GOP’s message on ObamaCare is us versus them

GOP’s message on ObamaCare is us versus them
© Greg Nash

Do you want to be known as the Republican who killed the repeal of ObamaCare? That’s the question every GOP senator will weigh over the next week, and it’s an integral part of the Republican leadership’s strategy to get the prized legislation a step closer to President Trump.

Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellSenate GOP breaks record on confirming Trump picks for key court Senate Democrats block resolution supporting ICE The Hill's Morning Report — Trump’s walk-back fails to stem outrage on Putin meeting MORE (R-Ky.) is expected to force a vote this week, despite complaints from conservatives that his draft bill doesn’t really repeal ObamaCare —  and deep reservations from centrist Republicans that it goes too far.

Trump badly needs a legislative win and will be pressing hard for Republican senators to toe the line. So will McConnell, as the vote could be a legacy-defining moment for the longtime GOP leader.

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“There’s going to be a lot of pressure to vote yes,” says Ron Bonjean, a veteran former GOP leadership aide. “This becomes team ball. Are you playing ball with the team or leaving the party twisting in the wind?” 

ObamaCare is one of the most partisan laws ever passed, and Republicans for seven years have promised to kill it.

Skeptical GOP senators can expect to hear the argument that they need to advance this legislation, with the promise that it will be fixed later in the House.

The us-versus-them mentality of cut-throat politics is the game Democrats played to pass former President Barack ObamaBarack Hussein ObamaEx-White House stenographer: Trump is ‘lying to the American people’ Trump has the right foreign policy strategy — he just needs to stop talking The Hill's 12:30 Report — Trump faces bipartisan criticism over Putin presser, blames media for coverage MORE’s signature legislation in 2010.

Every House and Senate Republican was united against the bill, meaning a single Democratic defection in the Senate would have killed it.

Instead, every one of the 60 Democrats backed it, from liberal Sen. Bernie SandersBernard (Bernie) SandersElection Countdown: Senate, House Dems build cash advantage | 2020 Dems slam Trump over Putin presser | Trump has M in war chest | Republican blasts parents for donating to rival | Ocasio-Cortez, Sanders to campaign in Kansas House Dems launching Medicare for All Caucus Let's remove the legal shield from hackers who rob us of our civil rights MORE (I-Vt.), who favored a single-payer system, to centrist Sens. Mary LandrieuMary Loretta LandrieuFormer New Orleans mayor: It's not my 'intention' to run for president Dems grasp for way to stop Trump's Supreme Court pick Landrieu dynasty faces a pause in Louisiana MORE (D-La.) and Blanche Lincoln (Ark.), who worried the legislation was too left-leaning and lost subsequent reelection fights.

Deals were struck to get many votes: Sen. Joe Lieberman (I-Conn.) insisted on the death of the public option; Sanders secured language on community health centers; and others received more Medicaid funding for their states.

In an interview with The Hill earlier this year, McConnell said it’s essential for Republicans to unify in order to pass their agenda.

“The only way you can achieve success in an environment like now, where there’s not much bipartisanship, is for us to have our act together and to work out our differences among ourselves,” McConnell said in late January.

With all Democrats expected to vote no, GOP leaders can only afford two defections. 

Four conservatives legislators — Sens. Rand Paul (R-Ky.), Mike Lee (Utah), Ted Cruz (Texas) and Ron Johnson (Wis.) — issued a joint statement saying they won’t vote for the current bill.

Sen. Dean HellerDean Arthur HellerSenate Dems build huge cash edge in battlegrounds Jacky Rosen hits Dean Heller over health care in first negative ad GOP moderates hint at smooth confirmation ahead for Kavanaugh MORE (R-Nev.), who is being targeted by Democrats in next year's election, also says he’s a no on the present legislation.

McConnell can’t afford all these defections, and he is also not going to be able to give them everything they want.

The situation is further complicated by the competing interests. A concession toward the Lee-Cruz group risks driving away not only Heller, but other Republicans including Sens. Susan CollinsSusan Margaret CollinsOvernight Health Care: Novartis pulls back on drug price hikes | House Dems launch Medicare for All caucus | Trump officials pushing ahead on Medicaid work requirements Senate panel to vote next week on banning 'gag clauses' in pharmacy contracts GOP senator: Trump's changing stances on Russian threat are 'dizzying' MORE (Maine), Rob PortmanRobert (Rob) Jones PortmanBipartisan bill would bring needed funds to deteriorating National Park Service infrastructure The Memo: Trump allies hope he can turn the page from Russian fiasco Trump seeks to quell Russia furor MORE (Ohio) and Shelley Moore CapitoShelley Wellons Moore CapitoLots of love: Charity tennis match features lawmakers teaming up across the aisle Senate takes symbolic shot at Trump tariffs America must act to ensure qualified water workforce MORE (W.Va.).

Such is the nature of the game, says GOP strategist Ford O’Connell.

“All of this may seem like a ‘prisoner’s dilemma’ for some Senate Republicans, but this is what they signed up for,” he said. “Some will certainly have to man up and walk the plank, but that is the nature of the beast.”

There are many land mines for Republicans before they get to a final vote, including a Congressional Budget Office score and possible intensifying criticism from constituents, powerful factions on the right and healthcare groups.

Numerous thorny policy matters remain unresolved, most notably on funding for Planned Parenthood.

The way Washington works, there are two likely scenarios for the vote on Thursday: The bill will eke by next week, or a like-minded group of GOP senators will band together and either call for a rewrite of the bill or just vote no.

It’s highly unlikely, therefore, that the legislation will go down by one or two or even three votes.

The last time Republicans moved a massive healthcare bill occurred in 2003 when they added a prescription drug benefit to Medicare. That measure attracted just enough Democratic support to pass but was rejected by Sen. John McCainJohn Sidney McCainEx-Montenegro leader fires back at Trump: ‘Strangest president' in history McCain: Trump plays into 'Putin's hands' by attacking Montenegro, questioning NATO obligations Joe Lieberman urges voters to back Crowley over Ocasio-Cortez in general MORE (R-Ariz.) and some in the House, including now-Vice President Pence.

Then-Sen. Trent Lott (R-Miss.), a critic of the bill, had a chance to kill it on a procedural vote. He was surrounded by Sens. Chuck GrassleyCharles (Chuck) Ernest GrassleyThe Hill's Morning Report — Trump’s walk-back fails to stem outrage on Putin meeting Senate GOP poised to break record on Trump's court picks This week: GOP mulls vote on ‘abolish ICE’ legislation MORE (R-Iowa), Don Nickles (R-Okla.) and Jon Kyl (R-Ariz.), who lobbied the former majority leader.

Grassley pleaded with Lott, telling him that it could take years to get this close again to passing the bill. Other arguments used to sway reluctant Republicans included: Do it for the team; President George W. Bush needs this to be reelected; and if we don’t pass this, we could lose the House and Senate.

Lott ultimately advanced the bill. He later said it was one of his worst votes he ever cast, though the drug benefit was less costly than initially projected and is popular with seniors.

Should the Senate pass its ObamaCare bill, GOP senators will likely lobby for the House to pass it, unchanged.

Such a request would trigger resistance from House conservatives who killed the initial bill that Speaker Paul RyanPaul Davis RyanWhy the rush to condemn a carbon tax? House votes to go to conference on farm bill House backs resolution expressing support for ICE MORE (R-Wis.) pushed this spring. The legislation was reworked and narrowly passed the House last month.

Merging and passing a final healthcare bill would be enormously difficult, but Republican leaders would lean on their members to take the final step, send it to Trump’s desk and fulfill a seven-year-old campaign promise.