Obamacare Repeal Faces Uncertain Future in the Senate
GOP moderates and conservative mavericks could sink Trump-backed health care reform
After a massive victory for GOP leaders on Thursday, the repeal of Obamacare was revived in the House, passed and sent to the Senate.
But its fortunes in the upper chamber are not clear. The Senate is a place of old, dusty rules and humorless statesmen who believe the august body can legislate more judiciously than the lower chamber.
“Although I will carefully review the legislation the House passed today, at this point, there seem to be more questions than answers about its consequences.”
An old joke in the Senate is that it is composed of 100 men and women, all of whom believe they should be the next president.
Their political ambitions aside, the Senate is now facing a beastly task that almost sunk the House: the repeal of Obamacare.
The House took weeks, after an embarrassing March 22 failure to pass the American Health Care Act, to get the repeal bill passed. Now Senate leaders are already suggesting they will write their own bill, and then reconcile the bills later, in conference.
“At the end of the day, I think it’ll be a Senate bill and then those two bills at some point will have to come together, and we’ll get started on that Senate bill immediately,” said Sen. Roy Blunt (R-Mo.), a member of Senate leadership, speaking to ABC News.
Influential Senate Republicans made clear even before the House vote on Thursday afternoon that they weren’t happy that the new version of the AHCA hadn’t been reviewed by the Congressional Budget Office (CBO).
Leading the midday charge was Sen. Lindsey Graham (R-S.C.), who enjoys being the regular supplier of buckets of cold ice water to pour upon the GOP agenda.
“A bill — finalized yesterday, has not been scored, amendments not allowed, and three hours final debate — should be viewed with caution,” Graham tweeted out midday.
Graham later tweeted that “I look forward to carefully reviewing the House-passed legislation to repeal and replace Obamacare,” but that he would look for how the final product benefits South Carolina.
The media pounced on the good news, to them, that there were Senate Republican skeptics.
“The Next Step for the Republican Health Care Bill: A Skeptical Senate,” The New York Times wrote, broadcasting the paper’s wishes that Obamacare somehow survive.
The Washington Post wrote that the Obamacare repeal faces a steeper climb in the Senate.
Of course, the claim is not without truth. The House Republican caucus is much more attuned to the Republican base. The Senate Republicans are much more focused on the Establishment, the business community, the doctors, the hospital associations, and other special-interest groups.
While it is true House members have to worry about re-election every two years, the concerns in the Senate are proportional. Senators get six years in a term, but they hope for a career span of 30 to 42 years — perhaps more. Being accused of being insensitive to the poor, in a brutal statewide election, can cause fears in senators even four years from a re-election battle.
On top of that, more than a few Republican senators have moderate tendencies.
Leading that list is U.S. Sen. Susan Collins (R-Maine), first elected in 1996. Collins released a statement on Thursday saying she wanted a CBO score of the bill.
"Although I will carefully review the legislation the House passed today, at this point, there seem to be more questions than answers about its consequences," Collins said in a statement.
The American Conservative Union doesn't think highly of Collins' record. Collins got a dismal 23 rating, out of 100, for the 2016 session. Her lifetime rating is a disappointing 44.9 rating. Sen. Ted Cruz (R-Texas), in comparison, has a 100 lifetime rating.
Conservative and liberty problems
In a Senate with a narrow GOP majority of 52, out of 100 members, Sen. Lisa Murkowski (R-Alaska) and Collins bolting could be a problem.
But in the case of a 50-50 tie, Vice President Mike Pence can always vote.
On the hard Right, the conservatives have three hardcore Republicans who would likely want more repeal than the Senate can likely give.
There's Cruz, who wants Senate GOP leadership to override the parliamentarian and repeal the whole 2010 law. Right now, the AHCA doesn't attempt that. Instead, the law repeals what is allowed within so-called "budget reconciliation." That means the Democrats cannot block the legislation with a filibuster.
Sen. Rand Paul (R-Ky.) and Sen. Mike Lee (R-Utah) are more libertarian, but Paul especially has shown a great desire to work with Trump on repeal. An idea Paul likes is to allow consumer associations, empowering people to band together and negotiate their own insurance rates.
The Byrd Rule
Then there's the Democrats. Remember them? They are completely out of power in Washington, D.C., sitting in minorities in the House and Senate.
But there has been some noise that Senate Minority Leader Chuck Schumer (D-N.Y.) would try to use the "Byrd Rule" to declare the proposed repeal as a violation of reconciliation. Therefore, it can be filibustered.
Schumer's office claimed additional amendments to the health care bill will mean Republicans can not pass the measure through reconciliation and would instead need 60 votes to pass the senate. If that's true, the bill is doomed. Democrats will not vote for the repeal of President Barack Obama's signature law.
Yet if there is good news in all of this, it's that the Senate is lead by the maestro, Senate Majority Leader Mitch McConnell (R-Ky.), a longtime veteran of the upper chamber, since 1984. McConnell is a master of conservative and Republican politics, and is also keenly aware of the rules and the needs of the GOP base. He celebrated the House passage on Thursday, a sign he is behind what will be a herculean effort to repeal most of Obamacare.
The president, too, is eager to proceed and use his full weight to lobby the Senate.
Speaking to House members and the press in the Rose Garden on Thursday, Trump reminded the crowd and the nation that the troubled 2010 law is buckling under its own weight, driving up premiums and causing insurance companies to pull out of the system.
"No matter where I went, people were suffering with the ravages of Obamacare," said Trump.