GOP gambles on high-stakes health bill
Republicans find themselves cornered after buildup on repeal
For Senate Republicans, the only thing worse than voting on a controversial health care bill may be not voting on it.
The GOP has been vowing to repeal the Affordable Care Act almost from the day it was passed, hammering away at it through four successive elections — campaigns in which Republicans managed to win control first of the House, then of the Senate and finally the White House last year.
That political bill has now come due, whether Republicans are ready to pay it or not.
In a high-stakes maneuver, a poker-faced Majority Leader Mitch McConnell, R-Ky., unveiled the 142-page “discussion draft” Thursday and vowed the Senate would vote on the Better Care Reconciliation Act of 2017 next week after just 20 hours of debate. That turnaround is extraordinarily fast for a major
piece of legislation, particularly on a measure that divides his troops and doesn’t yet command the 50 votes he’ll need to pass it.
Passage is far from assured. Four conservative Republican senators — Rand Paul of Kentucky, Ted Cruz of Texas, Ron Johnson of Wisconsin and Mike Lee of Utah — announced they would oppose the bill unless it was revised to do more to dismantle Obamacare. Meanwhile, the more moderate Nevada Sen. Dean Heller, who’s up for reelection next year in a state Hillary Clinton carried in 2016, expressed “serious concerns” about the bill’s deep cuts in federal Medicaid funding.
McConnell, who can afford to lose just two Republican votes, decided to move ahead anyway.
“Sen. McConnell knows that without putting this thing to a vote, the process is in danger of becoming interminable, which is just not acceptable to the voters who elected Republicans to run the government,” says Scott Jennings, a Republican consultant in Kentucky and former aide to President George W. Bush. “Letting Obamacare repeal sit out there for months on end clogs the drain,” delaying action on taxes, infrastructure spending and other legislative priorities.
If it passes, and the Republican-controlled House accepts it, GOP voters can cheer the first big legislative victory of the Trump presidency. If it is defeated, they can hold responsible the handful of Republicans who bring the bill down.
But if the bill never comes to a vote, they could blame the entire party.
This year, the GOP’s most loy- al supporters have been willing to dismiss the allegations of Russian election tampering as news media hype, attribute the failure to score major legislative achievements to Democratic obstructionism and hand Republicans victories in four closely watched special House elections.
What seems to be non-negotiable, though, is the long-promised action on the Affordable Care Act, President Obama’s signature achievement and the prime example of what Republicans see as dangerous governmental overreach in their lives. In an NBC News/ Wall Street
Journal poll Thursday, Republicans by a 6-1 margin, or 71%12%, said Congress and the president should continue their efforts to repeal and replace Obamacare. (Overall, the public was split 38%-39%; one in five had no opinion.)
Consider this: A closer-thanexpected vote in a special House election in ruby-red Kansas came just two weeks after House Speaker Paul Ryan scrapped a vote on a doomed House health care bill and President Trump threatened to walk away from health care.
That warning flag in April helped fuel a renewed effort in the House, which passed its version of a health bill last month. And this week, a Republican victory in a hotly contested special House election in Georgia, a campaign in which the debate over health care played a part, helped steady some Republican nerves.
“A GOP loss in Georgia might have made it impossible for McConnell to get the votes he needs to pass health care, but the Republican win doesn’t guarantee smooth sailing,” says Mark Mellman, a veteran Democratic pollster who has worked on dozens of House and Senate campaigns. He says congressional Republicans may rue the day they were forced to vote on health care.
“If failing to get things done were a major cause of members being defeated, incumbents would have been losing their seats right and left for decades,” Mellman says. “It is much more common for members to be damaged by the votes they cast than by the bills they never consider.”
One reason McConnell is determined to hold a vote next week: to prevent Republican senators from being swayed by demonstrations and protests from constituents over the Fourth of July recess.
Health care has a brutal political history. The failed effort by President Clinton, led by Hillary Clinton, contributed to Democrats’ loss of the House and Senate in 1994 and was still the stuff of attack in her presidential campaign more than two decades later. And the successful effort by Obama in 2010, passed by Democrats without a single Republican vote?
That has led us where we are today.