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GOP wrangling over health care begins
Factions will jockey to rewrite bill’s terms their way
WASHINGTON — Get ready for a drama-filled week of mock hand-wringing, political jockeying and backroom brinkmanship as the Senate GOP health care plan heads toward a hopedfor vote next week.
No sooner did Senate Majority Leader Mitch McConnell unveil the longawaited Obamacare overhaul Thursday than Republican senators started openly negotiating what it would take to win their votes.
Within just a few hours, four key conservative senators — Ted Cruz of Texas, Mike Lee of Utah, Ron Johnson of Wisconsin and Rand Paul of Kentucky — jointly announced they could not vote for the bill as is, unless it more fully guts the Affordable Care Act.
Likewise, centrists withheld their support unless they can push the bill the other way, as they mull the fallout from leaving millions more Americans uninsured.
Even President Donald Trump — who called the House overhaul bill “mean” — initially withheld his endorsement, suggesting “a little negotiation” would make the Senate version “very good.” Later in the day he tweeted he was “supportive” but looked “forward to making it very special!”
Almost certainly McConnell opened the door to the haranguing by presenting the legislation as a “discussion draft” and inviting input to make it better.
After being panned by Democrats and Republicans alike for crafting the bill with unprecedented secrecy, keeping details even from GOP senators — McConnell may now be eager to convey a sense of open debate and negotiation.
But if the process that played out in the House last month is any guide, expect the dealing-making to only go so far before Republicans quickly unify — preferring to hold hands and jump off the political cliff together rather than risk losing their best opportunity to fulfill the Republican promise to stop Obamacare.
With Republicans holding a slim 52-seat majority, leaders can only afford to lose support from two GOP senators and still pass the bill in the face of party-line Democratic opposition.
In many ways, the negotiations will give senators something they have not had during the crafting of the bill behind closed doors: a chance to publicly muscle and maneuver their concerns to the forefront of the debate.
Even if senators are not successful in changing the bill, they will be able to show their constituents that at least they tried.
“This current draft does not have the votes to pass the Senate,” Cruz told reporters. He is pushing for steeper Medicaid cuts and fewer requirements related to the essential benefits that insurers must cover.
But Cruz added, “We can get there.”
Voting is expected by the end of next week, a selfimposed deadline as Republicans worry that endless debates over Obamacare would dominate the congressional agenda and leave them — and Trump — with few other legislative accomplishments.
A delay would also give opponents more time to build up public momentum against the bill, as Democrats and many health care groups are already scrambling to do.
Protesters have rallied outside the Capitol and, on Thursday, more than 40 people, including many in wheelchairs, were arrested outside McConnell’s office. They warned that the proposed Medicaid cuts threaten to cut off federal money that allows disabled people to live independently.
A week can be a political lifetime in Washington, D.C., and few senators are willing to compromise so soon on an issue that has loomed so large over the party.
The risks are clear. If Republicans fail to repeal Obamacare after years of promising to do so, they face the wrath of conservative voters and outside groups. But if their overhaul leaves millions of Americans without coverage or raises costs, the backlash could be intense.
Polls show that Obamacare’s popularity has soared ever since repeal efforts began, and Americans largely oppose the House bill.
But even among voters, the politics that have always surrounded Obamacare plays a role. According to a June 13 YouGov poll, 56 percent of Republicans said they supported the House bill. But when compared to keeping Obamacare, 68 percent said they preferred the House bill.
Curtailing funding for clinics and insurance plans that provide abortion services may win conservative support but it poses a problem for several key Republican women, including Sens. Susan Collins of Maine and Sen. Lisa Murkowski of Alaska.
Few senators want to risk being the one responsible for derailing the legislation.