Senate defeats BCRA in opening rounds of ObamaCare repeal carousel

Mitch McConnell scored a win yesterday by managing his caucus through a motion to proceed on debate for repealing and replacing ObamaCare. That could be his last win for a while. Late last night, the Senate soundly rejected McConnell’s favored platform for repeal, with only 43 votes in favor of BCRA-2:

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The Senate embarked on a freewheeling process to rewrite the Affordable Care Act on Tuesday, as Republicans overcame deep divisions to bring their proposals up for debate by the narrowest possible margin.

But those same schisms threatened to leave the party far short in the coming days of its ambitious goal to undo major parts of the ACA, which the GOP has been vowing for seven years to dismantle. On Tuesday night, just hours after opening debate, Senate Republican leaders were unable to pass a bill that they had spent weeks crafting but that never gained sufficient traction with the rank and file.

Fifty-seven senators — including nine Republicans — opposed the updated version of the measure known as the Better Care Reconciliation Act (BCRA), while 43 supported it, portending a difficult road ahead for the GOP rollback effort.

It’s true that nine Republicans defected, but it wouldn’t have passed even if the caucus stayed together. Thanks to a lack of CBO scoring on the Lee-Cruz amendment, this version needed sixty votes to pass, and Democrats have no intention of cooperating with a repeal of ObamaCare under any configuration. The GOP naysayers included the usual suspects (Collins, Murkowski) as well as those who had opposed it publicly (Heller, Moran, Lee). The most surprising votes among the Republican caucus were Tom Cotton’s opposition and Ron Johnson’s support. Johnson had pulled his public support after accusing McConnell of double-dealing on Medicaid cuts, but apparently changed his mind again after the MTP passed.

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Unfortunately, that leaves Republicans without a clear plan on repealing ObamaCare. They will continue to use the House’s AHCA as a shell (as John McCain accurately called it yesterday) on which to hang numerous amendments to gain the 50 votes needed for passage. The hope is to get to a “skinny repeal” that will allow for an incremental rollback of ObamaCare — or more accurately, to get rid of the problem for good:

The end goal is likely a stripped-down repeal of Obamacare’s individual and employer mandates and the law’s medical device tax, perhaps with more add-ons. The GOP will now pass whatever can garner 50 votes, no matter how scaled-back McConnell’s ambitions of repealing Obamacare “root and branch” have become.

Their hope is to get something to the House and get it off the Senate’s plate. With any luck, senators say, they will end up in a bicameral conference and finish the job later this year. And now that McConnell has won a vote to proceed to an uncertain outcome, no one is counting him out.

If that’s the case, why not just vote for the AHCA? Yes, the House didn’t like it either, but it did manage to get a grim consensus between conservatives and moderates. That would eliminate the issue entirely, whereas voting for a new bill would still require a conference or at the least one more vote to have the House adopt the Senate’s version. If the two major goals are to say they’ve passed a repeal and to never have to deal with that part of the issue ever again, the AHCA — as flawed as it may well be — provides a perfect opportunity.

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Since no one seems to be thinking strategically other than McConnell, we’ll keep up with the vote-a-rama this week. The end result will likely be more of a lite repeal than a skinny repeal, in order to knock out more of the ACA’s statutes so that HHS Secretary Tom Price can have more leeway in the administrative tasks in deconstructing ObamaCare. Whether that can get 50 votes remains to be seen, but Senate Republicans seem to have belatedly realized that they are in a political trap of their own making, and doing nothing may be the worst option after seven years of promises to take action at the first opportunity. If everyone gets a chance to float their version as an amendment, perhaps everyone will buy into the end product. At least, that’s what McConnell will argue by the end of the vote-a-rama.

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David Strom 6:00 AM | April 26, 2024
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