Efforts will continue over the weekend to get the Republican health care bill back on track, but there’s virtually no room for error.
Republican leaders have vowed they’re committed to vote next week on some plan to overhaul Obamacare, but with Arizona Sen. John McCain out as he deals with newly-diagnosed brain cancer, Majority Leader Mitch McConnell can only lose one member of his conference and still advance a bill. As of now, there’s no indication the votes are there.
Adding even more uncertainty, leaders still haven’t announced what exactly members will even vote on next week when they return to the Capitol. Instead, they are urging their members just to vote “yes” on a procedural vote to begin debate on the House bill. Once the process begins, however, no one knows what will happen next.
“We don’t have a clear determination as to what it is we would be voting for so it is very difficult for me to say ‘yes’ or ‘no’ to proceed. We are not certain what we would be proceeding to,” said Alaska Republican Sen. Lisa Murkowski earlier this week.
What do leaders want from members?
Leaders are relying on one prevailing point to try and wrangle votes: senators can’t get what they want if they never get to the bill at all, multiple aides have said.
In other words, the wide-open amendment process that would begin (so long as the amendments are germane to the bill and within the budget rules) presents unlimited opportunities, for any senator, to amend the bill and move it in a direction they see fit. Better to start the process than shut it down altogether, the aides said.
Still, there’s a notable hole in that effort. That same amendment process would create no shortage of damaging political votes, a point politically vulnerable senators have been keenly aware of in the weeks leading up to this point. Asking senators to enter a debate and voting process without a clear end-game or agreement locked in, was described by one former GOP leadership aide as akin to jumping out of a plane with parachute that may or may not be packed.
“And it’s not even a 50-50 proposition at this point,” the former aide said. “It’s more like 10-90.”
There is no shortage of pressure, however, on undecided Republicans to back an overhaul of Obamacare they have been campaigning on for years.
“Senators have been elected to debate and amend, not simply take absolutist positions and expect everyone to come to them, If our members won’t even let us debate our own bills on the floor, especially to accomplish something we’ve been promising for seven years, it’s difficult to understand why they are here,” said one GOP aide who is close to the process.
A lot has transpired over the week
Let’s rewind.
McConnell announced Monday night (after it was clear that his repeal and replace strategy had run aground) that members would vote on a 2015 repeal-only bill. But during a lunch at the White House Wednesday, President Donald Trump urged Republicans senators to get back to work on their plan to repeal and replace the Affordable Care Act, injecting no shortage of confusion. Then on Wednesday night, it was announced McCain had an aggressive brain cancer.
That all left some things up in the air. Leaders said Thursday that no decisions had been made on what path Republicans will ultimately take next week.
“We’re going to vote on whether to proceed to a bill. And I know people are fixated on what bill are we going to vote to proceed on — but the problem with that is that this is a unique process where every senator can offer amendments to change the bill,” Majority Whip John Cornyn of Texas said Thursday. “So it really is irrelevant what technical vehicle we proceed to. This is just strictly, are we going to start the debate, so people can offer amendments and so we can at some point finish.”
For now, the Trump administration is trying to work behind the scenes to come up with some kind of Obamacare replacement bill that will satisfy moderates. Centers for Medicare and Medicaid Services Administrator Seema Verma has been meeting in both group and individual settings with moderate hold-outs, hoping to convince them that there is a way to protect low-income people in their states once Medicaid expansion ends. A new Congressional Budget Office score Thursday showed that Republicans had more than $200 billion more to spend on health care and still make their budget target. That may give leaders and the White House some room to negotiate.
But spending more money to win votes is making some Republicans uncomfortable.
“It’s beginning to feel like there is a lack of coherency in what we’re doing, and it’s almost becoming a bidding process. Let’s throw $50 billion here, let’s throw $100 billion there. And again, it may write itself, but it’s making me uncomfortable right now,” said Tennessee Republican Sen. Bob Corker.
The administration is also making a public push at this point to get the bill across the finish line. Vice President Mike Pence called into Sean Hannity’s radio show Friday afternoon, hosted grassroots organizations at his ceremonial office in Washington and, on Friday night, was expected to wrap up the day with a satellite tour into local evening news broadcasts.