If you’re wondering whatever happened to the Republican
health care reform bill, you are not alone. When we last heard from the
American Health Care Act, House Republican
leaders were waiting on the Congressional Budget Office to score the bill
before submitting the legislation passed in the House to the Senate. The CBO
scored the bill in late May, but the silence from the Republican ranks has
been deafening. The congressional
website does not show any action on the bill since it passed the House on
May 4.
Readers of The Resurgent are aware that the Republican health
care bill falls short of full repeal. Senate rules require 60 votes for
cloture on a repeal bill and Republicans would not be able to find eight
Democrats to join them in ending a Democrat filibuster. Even if Republicans
eliminated the filibuster entirely, they would not have enough votes for full
repeal because at least four
Republicans have pledged to oppose a repeal bill that does not provide for
a phase out of the Obamacare Medicaid expansion.
Now some Republicans are saying that it is doubtful that
they will be able to pass even an incomplete health care reform bill. “I don’t
see a comprehensive health care plan this year,” Senator Richard Burr (R-N.C.)
said in Politico.
“It’s unlikely that we will get a health care deal, which means that most of my
time has been spent trying to figure out solutions to Iowa losing all of its
insurers.” Burr serves on the Senate Heath, Education, Labor and Pensions
Committee.
In the Wisconsin
State Journal, Senator Ron Johnson (R-Wisc.) agreed that the first priority
to would probably be to act to preserve the health insurance markets in their
current form. Johnson said that a short-term “market stabilization” bill could
be passed that would fund the Obamacare exchanges with billions of dollars to
help prevent insurers from exiting the marketplaces. Such an approach would
reduce volatility in the Obamacare markets and buy time for Republicans to agree
on a reform bill.
“To me, this may be a two-part process. I would admit that’s
probably a minority view in the Republican Senate right now,” Johnson said.
Senator Jeff Flake (R-Ariz.) also tried to tamp down
expectations. “There are some still saying that we’ll vote before the August
break,” he told the Washington
Post. “I have a hard time believing that.”
The fundamental problem is that conservative and moderate
Republicans do not agree how to handle various aspects of the health care issue.
Although Republicans have been united in their desire to repeal and replace
Obamacare since the day it was passed, they disagree on the details of what
should come next.
In the eight years since Obamacare became law, Republicans
such as Tom Price, formerly a Georgia congressman and now Secretary of Health
and Human Services, have written legislation to repeal Obamacare and reform the
health insurance industry, but the party has not coalesced around any single
bill. When Donald Trump eked out a squeaker of a victory in the Electoral
College, Republicans were caught flat-footed and did not have a plan for how to
exploit his victory. Indications were that, as late as early February,
Republicans had not
even started writing an Obamacare reform bill. The Senate considers the
House bill dead on arrival and is writing its own version of health care
reform, which may be available
as early as this week.
President Trump’s antics are also hurting the possibility of
passing a health care bill. The investigation into the Trump campaign’s
possible connections with Russia and the firing of FBI Director James Comey are
distractions that make it even more difficult to find a compromise that is
acceptable to all GOP factions. The president showed leadership in the fight to
pass the AHCA in the House, but has largely been missing-in-action on the issue
in the month since the House vote.
Not all Republicans are pessimistic on health care. Senator
John Cornyn (R-Texas) was quoted in The
Hill as saying, “We do need to take care of our business, and I think you
mentioned healthcare, and that's certainly front and center in the United
States Senate — something we're going to have to get resolved here in the next
few weeks.” Cornyn said that he thought a Senate bill would be “done by the end
of July at the latest.”
Repeal of Obamacare has been the centerpiece of the
Republican platform since 2010. The fact that repeal is not possible, even with
Republican majorities in Congress and a Republican president, is not going to
please most Republican voters. If the new Republican administration leaves
Obamacare completely intact, it may well face a mutiny from the grass roots.
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