A renewed push among Republican lawmakers to repeal and replace Obamacare is gaining steam on Capitol Hill—and progressive activists are worried that with the absence of a major spotlight and a pervading mood among the general public that repeal efforts are all but dead, the GOP might have the perfect opening over the next two weeks to finally scrap the 2010 law.
But a legislative success is far from certain for Capitol Hill Republicans, who are facing opposition to the latest iteration of repeal-and-replace from within their own caucus, and are grappling with a looming deadline that might make it impossible to pass a bill. Nevertheless Senate Majority Leader Mitch McConnell (R-KY) is reportedly looking to gauge support for the bill this week with an assist from the White House in whipping the necessary votes.
The legislation—unveiled last week by Sens. Lindsey Graham (R-S.C.), Bill Cassidy (R-LA), Dean Heller (R-NV) and Ron Johnson (R-WI)—has reignited some Republicans’ hopes that they can finally deliver on the seven-year-old promise to repeal and replace the Affordable Care Act. As written, the bill would block-grant federal funds to individual states and allow state governments to use the money how they see fit, while scrapping the individual mandate.
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The senators are pushing for a floor vote before the end of the month, when the Senate can still pass the legislation with a simple majority of 51 votes under a practice known as budget reconciliation. After September 30, any proposal would need 60 votes.
But a separate—and possibly competing—effort is set to gain renewed attention this week. The Senate health committee has been working to put together bipartisan legislation aimed at stabilizing the Obamacare exchanges and preventing insurance premiums from skyrocketing in 2018. The effort, spearheaded by Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA), is due to be unveiled to McConnell and Senate Minority Leader Chuck Schumer (D-N.Y.) this week, and would need to be signed into law by September 27 so that individual states could meet contract deadlines with health insurance companies.
Murray told The Daily Beast last week that she worries Graham-Cassidy could imperil the committee’s bipartisan efforts, and in turn derail attempts to mitigate the potentially disastrous premium hikes. She said the debate on repeal-and-replace has been settled and “we’re not going there.” Moreover, a Democratic aide said it would be “counterproductive to an extreme” for Republicans to support the Alexander-Murray stabilization package and “then rip apart the same system they had just set up” by getting behind Graham-Cassidy.
But a Senate GOP aide pushed back on that suggestion, saying the Graham-Cassidy and Alexander-Murray efforts aren’t in conflict—and, in fact, might work well in tandem.
“We view it as more of a complementary effort rather than contradictory. Regardless of whether Graham-Cassidy passes or doesn’t pass, there still needs to be stabilization in 2018,” the aide told The Daily Beast. “In a policy sense, they don’t really contradict each other in any way. Politically, how much time there is and if both could go to the floor, that’s an open question.”
Just a week ago, Republican lawmakers weren’t particularly bullish on the prospects of Graham-Cassidy getting a vote—let alone passing the Senate. Sen. Orrin Hatch (R-UT) told The Daily Beast that he doesn’t foresee it getting to the Senate floor because there wasn’t enough support for the bill. The Graham-Cassidy bill did not receive a single notable mention on the Sunday political talk shows, a sign that it might not be resonating enough in the Washington echo chambers.
Conservative lawmakers such as Sen. Rand Paul (R-KY) oppose Graham-Cassidy because they believe it does not go far enough to repeal Obamacare. The legislation received a glimmer of hope earlier this month when Sen. John McCain (R-AZ)—who killed the GOP’s last effort to repeal and replace Obamacare in July—indicated he supports the concept behind it.
But on Sunday, McCain seemed to throw cold water on any attempt to rush on health care reform legislation.
“Are we going to ram through our proposal with Democrats and the president? That's not the way to do it,” McCain said on CBS’ Face the Nation. “The way to do this is have a bill, put it through the committee. We have Patty Murray and Lamar Alexander doing fine—bring it to the floor. Have debate. Have amendments.”
The desire to explore yet another attempt to repeal and replace Obamacare is scarce among Senate Republicans, according to one senior GOP aide.
“No one believes that Graham Cassidy is the solution we need and it is certainly not helpful right at this moment,” the aide told The Daily Beast. “Moderate Democrats can’t be pleased that Comrade Bernie is virtually proposing socialist solutions when they are trying to compete in the upcoming midterms.”
Moreover, the White House is reluctant to get behind Graham-Cassidy in full force. In a statement last week, President Trump issued lukewarm praise for the senators’ effort, but stopped short of offering a full-throated endorsement.
“I applaud the Senate for continuing to work toward a solution to relieve the disastrous Obamacare burden on the American people,” Trump said. “As I have continued to say, inaction is not an option, and I sincerely hope that Senators Graham and Cassidy have found a way to address the Obamacare crisis.”
The White House wasn’t ready to use its pulpit to rally support for Graham-Cassidy in private, either. In a meeting with staffers from the conservative Republican Study Committee last week, Paul Teller—a top White House legislative affairs official—said the administration is willing to push for the bill’s passage but declined to go further, an aide who attended the meeting told The Daily Beast.
Outside the halls of Congress, there has been a fevered push to ensure that activists opposed to an Obamacare repeal are ready to pay attention once again. Groups like Indivisible, formed as a resistance outfit to the Trump administration, found success in previous actions opposing GOP efforts at repeal—drawing national attention to the issue and galvanizing a large activist base to participate in sit-ins and nationwide protests.
But celebration over Sen. Bernie Sanders’ (I-VT) introduction of a Medicare for All bill last week, which garnered a third of Senate Democrats’ support, somewhat overshadowed the looming possibility of the Graham-Cassidy legislation—for which there was a press conference the very same day—passing the Senate.
“They had the press conferences at the exact same time. It definitely was a distraction,” Angel Padilla, policy director for Indivisible, told The Daily Beast in a phone interview. “We support single payer but if you read our guide, our position is we always need to be defensive right now.”
A Democratic Capitol Hill source told The Daily Beast the timing was "problematic.”
Sanders, who vehemently opposed the previous repeal attempts, seemed to acknowledge the necessity for Democrats to balance long-term and short-term goals.
“Our immediate concern is to beat back yet another disastrous Republican proposal to throw millions of people off health insurance,” he tweeted on Sunday morning.
Padilla and Indivisible have set their sights on attempting to impact the votes of Sens. Susan Collins (R-ME), Lisa Murkowski (R-AK), Rob Portman (R-OH), Shelley Moore Capito (R-W.V.), and McCain, all of whom are viewed as being more susceptible to constituent outcry than others.
“We were kind of screaming, ‘this is a thing,’” Padilla said of his warnings about the bill. “A lot of people just did not take it seriously. But within a day, people got the picture pretty quickly.”
This same sense of urgency took hold of Ben Wikler, Washington director for MoveOn.org, who similarly had to juggle excitement for Sanders’ bill with concern over yet another repeal effort. In a tweet-thread sounding the alarm for activists on Friday night, Wikler compared the constant repeal attempts to “ravenous velociraptors who keep throwing themselves at the door, but not quite breaking in.”
“Our sense is even within the Republican caucus, there wasn’t a sense of how much support this bill had gained since late last week,” Wikler told The Daily Beast in a phone interview. “When the Senate gets back to work on Monday, their phones should be melting with constant calls both in their Washington offices and home state offices.”
Wikler said that he thinks activists have a ten-day timeline for an all-out blitz with a likely vote, if one should happen, on September 27. And Senate Democrats, he said, are now engaged in this new battle after pivoting from the high of their single-payer bill introduction.
But it may have been the actions of Senate Democratic leadership that ironically helped pave the way for this renewed repeal and replace push.
Another moment now seen as important by some to clear the calendar before the end of the month was an agreement Trump reached with Schumer and House Minority Speaker Nancy Pelosi (D-CA) to get a debt ceiling increase and a government funding bill off the legislative docket. In Padilla’s view, Democratic leadership could have been in a stronger position to combat the latest repeal-and-replace attempts had they not cut a deal earlier in the month.
“If protecting ACA was the single most important priority for Democrats, they should have waited until that was behind them until they started cutting deals with Trump,” Padilla said.
