McConnell to GOP: We're fixing ObamaCare exchanges if you can't agree on repeal

A threat, or an acknowledgment of political reality? Mitch McConnell may have meant to deliver both in his comments at a Glasgow, Kentucky event yesterday afternoon. With his Senate caucus still stubbornly split on how to repeal and replace ObamaCare, the Majority Leader warned that a failure of Republicans to act through reconciliation will shelve repeal and force them to work with Democrats to fix the failing exchanges instead:

Senate Majority Leader Mitch McConnell (R-Ky.) said Thursday that if his party fails to muster 50 votes for its plan to rewrite the Affordable Care Act, it will have no choice but to draft a more modest bill with Democrats to support the law’s existing insurance markets.

The remarks, made at a Rotary Club lunch in Glasgow, Ky., represent a significant shift for the veteran legislator. While he had raised the idea last week that Republicans may have to turn to Democrats if they cannot pass their own bill, his words mark the first time he has explicitly raised the prospect of shoring up the ACA.

“If my side is unable to agree on an adequate replacement, then some kind of action with regard to the private health insurance market must occur,” McConnell said. “No action is not an alternative. We’ve got the insurance markets imploding all over the country, including in this state.”

It’s a potent threat — but likely to only a part of his caucus. Some of the moderates probably prefer this option, given the alternatives. The conservatives will be the ones left twisting in the wind, and this is an unsubtle jab at them to figure out a way to compromise with the rest of the caucus rather than dictate terms. It seems aimed particularly at Ted Cruz, Mike Lee, and fellow Kentuckian Rand Paul, who have demanded a clean repeal if the BCRA stalls.

Cruz upped the ante last night:

Sen. Ted Cruz (R-Tex.) said Thursday that he agrees with President Trump: If Republican senators are unable to pass a bill to repeal and replace key parts of the Affordable Care Act, the Senate should vote on a narrower bill to simply repeal the law and work on a replacement later.

“If we cannot bring the conference together and agree on repeal legislation, then I think President Trump’s absolutely right that we should pass a clean repeal,” Cruz told reporters.

Cruz said such a repeal should be delayed “either a year or two years” to give lawmakers time to work on a replacement.

There are two problems with that approach. A clean repeal will almost definitely not qualify under reconciliation. It involves too many non-budgetary components to pass the parliamentarian’s muster. Cruz would need at least eight Democrats to sign onto a repeal-only bill even if every Republican voted for it, and that’s as highly unlikely as getting the eight Democrats.

Second, even if it did, Cruz’ suggestion to wait “a year or two years” to do anything else would be inviting electoral disaster as access to insurers vanishes in the light of the present crisis in the individual markets. Voters sent Republicans to Congress to fix problems, not make them worse. Republicans would still need to work with Democrats to something immediately to prevent all sorts of unintended consequences and an avalanche of poor outcomes. They could have passed a straight repeal before 2013, when ObamaCare went into effect, but they lost that chance when Mitt Romney lost the 2012 election and Republicans didn’t take control of the Senate. It’s too late for that now, after millions of Americans have had to adjust for the past four years to the new status quo.

The “year or two years” formulation means that Cruz thinks he can wait until the 2018 midterms deliver a filibuster-proof Republican majority. That’s a bad bet under these circumstances. They’ll pick up seats in the Senate, but gaining eight will be a long shot, especially if Republicans totally disrupt the health insurance markets and leave voters to sink or swim through an election cycle. And even if by some miracle they won eight Senate seats, they might find that Democrats have taken over the House again.

That’s what makes McConnell’s statement a realistic acknowledgment of political reality, too. If Republicans don’t act through reconciliation when they have the chance and pass something that at least gets them further down the road to a repeal and replacement, they’ll miss that chance too. They will have no choice but to start dealing with Democrats; even without the filibuster being an issue, Republicans seem intent on refusing to form a majority on this issue.

And don’t think Democrats don’t know this. Here’s Chuck Schumer licking his chops:

Schumer was all too eager to jump on McConnell’s remarks. In a statement issued shortly after those remarks were reported, the minority leader said he was eager to help out on a measure to shore up the insurance programs.

“It’s encouraging that Sen. McConnell today acknowledged that the issues with the exchanges are fixable, and opened the door to bipartisan solutions to improve our health care system. As we’ve said time and time again, Democrats are eager to work with Republicans to stabilize the markets and improve the law. At the top of the list should be ensuring cost sharing payments are permanent, which will protect health care for millions.”

In the words of an old oil commercial, McConnell’s saying: You can pay me now, or pay me later. Republicans still can control this outcome, but they’d better start looking for common ground rather than continuing their trench warfare.