Persistent chatter that congressional Republicans will take another swing at repealing and replacing Obamacare this summer has increasingly drawn the ire of leadership and the White House, where there is virtually no desire to walk down that legislative path again.
Numerous White House officials scoffed at the prospect of an actual Obamacare-repeal revival, saying they can’t fathom depleting political capital on a project with virtually no chance of passage this close to the midterm elections. One West Wing official called it a “suicide” mission. A senior administration official said the issue wasn’t being taken seriously inside the building because the president’s team has concluded “the votes aren’t there.”
With Trump and his aides eager to avoid revisiting one of their biggest legislative humiliations, the likelihood of Obamacare repeal and replace actually getting another hearing is incredibly remote. But that hasn’t stopped some in the party from fretting that the issue remains a political tripwire. In leadership circles, there is an emerging fear that those floating the idea of taking another whack at Obamacare repeal and replace are setting up a lose-lose situation in which GOP lawmakers look either feckless for ducking the issue or impotent for again failing to successfully pass it.
“All these people out there not responsible for elected real-life senators don’t seem to realize there are consequences for failed votes,” said one top Senate GOP aide. “We experienced them last summer. I don’t understand why we would want to have that again.”
Or, as one top Democratic aide put it: “I can’t believe they would be so stupid. That said, they often surprise me with how stupid they are.”
For an Obamacare repeal-and-replace effort to actually have a chance at passage, a number of unlikely hurdles would have to be cleared. The first would be for Senate Majority Leader Mitch McConnell (R-KY) to introduce a budget that included instructions for a health-care overhaul to be considered by a simple majority vote. Then, McConnell would have to convince all other 49 voting Republicans (Sen. John McCain has been at home battling brain cancer) to back that budget, a tall task as Sen. Rand Paul (R-KY) traditionally votes against such measures.
At that point, the party would need to introduce an Obamacare repeal-and-replace bill. The prevailing theory is that the legislation introduced by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) would be the most likely vehicle. But McConnell would have to somehow persuade the same GOP senators who voted against all prior efforts—namely Susan Collins and Lisa Murkowski—to drop their opposition, on top of convincing those lawmakers from Medicaid expansion states that a bill that switches to a per-capita cap on funding for the program is worth supporting. And he’d have to do this all while assuming the House will follow suit—a proposition based on a similarly shaky foundation.
“I didn’t hear anybody seriously talking about Obamacare,” one House GOP lawmaker told The Daily Beast of chatter in that chamber. “They have their panties in a bunch right now on immigration and, secondarily, on the [spending cuts] package.”
With no cover from the administration and little-to-no assistance from GOP leadership, those hoping to revive Obamacare repeal and replace have adopted a ground-up approach.
In April, a group of conservatives put together guidance for another bid to overhaul the Affordable Care Act. The effort was and is being spearheaded by the Heritage Foundation and entails meetings with health-policy analysts to generate a consensus plan that would make it to the president’s desk. Those involved acknowledge the heavy lift, but the hope is that activists might pressure lawmakers to move before they potentially suffer losses in the midterm elections.
“There’s growing recognition that the current system is not meeting the intended goals,” Naomi Lopez Bauman, director of Healthcare Policy at the Goldwater Institute, told The Daily Beast. “We know there are obstacles, but this is such an important issue that there’s also recognition that the status quo is not going to get better.”
The Goldwater Institute, along with everyone from former Sen. Rick Santorum to Grover Norquist, have signed on to consult on the plan. In broad strokes, it would allow for money to be provided to states in the form of block grants that would replace Obamacare’s payments to private insurers.
The hope was to formally introduce a bill by mid-June. But as spring turns to summer, and no plan has materialized, some lawmakers are left to publicly encourage the party to put a final end to the notion that Obamacare will ever be fully wiped from the books.
“We’ve got to give up on repeal and replace,” Sen. Chuck Grassley (R-IA) said at a town-hall meeting in Iowa last week.
But for some directly involved with the plan, it’s vitally important to at least try to get something accomplished, precisely because, as it stands, Democrats are using Republican inaction on health care as an electoral cudgel.
“We need to have a plan that we can talk about as we go through the elections,” one source working on the initiative, requesting to speak on background, told The Daily Beast. “What it’s going to take is a political imperative to act. Republicans thought it was an existential crisis if they didn’t get tax reform done.”
Norquist also sees the prospect as a boon for Republicans’ electoral fortunes.
“Why not add another feather in your hat in addition to the tax cut?” Norquist told The Daily Beast. “I think people should be ready for it because it may happen. I think it would be a huge political winner.”
Inside the White House, the tactic being adopted is decidedly less optimistic. Rather than re-tackle the longstanding GOP promise to nuke the Affordable Care Act, Trump has been determined to declare that the mission of repeal and replace has already been accomplished.
“We had Repeal & Replace done (and the saving to our country of one trillion dollars) except for one person, but it is getting done anyway,” the president tweeted Monday morning, in a clear dig at McCain for his vote against repeal. “Individual Mandate is gone and great, less expensive plans will be announced this month. Drug prices coming down & Right to Try!”
The tweet continued the president’s spin that the 2017 tax bill’s repeal of the individual mandate (perhaps the least popular aspect of Obamacare) was tantamount to a form of ACA repeal. One source who’s been close to Trump for years referred to this play as a “coping mechanism” and said that in private conversations, the president has been repeatedly and emphatically critical of McCain for his vote, wondering if the Republican senator did it mainly to spite Trump.
“‘Blame John McCain, then pivot to how great it is that the [individual mandate] is taken care of,’ is the president’s messaging strategy for this. Shift blame, show a win,” a senior Trump aide told The Daily Beast.