Senate. And guess what? They’re already preparing to toss it right back:

“The Freedom Caucus has done a good job of trying to make the bill less bad,” Sen. Rand Paul (R-Ky.), one of the lead Senate agitators against the House health care push, said Wednesday. “For me, it’s a big stumbling block still that there’s taxpayer money that’s being given to insurance companies, and I am just not in favor of taxpayer money going to insurance companies.”

Phil Novack, a spokesman for Sen. Ted Cruz , also indicated that the conservative Texas firebrand isn’t sold, saying “significant work remains” in the Senate, “specifically to address Obamacare’s insurance mandates and enact major patient-centered reforms that will further reduce the cost of health care.”…

“Once they pass a bill, my assumption is, the Senate’s going to take a look at it but not necessarily be rubber-stamping what they’re proposing,” Cornyn said. “So I would anticipate that we’ll do what we used to do all the time which is, the House will pass a bill, we’ll pass a bill and then we’ll reconcile those in a conference committee.”

WaPo asked voters about the outline of the Freedom Caucus plan in its most recent poll. How do Americans feel about giving states more power to waive core ObamaCare provisions? Not so great:

That’s not a fair statement of the Freedom Caucus plan, which would require states to show some offsetting benefit (e.g., lower premiums) from a waiver in order to qualify for one and which would mandate coverage alternatives, like high-risk pools, for people with preexisting conditions. But the Democratic messaging machine isn’t going to fairly state the Freedom Caucus plan in 2018 ads either; the way WaPo phrased this is how it’ll be phrased in attacks in the purple districts inhabited by centrist Republicans. In which case, if you’re a moderate, what do you do? Bite the bullet and cast a hard yes vote knowing that it’s likely to go for naught in the Senate anyway, or vote no and risk Trump firing off pissy tweets about RINO traitors until the Republicans in your district are ready to stay home in the midterms? That potato’s getting hotter by the second.

There’s a chance the House could vote tomorrow, if Ryan thinks he has the votes, of course. Does he? The Hill’s tracking more than 80 key Republicans who will decide the bill’s fate. Just seven have committed to voting yes; more than 60 are undecided and 12 are already no’s, a bad sign given that Ryan can only afford to lose 22 GOP votes. Charlie Dent, one of the moderates, said yesterday that he thinks most centrist Republicans who were opposed before will stay opposed now, and if that’s true, it’s doom for Ryan. Although the Freedom Caucus got all the hype in March, there were oodles of centrists who were quietly prepared to vote no on AHCA v1.0. In fact, notes Harry Enten, of the 49 House Republicans who made disapproving noises about the original bill, the majority were moderates, not conservatives:

Instead, the AHCA would probably need somewhere in the neighborhood of five to 15 moderate Republicans who opposed the AHCA the first time around to jump on board (depending how many previously opposed conservative members do).

That could happen, but as moderate GOP Rep. Charlie Dent has pointed out, the new amendment could also lead to additional centrist Republicans coming out against the bill. There’s a group of House Republicans, about 303, who never signaled either way where they stood on the AHCA when it first came up. Perhaps they were hoping that they wouldn’t have to take a public stand — support a very unpopular or break with their party. Now, they may have to show their cards. And of the 30 members of this group for whom we have an ideological score, 16 were more moderate than the average House Republican. Even if AHCA backers are able to get most of this group, every defection makes it that much less likely the bill will pass the House.

This same moderate/conservative impasse will play out again in the Senate if and when the hot potato makes it into Mitch McConnell’s hands. Enten calculates that 29 Republican senators, more than half the caucus, are more moderate on balance than the average House Republican, and yet those senators are now on the verge of being handed a bill that’s more conservative than the first unpopular iteration was. No telling yet where the potato will ultimately land, but we can probably safely rule out Trump’s desk.