Senate GOP ready to pass health-care bill -- as long as there's no chance it becomes law

Do you realize how broken and insane this party has become? This is an actual headline at Politico this afternoon:

The headline is accurate. What’s floating around the caucus right now is “skinny repeal,” a.k.a. a bill that would repeal the individual mandate, partially repeal the employer mandate, defund Planned Parenthood for a year, annnnnd … not do much more than that. The point of skinny repeal is to simply take the parts of ObamaCare that Republicans hate most and stick them in a repeal bill on the theory that there are probably 50 votes to pass that. They couldn’t pass McConnell’s BCRA health-care bill; they couldn’t pass clean repeal of ObamaCare either. Maybe they can pass this.

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But here’s the important part. “Skinny repeal” is only supposed to be a vehicle to get the Senate to a conference committee with the House where they’ll supposedly work out a final compromise ObamaCare repeal-and-replace bill that’ll make both chambers happy. Skinny repeal isn’t intended to become law, for good reason. Yanking the mandate out of ObamaCare but leaving pretty much everything else intact risks knocking over the whole tower. Without the mandate forcing healthy people into the risk pool, insurers will run out of money to pay for sick people’s preexisting conditions. CBO estimated that premiums could rise 20 percent in the short term, potentially triggering either a death spiral or a federal bailout to stabilize the O-Care exchanges. Skinny repeal is terrible legislation and Republicans know it, but they’re okay with that because, again, it’s not supposed to become law. It’s purely a vehicle to trigger a House/Senate conference committee.

Now comes the catch. Some House Republicans are so exasperated with the health-care process and so anxious that the conference committee won’t be able to produce a compromise bill that can make it to Trump’s desk that they’re threatening to pass skinny repeal themselves if it passes the Senate. They’re not going to treat it as a vehicle for a conference committee; they’re going to rubber-stamp the Senate’s bill. Skinny repeal will become law in that case, since Trump will undoubtedly sign it. And so we come to the present moment, in which a Republican Senate is terrified of passing its own bill because there’s a risk that that bill might actually be enacted and wreck ObamaCare. It’s the perfect climax to seven years of GOP cowardice on health-care reform and a microcosm of the party’s new identity as a “post-policy” institution. We’ve reached the point where Senate Republicans will agree to pass something only on the condition that it not pass the other chamber.

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Which leaves us … where?

Yeah. What’s the point? Essentially, by passing a bill as a pure vehicle to trigger a conference committee, the Senate is punting to itself. Skinny repeal is happening only because they’ve tried to pass everything else and can’t find 50 votes for it. If skinny repeal is the only thing that can pass and the Senate doesn’t want it to become law, then effectively nothing can pass. The conference committee is pointless. Which brings us full circle in the health-care saga by turning this into a pure game of hot potato: The Senate doesn’t want to be solely responsible for having killed the dream of ObamaCare repeal so they’re trying to at least get to a conference with the House. Then, when the conference can’t produce anything that can pass, McConnell can claim that the other chamber shares blame for the party’s failure.

This is a good point too:

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If the Senate is terrified that the House will pass skinny repeal, then the House has all the leverage in conference negotiations. Either the Senate passes what the House wants or the House will pass what the Senate doesn’t want.

And yes, this would be fitting:

The House Freedom Caucus helped defeat the first version of Paul Ryan’s health-care bill in March. Now their misgivings about skinny repeal (which does nothing to roll back ObamaCare’s Medicaid expansion) may be the only thing preventing skinny repeal from becoming law if the Senate passes it. House conservatives, forever accused of “obstructionism,” may be the only thing standing between the GOP and a disastrous outcome on health-care reform — by obstructing the Senate’s own bill. I feel my brain literally splitting in two.

Update: In so many words, yeah.

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David Strom 11:20 AM | April 24, 2024
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