By David Thornton
When we last heard from the American Health Care Act, House Republican leaders were waiting on the Congressional Budget Office to score the bill before submitting the legislation passed in the House to the Senate. The CBO scored the bill in late May, but the silence from the Republican ranks has been deafening. The congressional website does not show any action on the bill since it passed the House on May 4.
Readers of The Resurgent are aware that the Republican health care bill falls short of full repeal. Senate rules require 60 votes for cloture on a repeal bill and Republicans would not be able to find eight Democrats to join them in ending a Democrat filibuster. Even if Republicans eliminated the filibuster entirely, they would not have enough votes for full repeal because at least four Republicanshave pledged to oppose a repeal bill that does not provide for a phase out of the Obamacare Medicaid expansion.
Now some Republicans are saying that it is doubtful that they will be able to pass even an incomplete health care reform bill. “I don’t see a comprehensive health care plan this year,” Senator Richard Burr (R-N.C.) said in Politico. “It’s unlikely that we will get a health care deal, which means that most of my time has been spent trying to figure out solutions to Iowa losing all of its insurers.” Burr serves on the Senate Heath, Education, Labor and Pensions Committee.
In the Wisconsin State Journal, Senator Ron Johnson (R-Wisc.) agreed that the first priority to would probably be to act to preserve the health insurance markets in their current form. Johnson said that a short-term “market stabilization” bill could be passed that would fund the Obamacare exchanges with billions of dollars to help prevent insurers from exiting the marketplaces. Such an approach would reduce volatility in the Obamacare markets and buy time for Republicans to agree on a reform bill.
“To me, this may be a two-part process. I would admit that’s probably a minority view in the Republican Senate right now,” Johnson said.
Senator Jeff Flake (R-Ariz.) also tried to tamp down expectations. “There are some still saying that we’ll vote before the August break,” he told the Washington Post. “I have a hard time believing that.”
The fundamental problem is that conservative and moderate Republicans do not agree how to handle various aspects of the health care issue. Although Republicans have been united in their desire to repeal and replace Obamacare since the day it was passed, they disagree on the details of what should come next.
In the eight years since Obamacare became law, Republicans such as Tom Price, formerly a Georgia congressman and now Secretary of Health and Human Services, have written legislation to repeal Obamacare and reform the health insurance industry, but the party has not coalesced around any single bill. When Donald Trump eked out a squeaker of a victory in the Electoral College, Republicans were caught flat-footed and did not have a plan for how to exploit his victory. Indications were that, as late as early February, Republicans had not even started writing an Obamacare reform bill. The Senate considers the House bill dead on arrival and is writing its own version of health care reform, which may be available as early as this week.
President Trump’s antics are also hurting the possibility of passing a health care bill. The investigation into the Trump campaign’s possible connections with Russia and the firing of FBI Director James Comey are distractions that make it even more difficult to find a compromise that is acceptable to all GOP factions. The president showed leadership in the fight to pass the AHCA in the House, but has largely been missing-in-action on the issue in the month since the House vote.
Not all Republicans are pessimistic on health care. Senator John Cornyn (R-Texas) was quoted in The Hill as saying, “We do need to take care of our business, and I think you mentioned healthcare, and that’s certainly front and center in the United States Senate — something we’re going to have to get resolved here in the next few weeks.” Cornyn said that he thought a Senate bill would be “done by the end of July at the latest.”
Repeal of Obamacare has been the centerpiece of the Republican platform since 2010. The fact that repeal is not possible, even with Republican majorities in Congress and a Republican president, is not going to please most Republican voters. If the new Republican administration leaves Obamacare completely intact, it may well face a mutiny from the grass roots.