Senate To Move Ahead On Health Care Reform Votes That Seem Unlikely To Succeed
The Senate isn't giving up in its efforts to 'repeal and replace' the Affordable Care Act, despite the fact that it seems clear that the votes aren't there.
Just since the beginning of the month, we’ve seen Senate Republicans delay a planned vote on their health care overhaul until after the July 4th recess because they didn’t have the votes to pass it in its then-current form. delay the vote again due to Senator McCain’s illness only to pull it completely once it became clear that there wasn’t sufficient support to pass it even with McCain’s vote, and then see their repeal-only plan die in less than eighteen hours. Despite all of this, and notwithstanding today’s news about Senator McCain that seemingly guarantees that his vote won’t be available for an unknown period of time, Senate Republicans still seem intent on moving forward:
WASHINGTON — The Republican health care push was declared dead Wednesday morning. By afternoon it had a breath of life. Legislation in Washington can assume Frankenstein-like qualities.
On the cusp of a humiliating and politically disastrous defeat, President Trump and the Senate majority leader, Mitch McConnell, took extraordinary resuscitative measures on Wednesday to pump oxygen back into their badly fading effort to overturn the Affordable Care Act. They somehow managed to stave off its imminent demise.
It may be only a temporary reprieve, but a fight that seemed finished just hours earlier was renewed and headed for a pivotal vote next week.
With his reputation for being a master of the Senate at grave risk, Mr. McConnell, a Kentucky Republican, extended a new offer to wavering Senate colleagues leery of scrapping the health care law. He backed away from his earlier insistence that the Senate focus on a plan to repeal much of the existing Obama-era law and allow a two-year window for its replacement — an iffy proposition given the difficulties that Republicans are currently having coming up with a consensus health care policy.
Instead, his new selling point was that senators should simply vote next week on a motion to open a rollicking health care floor debate and then let the amendment chips fall where they may — a case of creating national health care policy, which makes up about 20 percent of the United States economy, on the fly.
“What I’m telling you is no harm is done by getting on the bill,” Mr. McConnell told reporters outside the White House after a lunch where Mr. Trump hosted most Senate Republicans. “Wide open for amendment.”
“There’s no way that I, or anybody else, could prevent members from having amendments that any 51 of us can pass and change the bill,” he said by way of encouragement. “But we cannot have a debate until we get on the bill.”
Whether that will be enough to entice Republicans who feared that health insurance proposals crafted by the leadership would do damage to states like Ohio, West Virginia, Maine and Alaska remained to be seen. But there was no rush of outright rejections, and lawmakers planned to assemble with White House staff members to explore options that could win them over.
At the lunch, Mr. Trump mixed threats of political retaliation against Republicans who crossed him with pleas to move ahead with a long-promised repeal-and-replace legislation, urging senators to remain through their August recess if necessary. It was a stark change from his earlier promise to let the health care law collapse and let its beneficiaries face the consequences.
“My message today is really simple,” Mr. Trump told them. “We have to stay here; we shouldn’t leave town, and we should hammer this out and get it done. And not just a repeal,” he said, conceding he had backed that idea before. “I think the people of this country need more than a repeal. They need a repeal and a replace.”
That was good news to Senator Shelley Moore Capito of West Virginia, who had been one of the first Republican senators to balk at moving ahead on an outright repeal plan, along with Senators Susan Collins of Maine and Lisa Murkowski of Alaska.
“I’m glad @POTUS agrees that we cannot move to repeal Obamacare without a replacement plan that addresses the needs of West Virginians,” Ms. Capito said on Twitter.
It is difficult to say how much she and other Republicans — whom Mr. McConnell described as having “some difficulty in getting to yes” — were persuaded by the president’s appeal. But with several days remaining before a vote, Republicans were finding it hard to resist the call to at least make the effort to find some resolution, though many were very skeptical of the chances for success.
The window remaining before the vote also allows both opponents and proponents of the Republican health proposals to step up their pressure on key lawmakers, and they will face an assault.
A coalition of conservative advocacy groups took a harsh line against Republicans who were threatening to derail the health care effort, promising to initiate primary campaigns against them. They noted that all Republican senators who were then in office, except for Ms. Collins, had voted for a vetoed 2015 repeal plan that would be on the floor next week and that the party had campaigned endlessly on its promises to kill the Obama health care law.
Jason Pye of the group FreedomWorks put Ms. Capito and Senator Rob Portman, the Ohio Republican who had expressed reservations about earlier Republican plans, in the “Senate traitor caucus.”
“Our activist community in Ohio and West Virginia are not going to take this laying down,” he said.
This news comes at the same time that the Congressional Budget Office has released scores for both the Repeal-only plan and the revised version of the ‘repeal and replace’ plan. In the first case, the CBO estimates that the Obamacare Repeal Reconciliation Act, the repeal-only bill, would result in 32 million people losing coverage over ten years and premium increases of at least 100% over the same period. Meanwhile, the office estimates that Better Care Reconciliation Act would result in 22 million people losing insurance and premium increases roughly the same as those projected for the original version of the BCRA, which the CBO scored late last month. It also comes on the heels of multiple polls showing that the Senate plan is exceedingly unpopular with the American public and that even self-identified Republicans aren’t exactly enthusiastic about either the Senate or the House replacement bills.
Given these scores, it’s hard to see how Mitch McConnell and the rest of the Senate leadership is going to be able to pull together a coalition of fifty votes before the vote that they intend to take next week. As it stands, there is already a sufficient number of Senators opposing both the BCRA and the ORRA to prevent either one from passing even the fifty vote threshold that they would need with Vice-President Pence’s vote. Added into this is the fact that Senator McCain will obviously not be present to participate in any vote that would take place between now and the start of the summer recess, meaning that the GOP leadership can really only afford to lose one of the remaining 51 Senators that it has in the caucus right now. Given that, it’s hard to see this latest effort as anything more than a symbolic effort on Senator McConnell’s part to show that the Senate tried to do its part on ‘repeal and replace’ but came up short. Whether that will be enough for the so-called “grassroots” organizations that are attacking the Senators who are leaning against one or both of the Senate bills remains to be seen, but it’s at least worthwhile to note that two of the Senators who would be targetted by these organizations — Senators Capito and Collins — aren’t up for re-election until 2020, and that Lisa Murkowski and Rob Portman aren’t up for re-election until 2022. It seems unlikely that something that happens in the summer of 2017 is going to have much of an impact on those races.
In Trump, we have the Keyser Soze of politics.
He’s going to bully the stragglers –bet he can’t wait to go after Collins or Murkowski– then go find a couple of replacement votes among faithless Democrats.
@James Pearce:
There won’t be any “ffaithless Democrats.”
@James Pearce:
At this point, Collins and Murkowski are likely to laugh in Trump’s face. He’s a bully manque.
Speaking of which, after being publicly humiliated, Sessions didn’t resign as AG. At first I thought, “This man has zero self-respect.” Then it occurred to me that Sessions might want to stay right where he is and help sabotage Trump.
Revenge is a dish best served cold.
@CSK: The whole commentariat last night were off on the idea that if the president expresses a lack of confidence the secretary should resign. That is true with normal presidents, for whom an expression of lack of confidence would be a request for resignation. But Sessions knows Trump doesn’t know these rules. He assumes, probably correctly, that it was just a brain fart and forgotten already. He can defend Trump better, and himself from inquiries into the Prevezon case, as the sitting AG, even though “recused”.
@James Pearce:
The brilliant and enigmatic Trump could be standing in right front of you and you’d never know it.
The current GOP defies parody. Any attempt to caricature their feckless incompetence is immediately trumped* by what they actually do. Even the editors at The Onion seem to have given up on being too outrageous, and have gone for snark instead.
*Yeah, I know, but it really was the most appropriate verb here. Another reason to hate The Donald — he’s ruined a perfectly good verbal analogy.
@CSK:
This is partially what I thought…that and there are probably Senate colleagues of Sessions’ who are begging him to stay. One, because any AG nomination at this point is going to be someone who is even more questionable on the ethics front, and two, because the last thing they need/want at this point is another high-profile three ring circus cabinet appointment and confirmation process. And possibly a third point of realizing that Mueller now represents the best possible course to get rid of this disastrous administration and start over with Pence. There *have* to be people thinking that at this stage.
I’m honestly surprised that Republicans aren’t trying to figure out a way to fix the exchanges at this point. They are in charge–if they fix things so that people are happy, they get to take the credit. With as low as these replacement deals are polling, it is literally in the party’s best interests to stop messing with repeal & replace, and just fix what is wrong. Even if they work with Democrats, they’d be able to take all of the credit–this is precisely the scenario that pissed Newt Gingrich off so much about welfare reform in the 90s–they reached across the aisle and Clinton got all the credit. They really don’t learn, that crew.
There is another reason that Republicans might want Sessions to stay: Trump will really care about his replacement. For most positions, the incredibly lazy and stupid (brain damaged?) Trump is happy to sign off on whatever is put in front of him. But for AG he’s gonna want a personal pledge of loyalty, and make it clear that means squashing the investigations. So he will be looking for someone completely corruptible that is stupid enough or desperate enough to take the spot. And he needs to trust him (which rules out Chris Christie). There’s only one man for the job: Jared Kushner. That will bring a constitutional crisis up that will drag everything they attempt to do into the gutter.
As for that comment about Christie: given the past ten years or so of witnessing the pettiness and vindictiveness of the man I think he would promise Trump anything and then once in place do everything in his power to bring Trump crashing down. It is perhaps the only feasible way he can ever politically redeem himself for two years as Trump’s sycophantic loser boy.
@Doug Mataconis:
Well, I hope that’s true, but here we are…talking about faithless Republicans.
@CSK:
Are they? Are they really? (A lot of liberal cred given to these two Republican Senators….Is it deserved?)
@Grewgills:
He wouldn’t be standing in front of me. I don’t live anywhere near the White House.
@MarkedMan: I do with I could believe that “revenge is a dish best serve cold” and the Republicans are all secretly sharpening their knives, but there unfortunately is an easier explanation:
They’re terrified of Trump and his Trumpenproletariat.
OT but related: Good article from the NYT showing how the Brits are walking into chaos with their lack of Brexit planning.
Honestly, the Tories are starting to look like the Republican Party: stampede off the cliff and desperately yell “IT’S GOING GREAT!!!” just before splatting on the rocks below.
@grumpy realist:
I’ve already made modest money bets with 2 colleagues that the Senate will pass a repeal/replace/not-replace bill before they recess.
Cynically perhaps, but I have every confidence that senators like Moran and Heller will fold up, and others are sure to follow.
Seen this new AP poll?
Jeff Sessions wants to bypass the courts (imagine that) and steal citizens money.* He can’t let the whining tantrum of REPUBLICAN President Pork Chop Pud get in the way of his government sanctioned looting.
*Trigger Warning! Link is to Reason.com.
@grumpy realist: I guess I wasn’t clear. I’m not talking about Republicans in general, just specifically about Christie. And I don’t think his motivation would be primarily revenge (although Christie is extremely vengeful and would delight in it) but rather by him personally bringing down Trump he could erase the public impression of him as a fawning Trump toady.
@Jen:
Yes, this is a real possibility: that Sessions’s Senate colleagues are begging him to stay in order to speed the process of dumping Trump.
@James Pearce:
Of course Murkowski and Collins can laugh in Trump’s face. What’s he going to do to them? They know what he is: a buffoon, an oaf, a charlatan, and a pathetic weakling. Trump’s a tough guy only when he’s cheating a plumber or suing a freelance writer or molesting a 24-year-0ld production assistant.
@CSK:
Or Sessions has so little regard for Trump that he’s just ignoring him.
Imagine, giving up a Senate seat for 6 months of AG under Trump… not worth it. Best to just ignore Trump’s polite and roundabout suggestions the he resign, and keep doing the things he wants to do — oppressing minorities and making it easier for the government to steal from citizens!
@Gustopher:
Well, there’s that, certainly.
And it may well be that Sessions is so contemptuous of Trump that whatever Trump says is of no consequence to him, about as important as a toddler having a tantrum and screaming “I hate you.”
What process? These are the Republicans that have had seven years to develop a plan for healthcare in America. These are the Republicans who now have Total Control of the United States Government and can’t find their ass with both hands.
How many of these craven weasels have signed on to the recent filing of the Articles of Impeachment?
How many ever will?
@CSK:
Worst case, it will probably start with unleashing the troll army first, and if that doesn’t do the trick, he’s got an entire state apparatus with which to harass, intimidate, and basically mess with whoever he wants. As buffoonish as he is, restraint won’t tie his tiny little hands on any of that.
But more likely, and the way I think they’re going, is that he’s going to buy them off. He can, theoretically, buy off some Dems, too. He’s the Great Negotiator, remember? (Ha!) We’ll get a regrettable, compromised bill that needs fixing by more responsible parties, but Trump will get his “victory” and yet another moment from the Obama era would have ended jubilantly. MAGA all day, right?
That’s the direction I see this going. I don’t see Murkowski or Collins, or any of the other wobblers, standing for anything firm.
I wonder how long it will be before a Trumpie uses this to argue that the BCRA would save 10 million people.
@Jen: Senator Rand Paul seems to have some insights and logical ideas on this. He is a physician and should know A thing or two about the health care problems and what is needed.
@Tyrell:
First, in the history of health care reform in this country, no single culprit has stood more in the way of our country developing a universal health care system than the medical lobby. It’s the main thing that stymied the attempts by FDR, Truman, Nixon and Clinton, and which posed a major obstacle to the passage of Medicare, Medicaid, and Obamacare. Right or wrong, physicians as a whole believe reform poses a threat to their financial security and professional independence.
Second, physicians do not necessarily understand the economics of health care better than anyone else.
Third, Rand Paul is an eye doctor, and eye care tends to stand apart from other branches of medicine because its products function more like typical commodities. People shop for glasses all the time, but they are a lot less likely to shop for treatment for, say, appendicitis.
@Tyrell: Um, you do realize that Paul is one of those slavering at the bit for total repeal, don’t you?
Trump’s lawyers are researching the question of whether Trump can pardon his associates, family and self.
Because he’s so innocent. And totally not the Don of the Trump Crime Family (TCF).
The spokesman for Trump’s legal team suddenly resigned. And there are some strange maneuvering among lawyers at Wilmer Hale. And Kasowitz is suddenly demoted.
Because there’s nothing here, folks.
Except that Manafort owed one of Putin’s boys seventeen million dollars. . . before he became Trump’s campaign manager and suddenly needed no pay.
I don’t see Trump as a guy who will go down in flames standing atop the White House. And obviously he won’t do it with dignity. And I very much doubt that he’ll risk trials for Jared and Ivanka. So here’s my prediction:
He pardons everyone, including himself.
He then resigns blaming a vast conspiracy.
Grabs what cash he can and flees the country.
But where shall he flee? No, not Russia, he’ll have stiffed Vladimir. Somewhere he owns property, somewhere he can be safe from Putin and from US Justice. The Philippines wouldn’t be a bad choice, but last I heard his property wasn’t open yet. Saudi Arabia would be a tough lifestyle choice. Turkey would be nicely ironic.
Where in the world will the Donald be?
@Tyrell: Rand Paul was an ophthalmologist. He doesn’t even have certification anymore.
Calling him a physician would be like calling me a physicist because I took engineering classes…
Then there’s comments by Rand like this “I’ve heard of many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines,”
fucking nutcase..
@Tyrell: Rand Paul was an ophthalmologist. He doesn’t even have certification anymore.
Calling him a physician would be like calling me a physicist because I took engineering classes…
Then there’s comments by Rand like this “I’ve heard of many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines,”
He’s an idiot trying to latch on to daddy’s cash cow.
WaPo:
NY Times:
Sure seems innocent, don’t he?
@Kylopod:
And even here we have Luxoticca, a virtual monopoly on glasses.
@Jen:
Actually, I think they have–don’t do things with the Democrats cause they’ll get the credit. Beyond that problem is that whole thing about not being able to undo the most important domestic agenda accomplishment of the black guy who didn’t deserve to be President in the first place. It’ll still be Obamacare in the history books, he’ll still be the first black President, and he’ll still be regarded as a better choice than the guy who came before him and after him. They’ve got a lot of history to unwrite and anything other than striking the memory of Obama from history will not be enough.
Yeah, I wish they weren’t that stupid and petty, too, but…
@Kylopod:
I think they understand the economics perfectly–at least the only part of the economics that matters to them: I can make more money as a doctor in the US than I can anywhere else in the world, but only as long as we can maintain the current status quo (remembering that only the contracts with the insurers act to curb their incomes in any meaningful way).
@Just ‘nutha ig’nint cracker:
None of that suggests an understanding of the health care economy–how health care markets actually work, the effects of supply and demand, the factors driving cost, and so on. Many physicians are woefully ignorant about those matters, even master physicians like Ben Carson, just like being a rich businessman who likes regressive tax cuts doesn’t imply an understanding of the economics of taxation. Self-interest is a motivation found pretty broadly in the animal kingdom, and there’s a fairly large gulf between it and comprehension.
I had to giggle…..
@CSK:
You are over-thinking it. Sessions is just another spineless Republican who doesn’t have the cajones to do the right thing.
@michael reynolds: Count me as among those who think one should never collaborate with crazy people.
@Tyrell: Sen Rand Paul, the genius who certified himself to practice medicine. Right. Sure. You keep choking that chicken.
@michael reynolds:
Kasowitz has resigned. So has his spokesperson Corallo.
@michael reynolds:
In Hell eventually, provided there is one.
@Kylopod: spot on.
Spicer has supposedly retired.
@grumpy realist: Do you suppose he signed an enforceable non-disclosure agreement? Or should networks/newspapers be lining up with wheelbarrows of money for interviews?
@Matt: Rand Paul: okay, I get the point here. They do need to get experts on board to give advice and ideas. They need positive cash flow, not losing money. That is why the insurance companies are leaving.
@Kylopod: I wasn’t disagreeing with you; I was noting that they don’t give a flying flock. I’m sure that some do, you understand, but those who do usually are trying to assist in developing good policies. As to the rest, I became jaded on the day that I went to my cousin’s wedding reception back in the 80s where he and all of his doctor friends were noting that even though cardiology and neurology weren’t particularly interesting fields to them, that they were the only fields that paid enough to make medicine a field worth going into.
Many people become good, caring doctors who serve their patients well. Many don’t. Sadly, the don’ts seem to be the ones that set policy in our country and the never ending battle is to shut them down.
@Tyrell: They aren’t leaving because of negative cash flow. THey are leaving for a variety of factors including the games the GOP have been playing. Ranging from messing with the funding all the way up to the possibility of a repeal creating uncertainty whenever possible…
It’s not hard to understand. Insurance companies want to make as much money as possible. They aren’t in the business to help people they are in the business to extract as much money as possible while paying out as little as they can. Just one of several factors pushing our ballooning costs.