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 McConnellGrassley: Dems 'withheld information' on new Kavanaugh allegation Kavanaugh accuser set to testify Thursday McConnell told Trump criticism of Kavanaugh accuser isn't helpful: report 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 ObamaNational security leaders: Trump's Iran strategy could spark war The Hill's 12:30 Report — Trump questions Kavanaugh accuser's account | Accuser may testify Thursday | Midterm blame game begins Dems look to Gillum, Abrams for pathway to victory in tough states 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) SandersFive takeaways from Cruz, O'Rourke's fiery first debate Ben & Jerry’s co-founders announce effort to help 7 Dem House challengers Dems look to Gillum, Abrams for pathway to victory in tough states MORE (I-Vt.), who favored a single-payer system, to centrist Sens. Mary LandrieuMary Loretta LandrieuLobbying world Former New Orleans mayor: It's not my 'intention' to run for president Dems grasp for way to stop Trump's Supreme Court pick 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 HellerGOP plays defense on ObamaCare’s pre-existing conditions Heller embraces Trump in risky attempt to survive in November McConnell suggests he could hold Senate in session through October 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 CollinsKavanaugh accuser set to testify Thursday McConnell told Trump criticism of Kavanaugh accuser isn't helpful: report Dems see Kavanaugh saga as playing to their advantage MORE (Maine), Rob PortmanRobert (Rob) Jones PortmanGraham calls handling of Kavanaugh allegations 'a drive-by shooting' Overnight Health Care: Senators target surprise medical bills | Group looks to allow Medicaid funds for substance abuse programs | FDA launches anti-vaping campaign for teens Bipartisan group wants to lift Medicaid restriction on substance abuse treatment MORE (Ohio) and Shelley Moore CapitoShelley Wellons Moore CapitoThis week: Democrats pledge ‘sparks’ in Kavanaugh hearing Congress faces September scramble on spending California passes bill to ban controversial drift net fishing 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 McCainTrump hits McCain on ObamaCare vote GOP, White House start playing midterm blame game Arizona race becomes Senate GOP’s ‘firewall’ 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 GrassleyGrassley: Dems 'withheld information' on new Kavanaugh allegation Feinstein calls for hold on Kavanaugh consideration Grassley releases letter detailing Kavanaugh sexual assault allegation 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 RyanDems see Kavanaugh saga as playing to their advantage How does the 25th Amendment work? Sinema, Fitzpatrick call for long-term extension of Violence Against Women Act 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.