Health reform implementation

Dem leaders whip members into line on GOP ObamaCare bill

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Democrats are furiously whipping their caucus against a Republican bill that would pay for a bipartisan Medicare fix by delaying ObamaCare’s individual mandate.

{mosads}That’s a change: Rep. Steny Hoyer (D-Md.) did not whip a similar Republican bill earlier this month to remove the penalty for not buying insurance in 2014. The bill passed the House and picked up 27 Democratic votes in the process.

But Democrats desperately need to circle their wagons around the healthcare law after a devastating setback in Florida this week, where their loss in a special election exacerbated worries that ObamaCare will sink the party in this year’s midterm elections.

In this case, Democrats argue that blame lies with the Republicans for tying the fate of an important bipartisan measure to another assault on the Affordable Care Act.

President Obama this week threatened to veto the bill in the unlikely case that it ever reaches his desk. And House Minority Leader Nancy Pelosi (D-Calif.) said at a press conference Thursday that the GOP bill was an effort to “turn their toxic, empty partisanship against the health of our nation’s seniors.”

“It’s time for Republicans to end their obsession with destroying the Affordable Care Act,” she said. “Republicans should stop these reckless and destructive partisan tactics and work with Democrats…We were almost there when we had the majority working together and promises were made by the Republicans, but as you can see they have not been kept.”

A House Democratic aide said the decision to whip Friday’s vote was reached before Tuesday’s election result.

“We were always going to whip this bill,” the aide said.

The aide said the importance of enacting the Medicare fix — which is considered a must-pass measure by many lawmakers of both parties — sets this week’s vote apart from the previous bills to delay the mandate penalty.

Still, Friday’s vote puts Democrats in a tough spot. The Medicare side of the legislation emerged from more than a year of negotiations between Democrats and Republicans in the House and Senate.

For a decade, Congress has regularly patched Medicare payments to physicians to avoid major cuts ordered by law. The “doc fix” would repeal the formula that requires those cuts, but a late amendment by House Ways and Means Committee chairman Dave Camp (R-Mich.) would pay for the fix by delaying the individual mandate. The amendment is at the crux of the partisan fight.

Early indications are that the Democratic leadership’s message on the bill is taking hold.

The bill had 42 Democratic co-sponsors before the Camp amendment, but a handful of Democrats — Reps. Steven Horsford (Nev.), Raul Grijalva (Az.), Paul Tonko (N.Y.), and Mark Takano (Ca.) — have already told The Hill they will vote against the legislation they previously co-sponsored, now that it has the mandate-reversing element attached.

“House Republican leaders just can’t help themselves — they have rejected governing responsibly and made partisan politics their priority,” Horsford told The Hill. “By adding poison pills to the “doc fix” bill, they are sabotaging an important bipartisan piece of legislation for the sake of ideological games. I will not support any effort to weaken health care options for millions of Americans.”

Democrats have some political cover if they decide to vote against the bill.

More than a dozen healthcare industry groups have joined them in criticizing the Republican proposal, saying it needlessly pollutes a bipartisan bill that otherwise seemed likely to pass the House.

The American Medical Association (AMA), the nation’s largest physician group, blasted the amendment in a Thursday letter to Pelosi and Speaker John Boehner (R-Ohio).

“I am writing to profess our profound disappointment that a strong bipartisan, bicameral effort to repeal the Medicare sustainable growth rate (SGR) has become a victim of partisan approaches to resolve budgetary issues,” AMA president James Madara wrote.

But Democrats should not get used to having that kind of cover.

Republicans have vowed to make ObamaCare the primary issue in the 2014 election, and outside groups like Americans for Prosperity, backed by billionaire brothers Charles and David Koch, have already spent millions campaigning against vulnerable Democrats for their support of the healthcare law.

Many Democrats, particularly those up for reelection in red states, have been walking a fine line for months, criticizing the ongoing troubles with the rollout, while insisting that benefits of the law as a whole will one day become apparent.

The 2014 election cycle will test their unity, which has been fragile in the early going.

While Democrats did not whip the March vote to delay the individual mandate penalty, Pelosi spoke out strongly against it before the vote, and 27 Democrats still defected. A similar bill in July got 22 Democratic votes.

On Thursday, Rep. Kurt Schrader (D-Ore.) introduced a bill to extend the open enrollment period through the end of April instead of March. The Obama administration has said it will not push back the enrollment date, but Schrader says the bill is necessary to give those in his home state a chance to recover from problem-plagued rollout.

Despite the “poison pill” amendment, the “doc fix” is still likely to get some Democratic support from vulnerable incumbents that are acutely aware of the healthcare law’s unpopularity.

For now, Democrats are putting on a bold face.

The White House this week rejected the notion that the Florida special election was an indictment by voters of ObamaCare, and Pelosi said Thursday that the GOP’s efforts to campaign against the law was a miscalculation.

“I’m very proud of our House Democrats and how they have not only embraced the Affordable Care Act, but how proud they are of it,” she said. “I think the Republicans are wasting their time using it as their electoral issue, and they will find that out.”

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