JUNE 30, 2017 — Republicans owe their congressional majority to a simple promise: Repeal and replace Obamacare.
Although not all right-of-center voters put that goal first, the GOP ran hard against the health care status quo and won in multiple election cycles.
But so far, on the Hill, the party has struggled to make good on that victory. In the Senate, where the controversial House bill didn’t catch fire, a new and supposedly improved piece of legislation has stalled.
There still aren’t enough votes lined up to ensure passage. Reflecting and compounding the problem, public support for the bill has fallen to noteworthy lows. Republicans need to do better, and time is running short.
The trouble is that Senate leaders have attracted fire from both sides. Support for the overhaul is in the single digits among Democrats, but several polls show independents and Republicans also remarkably uneasy, with total support among all respondents languishing somewhere between about 12 and 27 percent. In some cases, this is a weaker showing than the much-maligned House bill, the American Health Care Act.
While critics on the left howl that the Senate bill unfairly moves away Medicaid resources while working in upper-end tax relief, some conservatives and libertarians have derided the arrangement as “Obamacare lite” — or even “Obamacare plus.” It’s hard to see the political wisdom in pressing forward with such a bill.
Supporters, however, do have some counterarguments. First, they argue, the bill’s unpopularity reflects skepticism over a secretive and insular process mishandled first by the Obama administration and the then-majority Democrats in Congress who passed Obamacare to begin with, ultimately creating more problems for the American health care system. House Republicans have repeated these errors.
Whatever the chances of winning over voters, there’s no denying that the Senate bill is a creature of Washington’s now typically tortured legislative process. Complex, interlocking rules about what kinds of laws can prevail with what degree of majority support have helped to ensure that big bills take the messy path toward passage. For example, in order to facilitate passage of the health care bill (as well as the forthcoming tax reform bill), Congress is using budget “reconciliation” rules to limit debate and avoid the possibility of a filiibuster in the Senate, though the rules also require a nexus to the budget, which could limit options on some policy reforms.
For many Republicans, the ideal way to proceed against Obamacare is a clean break, followed by a fresh start — virtually the opposite of what’s under way now. Surely, the GOP would not want to wait until repeal to sit down to the hard work of replacement.
But if the Senate isn’t careful, the current bill will serve to remind too many Republicans and independents what they like least about Washington, even if some of its substance would pay off down the road.
As it stands, the Senate bill isn’t where it needs to be for Republicans to get excited and get it passed. The good news is, with discipline and forthrightness, the GOP can show it’s ready and willing to see the hard work of lawmaking through to a successful end.