Can Republicans Actually Pass the AHCA in Two Weeks?

And can Democrats do anything to stop them?

Joshua Roberts
Senate Majority Leader Mitch McConnell at an interview in Washington on May 24.

Joshua Roberts/Reuters

If Senate Republicans want to meet their goal of passing a health care bill by the Fourth of July recess, they have exactly two weeks to do it. Congress is scheduled to recess at the end of business on June 30, which means Republicans have to move at breakneck pace while keeping debate to a minimum. What’s the rush? For any Americans who are aware that the Senate is racing to pass a tightly guarded health care bill—and if the GOP strategy works, there won’t be many of them!—Republicans are hoping their outrage dissipates over the holiday weekend. And the world goes on.

Passing this secretly developed, still-unfinished bill within two weeks would be a world historic achievement in underhanded policymaking. Put another way: This is the moment Senate Majority Leader Mitch McConnell was born for. This, reader, is his jam.

Ask a different member of the Senate Republican leadership whether they are sticking to the June 30 deadline, and you’ll get a different answer. Senate Majority Whip John Cornyn, the No. 2 Republican, has always been more of an “end of July” guy. South Dakota Sen. John Thune, the No. 3 Republican, treats it as more of a “hope” or an “aspiration,” a way of focusing the mind.

McConnell and his team, though, have not been “deterred… from the goal of a floor vote before the July 4 recess,” the Washington Post reports. “[A]s McConnell’s team sees it, the options have all been vetted. Now, the difficult decisions about what to put in and leave out of the final bill are all that remain.”

Much of the media has been operating under the assumption that the Congressional Budget Office would need two weeks to score the Senate’s legislation. That’s why senators were hoping to finalize the language by Monday night. It’s now Friday, and the language still isn’t finalized. But the CBO and Senate Republicans have been interfacing on legislative options for a while now, and leaders hope that the score could come quicker since CBO wouldn’t be building an analysis from scratch. As Wyoming Sen. John Barrasso told Talking Points Memo, the issues they’re dealing with are “dial-able… so you can say, ‘If you set this number, it does this and if you set that number, it does that.’ ” In other words, the CBO is just waiting for decisions on certain inputs—growth rates for Medicaid spending, the length of the Medicaid expansion phase-out, expiration dates for certain taxes, lists of regulatory waivers that will be available to states, and so forth. Perhaps CBO could get a score done in, say, one week.

So who’s going to make those tough decisions about which inputs to include? It’s definitely not going to be all the Republican senators, and there’s definitely not going to be anything like consensus reached. Pennsylvania Sen. Pat Toomey and Ohio Sen. Rob Portman, for example, are never going to agree about the proper growth rate for Medicaid. It will be up to McConnell and Cornyn to choose the proper balance that gets their conference closest to the 50 votes they need to pass the bill. That’s the phase they appear to be in right now. On the Hill Thursday afternoon, individual senators like Portman, Toomey, and Maine Sen. Susan Collins were ducking into McConnell’s office. The brainstorming sessions are finished, and now it’s about determining what each senator can live with.

Now, what about the Democrats? Let’s be generous and say McConnell settles on a recipe by over the weekend, and the CBO begins scoring early next week. The score comes back early the following week, and McConnell posts the bill. Is there much Democrats can do to stop it?

One theory among progressive activists is that Democrats could leverage the “vote-o-rama” process. Under reconciliation rules, senators can offer an unlimited number of amendments during the 20-hour debate period; after the debate, each filed amendment would be considered with an up-or-down vote. That rapid-fire voting session is referred to as a “vote-o-rama.”

Ezra Levin, an executive director with Indivisible, suggested on Twitter this week that Democrats should extend the “vote-o-rama” well past a long night’s work. He urged Democrats to threaten to “filibuster by amendment,” by filing tens of thousands of amendments to clog up chamber through the 2018 midterms.

But McConnell would have recourse. Though McConnell could let Democrats have their fun for a little while—at least to give off the veneer of a transparent, open process—he can eventually motion that the amendment process had become dilatory, the chair would rule in his favor, and—barring some appeals and other motions to draw the process out—the “vote-o-rama” would be finished. It might still be worth Democrats’ while to push ahead this way, though, to see how long they can draw out the process before McConnell breaks, and to please their base.

It comes down to this: If McConnell and a majority of senators want to rush this secret bill to a vote before the Fourth of July recess, then they can. McConnell needs 50 votes for the bill, and he needs 50 votes to bust through whatever procedural roadblocks Democrats lay before him.

Some Republican senators have begun to speak out against the secrecy of the project, noting that it makes them uncomfortable. That discomfort, however, has not been palpable enough for them to exert real leverage over the way McConnell has conducted the process so far. Any three Republican senators could have told the majority leader in early May that they wouldn’t vote for the bill unless it went through the normal open committee process. Maybe they didn’t think it would get this bad. Or maybe they agree with him: Speed and secrecy is the only way to do this.