“Repeal and Replace” is Dead – What Does that Mean for Georgia?
Monday night at a dinner with select Senators, in his typical bombastic way, President Trump said they — presumably meaning Senate Republicans and not Republicans in general to include him — would look like “dopes,” and also “terrible” and “weak,” if they didn’t pass the Better Care Reconciliation Act. Almost simultaneously, two Senators not at the meeting, Jerry Moran of Kansas and Mike Lee of Utah, announced publicly that they would join Senators Rand Paul of Kentucky and Susan Collins of Maine to become the third and fourth Republicans who would vote “no.”
For those keeping score at home, this bill was named as it was because Republicans had planned to pass it through the budget reconciliation process, which requires only 51 votes to pass. Under normal process, the Senate requires 60 votes to end debate and bring a bill up for a vote.
Leader Mitch McConnell has been on a rather quixotic crusade with “repeal and replace,” mainly because the President and most Republicans have insisted on repealing the Patient Protection and Affordable Care Act, whereas no Democrats were willing to go along, given it’s one of the defining pieces of legislation of the Obama Administration.
However, several Democrats have been open to helping Republicans mend PPACA if they chose that route. That was not what Republicans wanted, so they opted to use the budget reconciliation process. For weeks, there was discussion of how Vice President Pence would need to be the tie-breaker in a 50-50 split vote. That, by design, created a way for Senate Republicans to pass BCRA without any help from Democrats.
I’ve been skeptical of the ability of “repeal and replace” to actually happen, and now here we are. But why? Republicans control both Houses of Congress and the Presidency, after all.
Actually, former Representative Phil Gingrey explained it well in a blog post for his lobbying firm:
While complete repeal and replacement may have made sense in 2010 —when the GOP first took back control of the Congress and the ACA was not yet implemented— too much time has passed and too much of our nation’s health care infrastructure has been altered to get all the toothpaste back into the tube. A solution today should focus on keeping what works, fixing what is broken and tweaking the areas that need refinement and revision. Perhaps a more accurate name than “repeal and replace” would be “retain/repair/revise.”
But yet, that’s still not where we are. The Senate instead will be voting next week on “repeal only.” The number of Senators who are planning to vote against this measure currently stands at three, but other Senators have said publicly in the past they were not supportive of “repeal without replace.” I don’t see how McConnell gets to 51 votes for repeal only.
I think that’s been the point since January, though.
And, really, for a good length of time before this year. At some point, Republicans gave up on trying to fix health care for Americans and started using the repeal votes to solely score points with the base. How do I know?
The last time the House and Senate passed a PPACA repeal bill, they did so knowing that President Obama would veto it and they didn’t have the votes to override the veto. Some Senators have been talking in “what ifs” for weeks, with McConnell himself discussing how to shore up the exchanges if “repeal and replace” failed.
Also, President Trump gets to blame Congress as it stands, so his base won’t fault him. In case you didn’t know how it had gone down in President Trump’s Twitterverse, it’s the Democrats, stupid. Never mind that the Democrats by design weren’t supposed to be part of the equation. It’s their fault for not being part of the equation.
Weird how this is all working out, right?
Where does this leave Georgia Senators Johnny Isakson and David Perdue? Perdue, I am thoroughly convinced, would jump in a lake if the President told him to do it, and to that point, he’s already come out as a yes vote for repeal only. Isakson negotiated a deal to help charity hospitals in Georgia and other states that was put in the second version of BCRA, meaning he would almost certainly have voted for that bill. I’m thinking he’ll vote for the repeal only bill this time because he voted for the 2015 bill and is a vote that Senate Leadership can count on in a pinch, though he’s noncommittal so far. He has recently said that it would be wrong to vote for repeal without something to replace it, so I could be wrong.
Some points to ponder: When did Isakson and Perdue realize the bill would fail? What was the point of expending all that political capital, particularly in Isakson’s case, if it was always going to fail? Will Isakson vote for the repeal only bill?
It doesn’t matter in a sense, as the bill doesn’t have the votes to pass. It does, though, in another: Do our Senators really want repeal only, or do they think Georgians don’t have the sophistication to understand that repealing without a replacement will throw us back into the system that nobody liked before nobody liked Obamacare? (This also applies to any House Members calling for repeal only. Looking at you, Buddy Carter.)
That’s a cynical question, but an important one.
A more important question, though, is why President Trump, supported by so many in his base for his promise to make great deals for the American people, would have agreed to the partisan approach in the first place? Democrats passed Obamacare with the help of merely one Republican in the House and no Republicans in the Senate in 2009. That has not served them well, as every problem with the legislation has been all Democrats’ fault up until now. One would think Republicans would have learned something from that experience, as in “thank goodness it wasn’t us.”
Also, given that just seventeen percent of Americans recently polled on the issue liked the contents of BCRA, wouldn’t this strongly signal to the Dealmaker-in-Chief that he and Congress could and should do better than that? There are ways to find bipartisan compromises to our big problems that have a real majority’s support, not just the (slim) majority of the Senate’s support.
The biggest question, of course, is what now?
Legislators in the Georgia General Assemby had been looking at expanding Medicaid in 2017, but decided not to move forward with that plan after the House of Representatives passed its version of “repeal and replace.” Congressional Republicans have refused to fund parts of the bill over the past seven years in hopes that the exchanges would fail. Now, of course, Georgia has an issue with Blue Cross Blue Shield trying to get a massive rate hike out of its exchange customers. I hope McConnell will give up on repeal only and move on quickly to the shoring up of the exchanges. However, that doesn’t seem to be the way the White House wishes to proceed, with President Trump saying he would “let Obamacare fail.”
The President doesn’t want to “own it,” meaning any current problems with PPACA. Sorry, buddy. You’re the one who wanted to be President, and now you are, not Obama.
Everything that has happened since January is President Trump’s and Republicans’ to own on every topic, including all things health care. How many times have you heard people complaining about that terrible Lyndon Johnson for the current problems with Medicaid? What about that awful Dwight Eisenhower every time an interstate needs to be repaired? What was the last complaint you heard about that rascally Jimmy Carter regarding common core? No one does that. They always blame the current occupant of the White House.
I’m sure 2009 doesn’t seem that long ago. In the political world, though, that’s a lifetime, and voters’ memories are notoriously short.
Furthermore, Republicans — including Trump — promised Americans that if they’d just vote for them, just put them in charge, they would find a better path forward. I can promise you that a better path forward isn’t either the House or Senate versions of “repeal and replace.” It definitely isn’t any version of repeal only.
It’s one thing for Republicans to hold repeal votes when in the minority, however much of a fruitless and hollow exercise it became. It’s quite another to do it as the majority, when votes have real consequences and affect real lives.
When I particiapted in the Health Care Caucus working group (something I’m told doesn’t even exist in the House anymore, sadly), we had disagreements on where to go with health care reform, but one of the core principles for all of us was “access for all, not just insurance for all.” Maybe House and Senate Republicans might start there again with their way forward, and I’ll bet they’d get a lot of support from their colleagues across the aisle if they use that approach.
Make no mistake, though: There has to be a way forward. “Letting Obamacare fail” would also be failing the American people, and we wouldn’t have to wait very long to find out who voters think should own that.
Related
About Author
Holly Croft
Holly is an archivist at one of Georgia's institutions of higher learning. In a past life, she was a legislative assistant on Capitol Hill. She cares a lot about records management, open records laws, and privacy laws. Political persuasion? It's complicated. What's not complicated is that she's proudly equal parts Bulldog and Tar Heel.
Add a Comment
Cancel reply
You must be logged in to post a comment.
Trump doesn’t know or care what’s in the bill. Any bill. His agreement with the gopers is they’ll let him grift and in return he’ll sign whatever they pass. Failure to get the votes falls on McConnell and Ryan.
*
What do you make of Moran and Lee failing to notify the administration or McConnell before announcing they were denying their support? Blowing off Trump I can almost see, since he’s been a zero or less in the process, but it’s a real slam at the leader.
*
You ask when Georgia’s senators realized the bill would fail. Perdue hasn’t yet realized it. He’s still hitting talking points about the imminent collapse of Obamacare. Isakson I put in McConnell’s camp, blindsided and out of touch.
What do you make of Moran and Lee failing to notify the administration or McConnell before announcing they were denying their support? Blowing off Trump I can almost see, since he’s been a zero or less in the process, but it’s a real slam at the leader.
*
Harry Reid’s former Deputy Chief of Staff Adam Jentleson (A great Twitter follow, whatever your partisan persuasion, because he knows the inside players even when he’s giving his own spin) pointed out that McConnell always runs a very narrow leadership compared to Reid. While Reid always included Durbin and Schumer, then his broader leadership team, and then the various Chairs/Ranking Members in every decision making process, McConnell stays within his staff, then emails out marching orders. Cornyn is a gladhanding joke, who’s publicly revealed himself out of the loop tons of times in this process. Reid led his caucus with the usual mix of respect and consensus; McConnell leads mostly with respect. And this process has shown the Emperor has no clothes.
*
The contrast with how Reid handled Obamacare is instructive: Reid sent it through the various committees, markups, and amendments with his old bulls: Dodd (stepping in for Kennedy) and Baucus. Dodd would have always voted for it, but by respecting Baucus he got him on board (not easy for a Red State Senator) but helped carry along plenty of others who would have had every reason to duck out for something more incrementalist. It also gave potential thorns in their side the chance to have input in the process in such a way they had stakes to vote for it. Someone like Sanders, who could have played a Paul/Lee role (“I’m voting no because it’s not single payer!”), was given a pilot program on neighborhood health centers, or whatever.
*
McConnell wrote this thing entirely with the leadership and with minimal involvement or buy-in from any of the people who would have to take a really tough vote on this, either from a swing state (Heller, Flake, Collins) or in such a way that it would screw over constituents who were big winners of the ACA (Murkowski, Capito, basically any Medicaid Expansion state). Why did Moran and Lee thumb the nose at the leadership? Because the Leadership has been hanging them out to dry, taking away their power to do things for their constituents, all in service for a bill that’s massively unpopular everywhere. Why not?
Thanks for the info. I didn’t know McConnell held the bill so closely. I thought either McC would keep his caucus informed or the bill’s details would leak to members. Now I wonder how McC could be unaware of the resentment members felt until he got T-boned Monday night. The Senate gets more like the House every day. It’s scary to think what the dynamic means for tax reform and the debt-limit. I’ll hold out hope it won’t be a complete shambles.
I have a hard time seeing tax reform happen unless it’s just a straight big tax cut. There are too many interests who favor their various loopholes to actually get a straight bill. Ways and Means Chair Dave Camp worked hard to do tax reform in 2014, and the House GOP couldn’t even agree enough to bring it up in his committee. (I’m generally a skeptic on tax reform because post-86, the tradeoff is “We’ll lower the rates and drop out credits and the like that get used as loopholes” but then, over the following years, the rates stay down, the productive credits (using market incentives to overcome externalities to deliver for the public good; think a tax credit for cutting pollution or sending your kid to college are hard to bring back, and the corporate loopholes proliferate anyway.)
~~~~
The Debt Ceiling will be like this year’s earlier spending bills: The GOP has to go to Pelosi in the House because they have too many irreconcilables to get a straight bill, and she’ll drive a good bargain for delivering her members. As much as the right demonizes her and she has presentational problems, Nancy D’Allesandro Pelosi, daughter of an old Italian ward boss of Baltimore, is probably the best vote counter and nuts and bolts legislative leader on the Hill since Tip O’Neill.
“As much as the right demonizes her and she has presentational problems, Nancy D’Allesandro Pelosi, daughter of an old Italian ward boss of Baltimore, is probably the best vote counter and nuts and bolts legislative leader on the Hill since Tip O’Neill.”
That’s why they don’t like her. That, and you know, she’s a take-charge woman with liberal values. I used to hate her, but then I met her. She was really nice and very encouraging.
Yeah, and it’s such a waste. I didn’t vote for Trump, and he was one of the biggest reasons I left the GOP. But he’s wealthy and he was elected through an unusual coalition that isn’t necessarily conservative. I just think about all the good he could do if he found an interest in governing instead of constantly campaigning, specifically because he could out-fund the nut-wing groups that plague so many of the House and Senate Members. They then could do pretty much whatever as long as he provided the cover. It actually really depresses me every time I think about it, including now, so moving on…
*
I read somewhere that Moran told the Whip (John Cornyn), and that he and Lee decided to write the statement together because neither one wanted the heat of being the Lisa Murkowski of repeal and replace.
Gingrey’s statement exemplifies the nearly complete dearth of establishment GOP leadership—very few elected establishment Republicans have the cojones to make such a statement—you can bet Gingrey doesn’t plan to run for office again in the near future.
.
The GOP establishment places Isakson on a pedestal and upholds him as a model. His vote to repeal and not replace, should that come to a vote when it has no chance of passing, will illustrate his character. Depending on circumstances, it could depants a number of GOP electeds.
What? No mention of Georgia’s own Tom Price and his half dozen years of impressive leadership on healthcare legislation?
I’m sorry, you’ll have to fill me in. I just know what I’ve experienced firsthand or read in the papers. 😉
If that’s the case, you have the same comprehensive understanding of Price’s achievements and contributions as I do.
So what are we thinking will happen? The House passes repeal only but the Senate doesn’t? But they already passed repeal only once and Obama vetoed it. What does any Senator say now if they vote against it? So most likely this will be another item that doesn’t get a vote in the Senate to keep those guys from being put on the spot like that. I would think someone will pay for that. McConnell? I don’t think he’s got an election until 2020 though.
While I’m no fortune teller, here’s my best guess:
*
The House will hold a repeal only vote. (Side note: I used to really respect Paul Ryan, but now I miss John Boehner every single day.) McConnell is going to hold the vote in the Senate. I think you’re right in that it passes the House and fails in the Senate. The President will take to Twitter with his wrath.
*
Moderate Republicans will have already worked with Democrats on how to fix the exchanges. McConnell, who wanted this outcome all along, will allow a vote.
*
I think people are underestimating McConnell here. I think he’s gotten exactly – yes, exactly – what he wanted out of the process, and you cannot convince me otherwise because of the trail of clues he’s left over the past few weeks.
Oh, what do I know? https://www.washingtonpost.com/powerpost/trump-challenges-senators-to-resurrect-obamcare-repeal-effort-were-close/2017/07/19/468c2dc0-6c8f-11e7-9c15-177740635e83_story.html
I’m still waiting for the surprise that the Pres. mentioned while he was hanging out with the Chicago Cubs.