You’re going to be reading and hearing lots of breathless stuff over the next few weeks on health care. My advice to you would be not to take it seriously if it doesn’t recognize this basic fact: The is going to come down to the conference committee. That’s where the action is here.
You remember what a conference committee is? The House passes its version of a bill. The Senate passes its version. They’re different. Then, leaders from both chambers appoint a conference committee to smooth out the differences. Then, the agreed-upon bill goes back to both houses for passage a second time. Only then does it go to the president’s desk.
No, they didn’t make this easy. But usually conference committees do what they’re designed to do for the simple mathematical reason that if a bill passed both Houses, it was nearly by definition supported by the majority party in both houses, and it’s those party’s leaders who appoint most conference committee members, and they can stack it however they like.
All that is presumably a few weeks away. First, the Senate gets to work. All eyes turn to the wily Mitch McConnell. There is a slim chance—really slim—that McConnell, for whatever baroque set of insider-y reasons, doesn’t really want this to pass. Maybe opposition to what the House did really rises up over these next few weeks and he senses that his majority may be in danger. Maybe enough Republican senators come to him and say things like “Mitch, I’m getting hammered back home on this.”
If that’s the case, he can easily fix things behind closed doors in such a way that the House bill fails in the Senate, and he can say hey, we tried.
Another failure scenario is that three Republicans vote against it. This isn’t impossible. Dean Heller of Nevada, who’s up for reelection next year; Susan Collins of Maine; Lisa Murkowski of Alaska. Those are the three Republicans to watch. If you’re against what the Republicans are doing here and want to devote some time or energy to stopping this, devote it to groups working in those three states, trying to pressure those three senators.
But what’s more likely is that the Senate Republicans pass something. It will be their own bill. Tennessee’s Lamar Alexander, for one, has already said as much. Probably the two biggest points of departure from the House bill will be 1) senators, even most Republicans, won’t go for nearly a trillion dollars in Medicaid cuts, and 2) senators, even a lot of Republicans, would prefer to keep Obamacare rules on covering people with pre-existing conditions.
So the Senate’s going to pass a bill that’s less conservative than the House, and probably unacceptable to a lot of the Freedom Caucus people. And make no mistake—the Freedom Caucus people, the hottest of the red-hots, are who pushed this bill over the line yesterday. On the first go-round in late March, only seven of the caucus’ members voted yea. Thursday, 30 of them did. The caucus doesn’t disclose any official list of members but is thought to have around 35, so that’s a huge flip.
They’re not going to like what comes out of the Senate. And then it’ll all come down to the conference committee. Can those members get in a room for a week and hash something out that McConnell and Ryan just make people vote for because, folks, this is our only shot at this? In that case, I’m sorry to say, I think enough of them will vote yes, even to something they know is terrible. And I’d bet the conference bill looks more like the House version than the Senate one, because the House people are bigger crybabies, and crybabies get their way.
So that’s the inside game. It’s not especially hopeful.
But there’s an outside game, too, and the outside game can influence the inside game. It starts with pressuring those three GOP senators. It extends to letting so-called moderate Republicans who voted for this monstrosity—and there were 33 of them, from the Tuesday Group—know their constituents’ anger at their vote.
And the outside game also involves the two pivotal special elections that approach. Both are in red areas, but in both, the Democrat is running competitively, and the choice between the candidates is stark.
The first one you’ve read about, it’s the Georgia race where Democrat Jon Ossoff is facing Republican Karen Handel. After the vote, Handel praised it, while Ossoff, who’s been running a pretty moderate-ish campaign, said that “this bill puts Georgians’ lives at risk.”
The lesser-known race is out in Montana, where Democrat Rob Quist is running against Republican Greg Gianforte. This is to fill the seat vacated by Ryan Zinke, who’s now the secretary of the interior (but it’s the whole state, as Montana has just one at-large representative in the House). Gianforte gingerly endorsed the bill, but Quist yesterday came out guns-a-blazin’ against it, even highlighting its defunding of Planned Parenthood: “No Montanan would vote for this bill…[Gianforte is] all for de-funding Planned Parenthood, which this bill does. Montana deserves a Congressman who will speak out when something as disastrous as this bill that will raise healthcare costs for working Montanans.”
The Montana district is rated R+11 by Cook. The Georgia district, R+8. Those numbers mean Republicans should win them both fairly easily.
But here we have Democrats in both districts hitting Republicans hard over this bill, standing up for Obamacare and Planned Parenthood, and running strong. The Montana election is May 25, the Georgia one June 20. If the Democrats win, you can be very sure that McConnell and all his fellow Senate Republicans will take notice.