What Is Going On With The GOP Effort To Repeal Obamacare?

The Republican plan to repeal and replace the Affordable Care Act has been dealt a number of potentially lethal blows in recent days, but some supporters of the effort — including President Trump — continue to push their colleagues to move forward with repeal. Will a vote happen? Will it succeed? And how does the news of Sen. John McCain’s brain tumor affect the numbers?

For those who weren’t paying attention earlier this week, there were a number of important developments in this story. First, Senators Mike Lee (UT) and Jerry Moran (KS) came out in opposition to the Better Care Reconciliation Act, Majority Leader Mitch McConnell’s repeal-and-replace bill. Combined with the two other senators who had already said they would vote no on the BCRA, Lee and Moran effectively killed the legislation, since the GOP can afford no more than two “no” votes at this time.

In response, McConnell and President Trump called for moving forward with a straightforward repeal-only bill like the one that Congress passed in late 2015, only to have it vetoed by President Obama.

However, the straight repeal movement seemed doomed from the start, when three GOP senators announced they could not support the legislation because of the negative impact it would have on the people in their states. These concerns were backed up by the nonpartisan Congressional Budget Office, which projected on Wednesday that repealing the ACA would leave an additional 32 million Americans without insurance and ultimately double insurance premiums for those that hold on to their health care coverage.

Moving Forward

Despite the apparent lack of votes, McConnell is still planning for a vote to open the Senate floor to debate on the repeal-only bill, in the hope that the ability to add amendments will win over moderate party members — while also betting that some skeptical Republicans will support repeal out of concern about being labeled an Obamacare supporter (more on that below).

President Trump hosted most Senate GOP members at the White House on Wednesday, urging them to not give up on the repeal effort, and to stay working in D.C. until they reach some sort of deal.

“People should not leave town unless we have a health insurance plan, unless we give our people great health care,” said Trump. “We have to hammer this out and get it done.”

About half of the Senate Republicans held a Wednesday evening meeting in the hope of hashing out their differences, reports Politico, though participants in the conference say that no specifics were discussed and there is not yet any clear road to consensus.

What About McCain?

Arizona Senator John McCain revealed last night that he’d been diagnosed with a brain tumor during a recent surgery to remove a blood clot. Aside from the many medical concerns this raises for McCain and his loved ones, it also poses a big question for Senate Republicans.

With all in attendance, the GOP only has a 52-vote majority in the Senate. With McCain out, that drops to 51 votes, meaning Republicans can only afford to lose a single vote. Two no votes would cause the bill to fail. Some in the party are concerned that this is too narrow a margin to move forward on legislation the GOP has used as a marquee campaign promise for years.

It’s unclear when, or even if, Sen. McCain will return to work.

Political Pressure

Both the White House and conservative power brokers are dangling the threat of pulling political support — or opposing outright — GOP lawmakers who don’t fall in line with the repeal effort.

Sen. Dean Heller (NV) has been skeptical of McConnell’s legislation, and at yesterday’s White House lunch, he was directly targeted in President Trump’s remarks.

“Look, he wants to remain a senator, doesn’t he?” the president asked about Heller, who was seated next to him at the time. “And I think the people of your state, which I know very well, I think they’re gonna appreciate what you hopefully will do. Any senator who votes against starting debate is really telling America that you’re fine with Obamacare.”

The last part of that statement underlines the other possible motivation for moving forward with a vote next week, even if it falls short: Getting senators on the record about where they stand. McConnell’s hope seems to be that some on-the-bubble senators will follow the party line out of fear of being seen as possibly supporting the Democrats’ signature piece of health care legislation.

But that political sword of Damocles may not be enough of a threat for some senators, particularly those who face no immediate re-election concerns. In fact, the three senators who immediately opposed the repeal-only concept are all at least two election cycles away from having to run for office again. Both Shelley Moore Capito of West Virginia and Maine’s Susan Collins do not have to run again until 2020, while Lisa Murkowski of Alaska’s seat is not up for a vote until 2022. These three lawmakers are enough to halt the entire process.