The Senate repeal and replace fiasco

Last night, Sens. Jerry Moran and Mike Lee announced that they would not vote for the latest Senate version of Obamacare repeal and replace. They argued, in effect, that the proposed legislation did not really amount to repeal.

Sens. Rand Paul and Susan Collins were already “no” votes. Thus, the defection of Moran and Lee meant the demise of the bill.

What now? President Trump has called for the straight repeal of Obamacare.

Could this be done as “reconciliation,” i.e., with just 50 votes? Not, as I understand it, in pristine form.

However, in 2015, the Senate passed a form of repeal legislation with 52 votes. According to The Hill, the bill removed “the core pillars” of Obamacare by “repealing authority for the federal government to run healthcare exchanges, and scrapping subsidies to help people afford plans bought through those exchanges.” It also “zeroed out the penalties on individuals who do not buy insurance and employers who do not offer health insurance.” It included a two-year delay to provide for a stable transition period. It did not repeal the costly insurance rules, regulations, and mandates on plan offerings

As a practical matter, the reconciliation issue is moot because I don’t see how the Majority Leader can get 50 votes even for the 2015 bill, now that there is a president who would sign it. Sens. Collins, Murkowski, and Heller seem unlikely to vote to end free or subsidized medical insurance to millions of Americans with no replacement in sight. Other center-right Senators might also balk.

It seems to me that a vote on such repeal would amount to a self-inflicted wound on Senate Republicans. Senators in safe states would be happy to support it. But Senators in swing states would be forced either to alienate moderate voters or incur the wrath of the base for not backing legislation they once supported. Why put them in this position if the votes aren’t there to pass repeal?

Majority Leader McConnell might push for a vote on repeal coupled with the House bill (the AHCA) as the default to take effect in two years if no other replacement legislation is agreed upon. Ed Morrissey discusses this option here.

It’s doubtful that this approach could garner 50 Senate votes. GOP Senators rejected the AHCA out-of-hand, instead setting out on the rocky road that has led them nowhere. Susan Collins and some center-right members consider it too draconian. Some conservatives think it doesn’t go far enough. For example, it does not contain the “choice” provision that Ted Cruz demanded.

There’s also the question of whether the House would support such legislation. Sure, it passed once. But as Ed notes, some of the 217 Republicans who barely pushed the AHCA over the finish line did so in the expectation that Senate Republicans would create a better approach to repeal and replacement.

But whatever is true of the House, 52 Republican Senators apparently just doesn’t translate into 50 Obamacare repeal (or repeal and replace) votes.

Republicans have had high hopes for extending their Senate membership to 55 or more in the 2018 elections. After all, the Democrats will have to defend numerous seats in states carried by President Trump. Not all of those seats seem winnable, but around half a dozen of them do.

With 55 to 58 Republican Senators, the prospects for passing repeal and replace would probably be good, especially with Obamacare continuing to fail. However, getting to 58, and maybe even to 55, suddenly seems like a tall order.

The failure to deliver Obamacare repeal/replace legislation is one of the main reasons.

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