The Senate Republicans’ health care bill died Monday night around 8:45 p.m., when Senator Mike Lee tweeted that he and GOP colleague Senator Jerry Moran could not vote for it:
MTP means “motion to proceed,” which needs 50 votes. Senators Susan Collins and Rand Paul had both already said that they’d do the same. There being 52 Republican senators, this means Mitch McConnell has gone from having 50 votes—with which the bill could still pass, because Mike Pence would provide the 51st vote to break the tie—to having 48. And even in the United States Senate, 48 loses.
This is huge. The bill is dead. The cynical, all-politics, non-policy, no-hearing bill is dead. Mr. Tactical Genius, McConnell, who certainly is a tactical genius when it comes to blocking what the Democrats want to do, may not be such a tactical genius when it comes to passing what his own party wants to do.
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So the bill is dead. But while we uncork the champagne, let’s also remember: This bill is dead. This bill. Some other bill could still maybe win. After all, that’s what happened in the House, wasn’t it? Remember? The House’s first pass at Obamacare repeal failed; then, the leaders regrouped and added some sweeteners for the Freedom Caucus, and the second time around they passed it.
Can McConnell do the same? Let’s game it out.
What’s McConnell going to do now? Well, we can make a guess based on where his problem is. The decisive opposition is coming from the right. Collins opposes from the center, but the other three opponents—Paul, Lee, and Moran—are all opposing the bill from the right. Because it doesn’t go far enough.
So McConnell will have little choice but to placate these three to get their votes. In other words, he’ll move the bill farther to the right, by doing what Paul and the Koch brothers, among others, have been asking for—for example, doing even more to eviscerate Medicaid. A Koch spokesman denounced the current Senate GOP bill as just doing “a slight nip and tuck” to Obamacare.
If he makes moves to get the votes of Paul, Lee, and Moran, he’s back at 51. But what does he risk losing on the other side?
That’s the question, and in a way that’s always been the question: Will the “moderates” show any spine? (I laugh when I see these people called moderates. They’re just normal conservatives, instead of rabid conservatives. But whatever. Call them moderates if you want.) What will they do?
The first instinct is to think they’ll cave. They often have. But consider the following.
Soon, like on Tuesday, the Congressional Budget Office is going to score this latest version of the Senate GOP bill, with Ted Cruz’s measure allowing insurers to offer plans that don’t comply with current Obamacare regulations thrown in. It’s not likely to be pretty. Then, if McConnell comes up with a new bill of some kind, the CBO will score that again. And if he moves the bill rightward, the score will be worse. Any new bill along those lines will almost surely throw even more than 22 million people off the rolls.
In addition to the CBO, the big interests and players will weigh in. That letter that AHIP and Blue Cross/Blue Shield sent to McConnell and Senator Chuck Schumer about the Cruz provision didn’t quite get the attention it deserved, but it was devastating. The big insurance companies—yes, the GOP is now to the right of the big insurance companies—are already flashing the siren on this thing. And if the bill moves farther in a Cruz-Paul direction, they just may come out officially against it. The moderate Republicans will notice this.
Finally, there are hospitals, especially rural hospitals—of which there are quite a few in Ohio (Rob Portman), Nevada (Dean Heller), Alaska (Lisa Murkowski), and West Virginia (Shelley Moore Capito). When you think about those four, don’t think about protestors outside their state offices, compelling television though that may make. Think about them on the phone with administrators of rural hospitals whose funding would shrivel under the GOP bill and that may have to close.
I know from talking to some people in my home state of West Virginia that this situation is different and complicated. It’s not just an Obama vs. Trump thing. Loads of Trumps voters are getting care because of this law. You can’t go around the state saying, “Hey, isn’t Barack Obama a great guy?” But you can go around the state arguing that Uncle Delbert has been doing better since his dialysis treatments, and it’s changed his life, and it would be horrible if Capito voted to take it away from him.
McConnell’s other choice is to say, “Okay, we’ll work with Democrats.” Fine. This will thrill the media. Bipartisanship!
And maybe Democrats will do it, at least for a while, although I kind of doubt it, because why should they, given that the GOP intention here is obviously not to improve the Affordable Care Act?
But even if they do—even if both sides in the Senate approach the table in good faith and hammer out a compromise bill that fixes the ACA’s problems—what difference would that make, politically? The Republican House would never, ever, ever vote for such a bill. So any bipartisan Senate bill would die in the House. As McConnell—and Schumer—certainly know.
I don’t know what Jerry Moran and Mike Lee ate or drank Monday night. But whatever it was fortified them to be willing to be the people who killed Obamacare repeal. Feed more of them that stuff.
