In the last few days, I’ve had the chance to meet with over half a dozen Republican members of Congress (both House and Senate) along with senior congressional staffers. Among my interlocutors was a roughly even split between those who were disappointed that the House’s first attempt to repeal and replace Obamacare had failed because it showed the GOP as being unable to govern even with nearly full control of the federal government and because of the importance of the underlying policy goal, and those who argued that the bill was so flawed that the GOP and the public are both fortunate that the measure was stopped.
Several consistent themes emerged from my conversations:
While there was some frustration by those on each side of the yes/no divide toward the other, nobody dismissed those who had reached a different conclusion as opposing-for-the-sake-of-opposing, as radical or out of touch, as arguing or negotiating in bad faith, or even as certainly wrong. It struck me as a welcome change from the GOP circular firing squad we’ve all become so used to.
Many reiterated Rand Paul’s line (Sen. Paul not being among those I spoke with) that all Republicans campaigned on repealing Obamacare, but far from all campaigned on replacing it. Most Republicans realize that it is politically difficult or impossible to repeal Obamacare without replacing at least some parts of it, while simultaneously realizing that the details of replacement remain divisive within the GOP conference.
Similarly, some House Republicans would like to offer as little in the way of replacement as possible, and just move repeal, possibly along with Medicaid reform, to the Senate while others want to include as much replacement as they believe can get through the Senate’s “reconciliation” process.
Much of this calculation rests on what strategy is more likely to force at least 8 Democrats to work with Republicans in what the GOP calls “Phase 3” of their broader plan, namely to pass future health-insurance-reforming legislation that cannot be included in reconciliation and therefore will need 60 votes to overcome an inevitable Democratic filibuster. For those thinking further ahead, this calculation is also impacted by the fact that the 2018 elections will include three times as many Democratic-held Senate seats as GOP seats, including 10 Democrats running in states which Donald Trump won.
While President Trump has over the course of less than a week vacillated between “I’m moving on” and “a deal is near,” Republican congressmen are ignoring the White House. Mr. Trump has done all the cajoling and arm-twisting he needs to do. Most Republicans are already as motivated as they can be to repeal and replace Obamacare. At this point, more presidential involvement is not only unneeded, but would serve only to slow down the process.
Despite President Trump’s back-and-forth, and Senate Majority Leader Mitch McConnell’s depressing statement that the Obamacare “status quo…(will) go forward, regretfully,” every House member I spoke with believes that an improved measure will come up for a vote in less than a month, perhaps in just one to two weeks.
Those who were likely “yes” votes on the prior bill agreed with most criticisms of the bill by the “no’s,” but did not believe the policy issues were large enough that the bill should have been defeated. Those who were likely “no” votes agree with the others that it is tremendously important that the GOP show it is capable of governing, and not just opposing. Every likely “no” vote in the House and Senate whom I spoke with appeared sincerely to “want to get to yes.”
Members of both chambers believe that Senate Republicans will substantially weaken whatever bill the House sends them. But they all agreed that this is not House members’ problem. They need to get the best bill they can out of the House and then hope that the Senate modifies the bill to remain as pro-free-market as possible while still getting 50 votes (plus the tie-breaker of Vice President Mike Pence’s vote).
There were interesting differences about the importance of Medicaid reform within the repeal-and-replace package. To be clear, all were in favor of it, especially of returning as much control as possible to the states and reducing the number of Americans dependent on government for health insurance. But some saw it as a critical item within the overall package while others saw it as not fundamental to a primary policy goal of returning market forces to the private health insurance market, to “let insurance be insurance.”
Those Republicans such as Peter King (R-NY) who are now making noises about moving directly to spending hundreds of billions of dollars on infrastructure and “working with Democrats” are making an enormous political mistake, an enormous policy mistake, and are doing little more than showing their fundamental unwillingness to do the hard work of governing. They must be ignored.
The late columnist Robert Novak once said, “God put the Republican Party on earth to cut taxes. If they don’t do that, they have no useful function.” Repealing Obamacare amounts to roughly a trillion-dollar tax cut (over a decade) as well as a much needed step away from trying to remedy one government failure by piling another one no top of it.
Beyond the policy aspects of this debate, the politics are crucial: Republicans have a rare opportunity to lead, and a president who is not afraid of bold steps. They cannot remain mired in the mindset of an opposition party. If with control of the House, the Senate, and the White House, the GOP cannot fulfill their most important and best known campaign promise, why should voters ever cast another ballot for a Republican?
I have never seen such fundamental agreement among Republicans, notwithstanding Peter King and a few other big-spending RINOs, about the importance of getting this done, of actually repealing (and at least partly replacing) Obamacare.
I once read that the best compromise is one in which all sides end up slightly unhappy. That’s where Republican moderates and conservatives alike must be willing to end up, though preferably with conservatives getting somewhat the better of the argument in the final product. The guts of Obamacare MUST be repealed.
The country needs it. The Republican Party needs it. And most importantly, it is the only way to begin moving in the right direction when it comes to the nearly one-sixth of our economy that health care represents. Or, to put it another way, it’s time to make health insurance great again.