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Home / World

Once a unifier, undoing Obamacare is now an albatross around the GOP's neck

Washington Post
28 Jun, 2017 02:39 AM5 mins to read

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Senate Majority Whip John Cornyn, centre, talks with others before President Donald Trump arrives for a meeting with Republican senators about healthcare in the White House. Photo / Washington Post

Senate Majority Whip John Cornyn, centre, talks with others before President Donald Trump arrives for a meeting with Republican senators about healthcare in the White House. Photo / Washington Post

By Dan Balz analysis

For Republicans, Obamacare was always the great unifier. In a fractious party, everyone agreed that the Affordable Care Act was the wrong solution to what ailed America's healthcare system, with too much government and too little freedom for consumers.

Replacing Obamacare has become the party's albatross, a sprawling objective still in search of a solution.

The effort to make good on a seven-year promise has cost the Trump Administration precious months of its first year in office, with tax restructuring backed up somewhere in the legislative pipeline, infrastructure idling somewhere no one can see it and budget deadlines looming.

Republicans have been here before on healthcare, on the brink and scratching for votes.

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The House eventually found a way through this political and substantive maze. Now it's left to Senate Majority Leader Mitch McConnell to find the puzzle pieces and President Donald Trump, perhaps, to supply some muscle, lest the GOP be forced to admit failure on the party's top legislative priority.

Was it only yesterday that Majority Whip John Cornyn boldly declared there would be no turning back this week, that the Senate healthcare bill would be put to a vote before lawmakers leave for the July 4 recess? "I am closing the door," he tweeted. "We need to do it this week." So much for that.

If it was a bluff by the leaders, other Republican senators called it.

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McConnell, a shrewd legislative poker player, quickly folded today. Instead of moving forward, the bill is now on ice.

The original Senate leadership plan called for negotiations in secret by a small group, springing the results on the other members and forcing a quick vote before outside opponents could mobilise. Instead, the calculation that time was of the essence crashed into the reality of vote counting. The new calculus is that delay is better than defeat.

Inside the GOP’s health care flop https://t.co/Jaz9ij00Uk pic.twitter.com/WnDxkOoSEv

— POLITICO (@politico) June 28, 2017

But will more time help to melt away the opposition?

It did in the House, after the sudden and spectacular collapse of the leadership's bill hours before a scheduled vote in late March. By early May, after weeks of negotiations between Freedom Caucus conservatives and members of the less-conservative Tuesday Group, the House approved a bill.

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The President was so hungry for even a partial victory that he held a ceremony of celebration with House members in the Rose Garden. Later, he privately and then publicly called that House bill "mean," and it was left to the Senate to make amends.

In a worst-of-all-worlds environment, Republicans continue to struggle with what they're selling, beyond the stated goal of repealing or revising the Affordable Care Act.

Whatever overarching arguments they hope to make on behalf of their legislation have been lost in a welter of competing claims and demands among senators with different priorities and dissimilar ideological viewpoints.

The Republicans' major selling point is that Obamacare is collapsing. Even Democrats acknowledge weaknesses with the current law, though some Democrats have accused Trump and Republicans of deliberately trying to make those problems worse.

The Congressional Budget Office put a dagger in the Senate GOP's efforts. The CBO analysis said the Senate bill would result in 22 million more Americans without health care than under current law, just 1 million fewer than the House bill. Reductions in Medicaid spending pose another obstacle, particularly to GOP senators from states that expanded Medicaid under Obamacare.

The CBO report wasn't all bad news for the senators. The Senate bill would save significantly more money than the House bill, giving McConnell and company funds to use to ease the opposition of some senators.

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But money alone won't resolve all the differences, particularly among those who want to see the Affordable Care Act largely dismantled. It will be a tedious, though not impossible, process to find the votes.

The healthcare fight has left the President frustrated and at times looking helpless. He is torn between his desire for the ultimate victory and the many things he said about the subject during his campaign and even since, such as that he wants coverage for everyone.

He has reduced all that to saying he wants something with heart. Does a bill that reduces coverage as significantly as the CBO says the GOP bills would do meet that definition?

What are the party's options? Fail and be held accountable by a conservative base that for years has been promised that Obamacare would be gone once the GOP held power. Pass something that looks like either the House or Senate bills and be left with the potential political consequences of being accused of eliminating coverage for 20 million more Americans.

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