The Obamacare-Repeal Dead-Enders

Some Republicans still want to take another shot at repealing the Affordable Care Act.

Sen. Ted Cruz speaks during a rally to launch his re-election campaign at the Redneck Country Club on April 2 in Stafford, Texas.
Sen. Ted Cruz speaks during a rally to launch his re-election campaign at the Redneck Country Club on April 2 in Stafford, Texas. Erich Schlegel/Getty Images

The era of Republican rule effectively ended in January, when Doug Jones was sworn in to the U.S. Senate. With a Democrat representing Alabama and Arizona Sen. John McCain out indefinitely, Republicans can no longer afford a single defection on big, partisan legislation considered under fast-track reconciliation rules, meaning they now have a majority in name only.

Some conservatives, though, are in denial about the curtain closing and are anxious to get more before their era of unified control comes to an end.

Texas Sen. Ted Cruz, as the Hill reported this morning, “is leading a group of restive conservatives who want to vote on a budget resolution that would set up a special process—known as reconciliation—to allow the GOP to pass ambitious legislation, such as an ObamaCare repeal, with a simple majority.” Cruz is a believer in base-turnout elections. He also needs to turn out his own base, in particular, to win re-election back home.

Senate Majority Leader Mitch McConnell earlier this year chose not to pursue such a budget resolution. Any kind of controversial, partisan legislation through reconciliation would both make life better for red-state Democrats and probably fail, since it would require crafting a product that Sens. Rand Paul, Mike Lee, Susan Collins, and Lisa Murkowski could all agree on. If the idea being pursued through reconciliation is health care—and what else would it be?—each of these problems would be degrees more damaging. Health care remains Republicans’ worst issue, and the longer it’s in the news, the more it harms them and helps vulnerable Democrats. We’ve seen several attempts to get Collins and Paul on the same comprehensive health care bill. They have all failed for reasons far more unbridgeable than bad luck.

But maybe the next time would be different?

The Washington Examiner’s Quin Hillyer reports that representatives of numerous conservative groups, under the stewardship of former Sen. Rick Santorum, “seem just a few weeks away from being able to unveil” a “new Obamacare replacement that could both pass Congress and work well in the real world.” The unveiling will coincide with the groups launching “a concerted effort to rally grassroots support and give courage to House and Senate members to pass it.” Hillyer notes that the White House “has been quietly yet constructively supportive of the project,” with Vice President Mike Pence personally involved.

The legislation would be similar to the failed Graham–Cassidy bill of last fall, which would wipe out the current Obamacare structure and replace it with block grants to the states. The new version would fiddle with the formula that, in previous iterations, disproportionately hurt states that had expanded Medicaid—i.e., mostly blue states.

It is not hard to believe that Rick Santorum has spent the past few months sitting in a restaurant booth somewhere scribbling out a new comprehensive health care bill on napkins. Nor is it difficult to believe that conservative groups occasionally join him in this booth, and that even Mike Pence has paid a visit.

What seems much harder to believe is that Mitch McConnell would see this as having anything close to a chance of reaching 50 votes, or that it would be good politics right now. Even if, say, Susan Collins and Lisa Murkowski found themselves so peeved with Democrats over the failure last month to pass an Obamacare stabilization package that they were willing to stick it to the libs by supporting repeal—and I don’t see them doing that!—it still wouldn’t solve the Paul problem. Rand Paul does not believe that the federal government should be spending money, in the form of premium subsidies or block grants, on health care. He hated Graham–Cassidy, and he’ll hate this new version too.

McConnell will not want to touch this. He wants to put a few difficult bills for red-state Democrats on the floor, perhaps one to make the individual tax cuts permanent, and otherwise focus on confirming as many judges as he can. Judges, deregulation, tax cuts, judges, judges, tax cuts. This is the message he wants to focus on, and when McConnell commits to a certain strategy, he commits.

Though the House might feel that their majority is lost, and they might as well push for as many partisan items as possible now, the Senate is a different story. It’s far from lost, but if they’re not careful, they could cede control over executive and judicial nominations to Chuck Schumer. Republicans had a little more than a year to get done what partisan legislation they were going to get done, and they had some hits and misses. That time period is over.