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 McConnellThe Hill's Morning Report - Presented by Pass USMCA Coalition - Dems look for traction following Barr-Mueller findings Senate GOP eyes probes into 2016 issues 'swept under the rug' Senate gears up for Green New Deal vote 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 ObamaTrump Jr.: Obama, Bush 'couldn't have done' what my father's done for the American people Decentralized identity standards can solve Facebook's problem Jam-packed primary poses a serious threat to Democrats in 2020 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) SandersHere's why Biden, Bernie and Beto are peaking Senate gears up for Green New Deal vote Overnight Energy: Green New Deal vote set to test Dem unity | Renewables on track to phase out coal, study finds | EPA chief reportedly recuses himself from mine review MORE (I-Vt.), who favored a single-payer system, to centrist Sens. Mary LandrieuMary Loretta LandrieuDems wrestle over how to vote on ‘Green New Deal’ Lobbying world Former New Orleans mayor: It's not my 'intention' to run for president 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 HellerTrump suggests Heller lost reelection bid because he was 'hostile' during 2016 presidential campaign Trump picks ex-oil lobbyist David Bernhardt for Interior secretary Oregon Dem top recipient of 2018 marijuana industry money, study finds 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 CollinsThe Hill's Morning Report - Presented by Pass USMCA Coalition - Dems look for traction following Barr-Mueller findings Senate rejection of Green New Deal won't slow Americans' desire for climate action Senate GOP poised to go 'nuclear' on Trump picks MORE (Maine), Rob PortmanRobert (Rob) Jones PortmanTrump faces political risks in fight over GM plant GOP moves to rein in president's emergency powers The 25 Republicans who defied Trump on emergency declaration MORE (Ohio) and Shelley Moore CapitoShelley Wellons Moore CapitoFCC claims on broadband access under scrutiny Senate GOP proposes constitutional amendment to keep Supreme Court at 9 seats Pence, GOP senators discuss offer to kill Trump emergency disapproval resolution 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 McCainSenate GOP eyes probes into 2016 issues 'swept under the rug' Gallego won't seek Ariz. Senate seat, clearing Dem path for Kelly Khizr Khan blasts Trump's McCain attacks: 'How dare this Russian-tainted president disrespects our hero' 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 GrassleySenate GOP eyes probes into 2016 issues 'swept under the rug' Treasury expands penalty relief to more taxpayers Overnight Health Care: Senators seek CBO input on preventing surprise medical bills | Oversight panel seeks OxyContin documents | Pharmacy middlemen to testify on prices | Watchdog warns air ambulances can put patients at 'financial risk' 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 RyanFormer Dem candidate says he faced cultural barriers on the campaign trail because he is working-class Former House candidate and ex-ironworker says there is 'buyer's remorse' for Trump in Midwest Head of top hedge fund association to step down 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.