Whythe rush to pass a health care bill?

Analysis: GOP hopes to use the reconciliation process to pass a bill

WASHINGTON — White House press secretary Sean Spicer promised that the Republican effort to replace “Obamacare” wouldn’t be “jammed down people’s throats” in the way he said the Affordable Care Act was in 2010. Republicans would observe “regular order” in Congress, moving the legislation through committee and ensuring that the public had an opportunity to see what was under consideration.

That was two weeks ago. Since then, Republican leaders have scrambled to revise their initial proposal, the American Health Care Act, to shore up enough support from their own caucus to ensure that it can pass the House. Late Wednesday night, reports surfaced that substantial components of the bill were being reconsidered to that end. Members of the conservative House Freedom Caucus met with President Donald Trump on Thursday, resulting in more caucus members voicing their opposition. By late Thursday, Trump told reporters they needed to pass the bill on Friday or he would leave the Affordable Care Act in place.

It all raises the question: Why the rush? Republicans control the House, the Senate and the White House. They could, theoretically, pass something at any time. Instead, they’re hustling for a vote this week, less than three weeks after they unveiled the original version of the AHCA. So: Why? Two big reasons. The most important relates to the process Republicans hope to use to pass the replacement. The AHCA is part one of three meant to constitute a new system. While parts two and three are somewhat theoretical at this point, the strategy behind the AHCA is not.

Passing the AHCA relies on the congressional reconciliation process, a specific mechanism tied to the overall budget process. It was created in part to provide a system for adjusting mandatory spending figures that can’t be changed through the normal appropriations process. But it also creates a fast-track system for passing very specific types of legislation and — critically, for the purposes of this discussion— avoids filibusters in the Senate. If the AHCA can pass the House and if the Senate’s parliamentarian thinks it meets the various requirements necessary to be considered a reconciliation bill, Republicans need only 51 votes in the Senate (perhaps including that of Vice President Mike Pence, in the event of a tie) for the bill to head to Trump’s desk.

(A quick aside: That need to check all of the boxes to be considered a reconciliation bill is one of the minefields Republicans face as they scramble to finalize a package that can pass the House. There’s no way they’ll get enough votes in the Senate to avoid a filibuster on non-reconciliation legislation.)

On Jan. 12, the House and Senate kicked off the reconciliation process using the fiscal 2017 budget resolution as a vehicle. (One of the rules about reconciliation is that it can only be deployed to adjust spending or revenue once per budget resolution.) After blowing past a Jan. 27 benchmark for reconciliation proposals from committees, Republicans came up with the AHCA.

Now, all of that said, there’s no time limit on the reconciliation process. But Republicans want very much to move on to largescale budget reform, which means passing a budget for fiscal 2018 and an associated reconciliation bill of its own. That reconciliation could theoretically revamp both health care and tax rules but that would be an even more complex — and therefore more politically tricky — bit of legislation.

Which brings us to the other reason Republicans are moving quickly: political opposition.

Republican leaders want to wrap up Obamacare reform and tax reform before August. Why August? Well, for one thing, because August is when Congress goes on recess and representatives generally head back to their districts and host town halls. When Republicans held town halls in January and February, it didn’t always go that well, because a lot of constituents showed up to complain about the attempt to overturn Obamacare.

Politico’s Tim Alberta reported that Speaker Paul Ryan’s allies believe that opposition will continue to firm up as the debate over the AHCA continues. That already seems to be true: Opposition from Republican members of Congress has apparently increased and the bill itself — while relatively unknown — is unpopular with the public. It’s less popular than Obamacare was when it passed, even though Obamacare was viewed more negatively than positively. Legislators are already reporting broad, consistent opposition from constituents; it’s not clear why that would change as the fight drags out. Again, Obamacare is instructive: As the vote on it neared, the proposal grew less popular.

By moving quickly, Republican leaders seem to think that they can get past the hurdle of opposition before it becomes insurmountable. They may have already missed that mark.