Senate Republicans are moving into high gear on their effort to repeal the Affordable Care Act, making it likely that within the next few weeks they’ll either pass something and keep the process hurtling forward, or abandon it altogether.
Judging from what they’re saying, it looks like the latter is the most likely scenario: They fail to pass their version of repeal, then say, “Well, we tried,” shake that albatross off their shoulders, and move on to the rest of their agenda. It would leave many in the party infuriated, but it might be the best of the bad options available to them.
The latest developments suggest Senate Majority Leader Mitch McConnell (R-Ky.) may be hoping to rip the Band-Aid off as quickly as possible and get this whole thing behind them.
After spending a month deliberating over a response to the House’s passage of a bill to repeal the law, Senate Majority Leader Mitch McConnell (R-Ky.) is accelerating the party’s stagnant work as a jam-packed fall agenda confronts congressional leaders and President Donald Trump. Republican leaders want resolution to the tumultuous Obamacare repeal debate by the Fourth of July recess, Republican sources said, to ensure that the whole year isn’t consumed by health care and that the GOP leaves room to consider tax reform.
It’s a gut-check situation for Republicans, who are about to be confronted with tough choices that may result in millions fewer people with insurance coverage as a condition for cutting taxes and lowering some people’s premiums.
While it’s possible that McConnell is pushing this accelerated schedule because he thinks it’ll produce a bill that passes before anyone has a chance to realize what’s happening, that seems like a long shot, particularly given how many Republicans are expressing doubts about whether they can get the 50 votes they need to pass it (the current GOP margin in the Senate is 52 to 48):
- McConnell himself said “I don’t know how we get to 50 at the moment” in an interviewtwo weeks ago.
- “I don’t think there will be” a successful vote this year, said Sen. Lindsey O. Graham (R-S.C.). “I just don’t think we can put it together among ourselves.”
- Sen. Richard Burr (R-N.C.) said the same thing last week: “I don’t see a comprehensive health-care plan this year.”
- And Sen. Jeff Flake (R-Ariz.) said: “There are some still saying that we’ll vote before the August break. I have a hard time believing that.”
That’s a whole lot of skepticism. One big problem they’re facing is that there are multiple factions and working groups among Senate Republicans, all potentially coming up with their own very different versions of the bill. That’s a result of McConnell’s decision not to run the bill through the ordinary committee process, since he didn’t want there to be public hearings at which Democrats would have a chance to speak and question witnesses. In that vacuum, everyone wants to exercise their own influence. So apart from the 13-member group that McConnell appointed, there’s also a group led by Sen. Susan Collins (R-Maine) and Sen. Bill Cassidy (R-La.), and a group led by Sen. Rob Portman (R-Ohio).
But the intractable problems are likely to be substantive. Can senators from states that have benefited hugely from the ACA’s Medicaid expansion — such as West Virginia, where 28 percent of the state population is now enrolled in Medicaid, including 170,000 citizens who got it because of the expansion — come to an agreement with senators such as Ted Cruz (Tex.) and Mike Lee (Utah) who would like to see Medicaid undermined if not utterly destroyed? And can they all agree on something that can also get a majority in the House, where ultra-conservative Freedom Caucus members wield so much power?
So here are the potential outcomes: