Republicans are having a break-the-glass moment on Obamacare.
After promising for years to upend the Democratic health care law the first chance they got — and with plans to hold a vote to repeal vote by early April — the party remains far from consensus. So far, in fact, that Senate Majority Leader Mitch McConnell has called a special all-members caucus meeting Wednesday to try and get his rowdy caucus in line.
Two key House committee chairmen running point on the House’s Obamacare efforts will be on hand to explain why Republicans should support their proposal to roll back Obamacare’s Medicaid expansion and replace insurance subsidies with tax credits, among other provisions. But a leaked blueprint of their plan is already taking serious heat from the GOP’s right flank, jeopardizing the entire repeal bid.
In the Senate, Republicans can afford to lose only two of their members. But GOP leaders are facing pressure from both moderates and conservatives as they try to craft a bill. Centrists are signaling they won’t back a bill that rolls back Obamacare’s Medicaid expansion, which covers some 11 million Americans. But conservatives like Sens. Ted Cruz, Mike Lee and Rand Paul, as well as the House Freedom Caucus and outside conservative groups say they’ll oppose any measure that provides refundable tax credits to help people buy insurance — which is what the House’s emerging plan would do.
Ways and Means Chairman Kevin Brady and Energy and Commerce Chairman Greg Walden will defend that proposal on Wednesday’s all-members meeting of Senate Republicans. But GOP leaders are coming to grips with the growing possibility they’ll have to just put a repeal bill on the floor — and dare GOP lawmakers to vote no.
“Are you for the status quo or are you for fixing this? That’s what our members are going to be faced with,” said Sen. John Thune of South Dakota, the No. 3 Senate Republican. “Are any of our members going to vote against a bill that repeals Obamacare? I think not. I hope not.”
But Thune’s conservative colleagues are drawing a hard line ahead of Wednesday afternoon’s meeting in the Strom Thurmond room, where the party has gathered in recent years to avert crises and plan strategy during urgent moments. Cruz, Paul and Lee say they won’t vote for “Obamacare-lite” — the derisive label critics have attached to the House plan — and they’re backed by groups like FreedomWorks and Club for Growth.
Cruz, for his part, says he won’t back any measure that offers refundable tax credits, saying such a scheme would amount to “a massive and new entitlement program.”
The House Freedom Caucus is also sounding off against the Republican House proposal, in what could be a major problem for Ryan if that opposition cements. The hard-line group has enough votes to sink any Obamacare plan, and its members are suggesting they will do just that without a change in course.
“In political terms, you feel for leadership because they are between a rock and a hard place on this,” said Rep. Mark Sanford (R-S.C.). “You can’t go out there and say to the base for 6 to 7 years … we’re going to repeal Obamacare, and then when you have the chance to do so, buckle.”
Still, the speaker predicted Tuesday that, in the end, the GOP will be “unified on this.” He pointed out many conservatives have supported tax credits in the past.
Moderates and Senate Republicans from states that have expanded Medicaid under Obamacare have been less vocal but are no less influential in the debate. Sen. Susan Collins (R-Maine) is concerned about defunding Planned Parenthood, which many conservatives are insisting on. And there are 20 GOP senators from Medicaid expansion states, some of whom may end up opposing plans to gut the Medicaid expansion that’s helped millions of low-income Americans receive insurance.
Even Collins, whose state has not expanded Medicaid, said she was troubled by House Republicans’ plans to roll back the program.
“We have some 32 states that took advantage of that part of the Affordable Care Act. And they did so with the reliance that the federal government would pick up something like 90 percent of the cost. And I don’t think it’s fair to say to those states: Nevermind,” Collins said in an interview.
Sen. Lisa Murkowski (R-Alaska) told state legislators last week that as long as they supports the Medicaid expansion, she will not vote to roll it back. It would take just a couple more defectors to threaten GOP leaders’ plans. Already, some Senate Republicans aren’t convinced the House will cover all their constituents.
“My concern is that we want to make sure none of these folks gets dropped. And I’m not fully convinced that what the House is working on can give me that assurance,” said Sen. Shelley Moore Capito (R-W.Va.), who plans to press Brady and Walden on specifics.
But moving to the center and preserving the Medicaid expansion would further anger conservatives.
Voters “didn’t tell us to repeal [Obamacare] but keep the Medicaid expansion,” said Rep. Jim Jordan (R-Ohio), referring to tax credits in the House plan. “We think you should actually do what you said you would do.”
With public sentiment moving in favor of Obamacare, protesters swarming town halls and Republican infighting on the rise, GOP leaders nonetheless say they have no plans to slow down. In fact, senators said McConnell and Ryan are setting an ambitious, if soft, deadline to hold a vote to gut the law ahead of the Easter Recess. They’re betting that after all the promises to repeal Obamacare, Republican agitators will find it impossible to vote against Obamacare repeal, even if they’re not crazy about all the particulars.
“We’re getting down to the decision point where we need to get behind one approach,” said Senate Majority Whip John Cornyn (R-Texas), the party’s chief vote counter. “People are slowly coming to a recognition that they have to make a decision.”
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