Republicans debate Plan B if ObamaCare repeal fails

Senate Republicans are starting to consider what they should do if their ObamaCare replacement bill fails to pass. 

Lawmakers are largely splitting into two camps: those who want to work with Democrats on a fix to the healthcare law, and those who want to simply pass a straight repeal of the law and work on a replacement later.

While conservatives are mainly behind the second option, Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellMcConnell expects Paul to return to Senate next week Former Hill staff calls for mandatory harassment training Gaming the odds of any GOP tax bill getting signed into law MORE (R-Ky.) made waves on Thursday by saying that his party could work with Democrats to stabilize ObamaCare markets if the repeal bill fails. 

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“If my side is unable to agree on an adequate replacement, then some kind of action with regard to private health insurance markets must occur,” McConnell said.

McConnell’s comments could have been intended as a message to conservatives who are opposed to the existing repeal bill, suggesting they will like the result even less if the GOP has to work with Democrats. 

Indeed, McConnell warned late last month that “my suspicion is that any negotiation with the Democrats would include none of the reforms that we would like to make.”

Nonetheless, Democrats seized on McConnell’s comments. They said McConnell has now acknowledged that ObamaCare markets can be fixed and that the law is not collapsing and beyond repair, contrary to the arguments that Republicans have been making for years.

Some Republican senators have even expressed eagerness to work with Democrats on a healthcare bill. 

In announcing her opposition to the ObamaCare repeal-and-replace bill last month, centrist Sen. Susan CollinsSusan Margaret CollinsBipartisan group of lawmakers aim to reform US sugar program A bipartisan bridge opens between the House and Senate Gaming the odds of any GOP tax bill getting signed into law MORE (R-Maine) pointed to the millions of people who would lose coverage under the Republican bill and wrote on Twitter: “I want to work w/ my GOP & Dem colleagues to fix the flaws in [the Affordable Care Act].” 

Sen. Ron JohnsonRonald (Ron) Harold JohnsonDemocratic Homeland Security members request additional DHS nominee testimony Key differences between the Senate and House tax plans Senate panel delays vote on Trump’s Homeland Security pick MORE (R-Wis.) has also been pushing for a bipartisan fix. “Let's stabilize the markets, then work long term on a bipartisan solution to actually fix the healthcare system,” he said last month.

Sen. John McCainJohn Sidney McCainGOP rushes to cut ties to Moore GOP strategist: 'There needs to be a repudiation' of Roy Moore by Republicans World leaders reach agreement on trade deal without United States: report MORE (R-Ariz.) said on CBS on Sunday that the GOP bill is "probably going to be dead."

He then suggested that Democrats be at least somewhat involved in the new process if the current measure fails.

"It means they can have amendments considered," he said. "And even when they lose, then they're part of the process. That's what democracy is supposed to be all about."

But several conservative senators are taking the opposite tack. If the current bill fails, they say, Republicans should just repeal the healthcare law without a replacement, then work on an alternative later.

Conservative Sens. Ted CruzRafael (Ted) Edward CruzOvernight Finance: GOP criticism of tax bill grows, but few no votes | Highlights from day two of markup | House votes to overturn joint-employer rule | Senate panel approves North Korean banking sanctions GOP criticism of tax bill grows, but few ready to vote against it Anti-gay marriage county clerk Kim Davis to seek reelection in Kentucky MORE (R-Texas), Mike LeeMichael (Mike) Shumway LeeOvernight Health Care: Trump officials to allow work requirements for Medicaid GOP senator: CBO moving the goalposts on ObamaCare mandate Cornyn: Senate GOP tax plan to be released Thursday MORE (R-Utah), Rand PaulRandal (Rand) Howard PaulGOP senator asks to be taken off Moore fundraising appeals Red state lawmakers find blue state piggy bank Prosecutors tell Paul to expect federal charges against attacker: report MORE (R-Ky.) and Ben Sasse (R-Neb.) have all expressed support for that strategy.

President Trump has also endorsed the idea of repealing first and replacing later.

“If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date!” Trump tweeted last week.

The problem is that a straight repeal bill almost certainly would not have the votes to pass, given that many other Republicans want to put forward an alternative way for people to get coverage at the same time.

That dynamic is immensely frustrating for conservatives, who note that moderate Republicans already voted for straight repeal of ObamaCare in 2015, when they had the safety of knowing it would never become law because then-President Barack Obama would veto it.

“Remember, in December of 2015, every Republican senator, except, again, Susan Collins, everybody voted for a repeal plan,” Sasse said on CNN this month. “The only thing then was that President Obama vetoed it. Now President Trump would sign it.” 

McConnell, though, rejected the idea of repealing first and replacing later over the recess.

"The private health insurance market is imploding,” McConnell told WBKO in Kentucky. “Premiums are going up, co-payments are going up, deductibles are going up, so we have to solve the current crisis, and I think repealing and delaying the replacement doesn't work."

All the talk of a backup plan comes as Republicans remain divided and well short of the needed votes to pass the current replacement bill, known as the Better Care Reconciliation Act. 

McConnell is trying to save the bill with concessions to both moderates and conservatives, but satisfying both sides could prove difficult. 

Meanwhile, Washington is trying to game out how a possible bipartisan bill on ObamaCare — something that has rarely happened since Democrats passed the law in 2010 — would work.

Democrats have argued that there are pieces of the current Republican measure that would help stabilize the markets, like money for a stability fund and for key ObamaCare payments to insurers known as cost-sharing reductions, which help insurers offer affordable plans to low-income customers. Those provisions could help cut down on the current uncertainty, stop some insurers from losing money on ObamaCare plans and entice insurers to participate in more markets.  

Democrats might be willing to give a few concessions to Republicans in exchange. 

Conservatives, though, dismiss these ideas as simply giving more money to insurance companies.

“If the Republican Party wants to work with Democrats to bailout Obamacare, the results will be catastrophic for the party,” Michael Needham, CEO of the conservative group Heritage Action, said in a statement Friday.

“For seven years it has pledged it is the party of repeal and now is the time to work toward that goal."