Health care state of play: McConnell moves on from repeal to replace
Posted July 18
Senate Majority Leader Mitch McConnell announced Monday night that the latest plans to repeal and replace Obamacare were dead and said he would attempt to hold a vote on a repeal-only bill, using essentially the same legislative language the vast majority of the GOP conference voted for last Congress.
This is a massive collapse, but one that seemed close to happening for days.
As one aide told CNN Monday night, "The votes weren't there, aren't there, were never gonna be there."
Bottom line: There are a lot more than four "no" votes on the Senate bill. We're talking like eight to 10, some which could come out Tuesday.
What comes next:
This is very important: What McConnell has committed to do is bring up a procedural vote to take up the House health care bill. That will come first, not the vote on repeal only.
RELATED: How the Republican health care bill fell apart
Keep in mind, this was the same exact procedural motion that would've been necessary before taking up the last health care proposal, and GOP leadership was short of the votes. Now they are trying again, without a compromise agreement on a final language. Aides are very skeptical Republicans will vote for this.
What to watch Tuesday: Senate GOP Policy lunch
Pretty simple: Every single GOP senator will be asked if they will vote to proceed to the bill. There's no reason to dodge the question. No analysis to say they are waiting for to decide. In reality, we will likely know by the afternoon whether this effort will fail.
Also of note: McConnell will announce his timeline and strategy to the conference. So congressional observers should expect to know everything that's happening, when the vote will be etc., by Tuesday afternoon.
Quick policy quibble:
This effort is not technically "full repeal." It is repeal only, no replace, but it's in no way a full repeal of the Affordable Care Act. Because of budget rules (and some politics) the 2015 bill this would be modeled after leaves in place large portions of the ACA (most notably, some regulations so loathed by conservatives).
When would the vote take place:
McConnell's statement said "in the coming days." Senate aides told CNN there's a decent chance it will be sometime later this week.
If that's the case, yes, Sen. John McCain will still be at home recovering. While McCain, in a statement Monday night, called for Republicans to start over on their health care effort entirely, it's worth noting that McConnell appears to be willing to move forward on this strategy without his entire conference present.
That gives you a pretty good indicator of how he thinks things are going to go.
How the process works:
McConnell brings up the motion to proceed to the House health care bill
If that passes, the first amendment to that bill would strip the House bill language in its entirety and replace it with the repeal-only language. This is almost certain to fail.
Then -- and this is important -- the floor would be open to anyone to offer any amendment. The vote-a-rama we've been talking about forever would still occur under this process. So in other words, the repeal-only amendment wouldn't be the end of it. Just the start in fact. After all the amendments are done, they'd vote on final passage.
To state the above is an uphill climb would be a vast understatement.
Voting yes to proceed to the bill, knowing there is no compromise bill waiting is a really, really tough ask for senators. The vote-a-rama will be packed full of deliberately terrible political amendments offered by Democrats. And there is zero certainty what a final bill would actually look like.
"Seems like we're just working this one out as we go," an aide told CNN on Monday night. "No, that doesn't make any of our bosses comfortable."
Is there a way this all actually works?
Never say never, particularly on the Senate floor.
But there's still no sense as to how, or if they even got onto the bill, what the strategy would be after that.
"We're flying blind here," a GOP aide who worked on the Senate bill told CNN. "Basically, (we're) just going to put it up and see what happens from there. Rock and roll, man."
The repeal-only effort was the plan of congressional Republican leaders at the start of this Congress.
Their own members (and the President) rejected this effort. That's why they moved to repeal and replace. In other words, they very clearly didn't have the votes for repeal-only in January. They still don't have them now.
Pay attention to this idea:
There were no shortage of Senate aides, K-Streeters and even senators trying to game out McConnell's strategy Monday night. The general consensus is this: it's an effort that appears designed to fail.
The unknowns of going into a vote-a-rama without any type of compromise repeal-and-replace plan queued up are a nightmare scenario for rank-and-file Republicans.
The repeal-only option doesn't have the support of 50 Republicans (and probably significantly less than that), yet many of them voted for repeal-only last Congress, so it's essentially leadership deliberately setting up a flip-flop vote. This is, shall we say, not a typical strategy.
What McConnell is doing?
He's calling the bluff of his members, essentially. The argument, however precarious on its face, is this: the vast majority of the GOP conference voted for this bill last Congress. Those lawmakers are on the record. To vote against it would be a flip-flop.
And to the conservatives who have been opposed to moving forward -- this is explicitly what you were asking for. Time to come on board.
The ramifications of moving forward aren't secret to anyone, so it's tough to see this argument carrying the day, but McConnell's not wrong -- his conference, almost to a senator, voted for this last Congress (then-President Barack Obama vetoed the bill). And at least one conservative, Sen. Mike Lee, is already on board Tuesday morning to support the motion to proceed, CNN's MJ Lee reports.
So why is this happening?
As one former senior GOP aide, now health care lobbyist put it: McConnell "needs to show his conference, and probably most importantly, the President, that repeal-only can't be done. They won't be able to move on until that happens. So that's what's going to happen."