The American Health Care Act (AHCA) has cleared three of the four committees whose approval it must have to be considered by the full House, and GOP leaders are confident enough in its prospects with the Rules Committee that a floor vote has been scheduled for Thursday. In other words, the time for posturing at press conferences, making passionate speeches to C-SPAN cameras, and concocting sound bites for cable talk shows is over. Before the end of this week, House Republicans will have to cast actual votes for or against Obamacare repeal — and the American people will be watching.
To pass, the bill needs to get 216 votes (normally it would be 218, but 5 vacant seats have lowered the threshold). There are 237 Republicans in the House, so the bill can pass without any Democratic votes and as many as 21 GOP defections. The Republican leadership doesn’t want it to be that close, however. Thus, it has been working closely with the White House to get ambivalent members off the fence. President Trump has enthusiastically supported the measure, saying he is “100 percent in favor” of it. If the bill fails to pass, it will be a huge embarrassment for his nascent administration.
Thus, Trump has personally engaged in negotiations with key House Republicans, and his efforts appear to be bearing fruit. After an all-night discussion with the Republican Study Committee (RSC), he convinced the influential caucus to support the bill in exchange for alterations in the way the bill deals with Medicaid reform. After the meeting, the president told reporters, “I just want to say that these are folks that were either a ‘no’ or a ‘maybe.’… We’ve been talking all during the night.… Every single person sitting in this room is now a ‘yes.’” RSC chairman Mark Walker added the following:
We’re excited about today because it’s historic knowing that we’re getting a couple of very important things — work requirements throughout the country [for Medicaid recipients who are able-bodied and without dependents], and also something that we call ‘block grants’.… We also think this would provide more coverage for the indigent, for the sick, and for the disabled. So we’re excited about it today, and that’s why we’ve come today to celebrate the American Health Care Act and moving forward with a “yes.”
Aside from its importance in getting the bill passed, this RSC deal was a crucial accomplishment for Trump. He ran for president largely on his abilities as a negotiator, and last week, he characterized the disagreements within the GOP about repeal as “a big fat beautiful negotiation.” Failure to successfully work out deals with members of his own party on something as crucial as Obamacare repeal would seriously undercut his credibility. Thus, bringing Walker and the RSC around on this bill has much larger ramifications than a few nuances in the way Medicaid is managed by the various states.
This doesn’t necessarily get the House bill completely out of the woods, of course. In fact, the deal with the RSC is likely to render certain “moderate” Republicans even more weak-kneed than usual. And the intestinal fortitude of those pusillanimous members wasn’t strengthened by last week’s report on the American Health Care Act from the Congressional Budget Office (CBO). Meanwhile, the media exacerbated their jitters. CNN gleefully reports, “A devastating analysis from the Congressional Budget Office on the House GOP bill to repeal Obamacare has rattled moderate Republicans in the House.”
The irony here is that the CBO report wasn’t actually “devastating.” First, despite the tsunami of fake news produced by the legacy media, the CBO didn’t say that it would cause millions of Americans to lose or get kicked off their health coverage. The report said that many Americans would simply decline to buy expensive coverage in the absence of a penalty. The media focused on that feature of the bill, because it was about the only part of the report they could spin as a negative. The rest of the report contains great numbers for AHCA. As Grover Norquist writes in the Washington Examiner:
CBO announced that the repeal bill reduces taxes by almost $900 billion and reduces federal spending by $1.2 trillion over the next decade. This reduces deficit spending by $300 billion over the next 10 years… the $300 billion in deficit reduction gives Republicans a great deal of wiggle room to amend their basic plan to win votes in the House and Senate to win those 218 congressmen and 51 senators. Tax cuts can be added into the mix. Thanks to the CBO score and the underlying power of the legislation, Obamacare repeal will now pass.
In other words, there really is no legitimate excuse left for any Republican to withhold support for the repeal process that President Trump and the GOP leadership have laid out. The CBO has given conservatives ample reason to support the first stage, to be passed via reconciliation, by showing that it is fiscally responsible. And the revisions to its Medicaid provisions negotiated with the RSC by Trump should further satisfy those conservatives. The so-called moderates can’t honestly claim that it kicks anyone off their health plan, but a few will no doubt use that as an excuse to vote against the bill.
These are the people whose names should be recorded on the 2018 proscription list. House Speaker Paul Ryan has guaranteed that he will have enough votes to pass the bill, but that doesn’t mean every Republican will have what it takes when it gets down to “nut-cuttin” time. Note the names of the GOP cowards who vote against Obamacare repeal on Thursday. They will be up for re-election in less than two years. Those will be the gutless wonders who should be primaried and replaced in 2018.
