The Health Care Situation
Posted on June 28, 2017
If I were reporting on the Senate health care situation, here would be my takes.
1 - What doesn’t kill you makes you stronger.
Mitch McConnell didn’t kill the bill by scheduling it for a vote and having it go down. That means he must believe that he has a chance to pass it after the July 4th deadline. Everybody knows that the Leader is a fierce guardian of the Senate schedule and he is losing his patience with the repeal and replace strategy. Most folks assumed that if he couldn’t get this done in a badly fractured Senate, he would pull the plug quickly and move on. The fact that he hasn’t bodes well for its ultimate passage.
2 - The media missed the story on the budget score.
The Congressional Budget Office scored the Senate bill as saving $200 billion in revenue and predicted that 22 million would lose their coverage as a result. The media uniformly said that this was a bad thing for the Majority Leader as he tried to cobble together enough votes to pass it by focusing almost exclusively on the 22 million people. But that wasn’t the real story. The real story is that Senator McConnell has about 100 billion dollars to play around with to get to 50 votes. That’s a lot of money for opioid treatment or expanded Medicaid funding. The reason so many Senators jumped off the bandwagon yesterday was pretty simple. They want some of that money.
3 - The business community, especially the Chamber of Commerce and the Business Roundtable, is starting to get engaged in the debate.
Most of the provider groups are against the Republican effort to repeal and replace Obamacare. They know a good deal when they get one and they see the Republican effort to turn off government funding as a bad thing for them. The rest of the business world has been largely ambivalent about the effort. Why should they care if it isn’t their ox that will be gored. But the problem with that thinking is that if there is a huge health care car crash, the legislative highway gets jammed up. And that makes tax reform that much more difficult to get done. So, for the first time, you saw the Chamber get engaged in the process by endorsing the Senate bill.
4 - The conservative movement is split.
The hard right is all over the place on this effort. Mike Needham is generally for it. David McIntosh is against it. Freedom Works doesn’t like it. Heritage is generally supportive. What does that ultimately mean? It’s unclear if these organizations have much juice these days, but they have even less juice when they can’t really agree among themselves. That’s probably a good thing for McConnell as he tries again to cobble together a coalition of the willing.
5 - The President is a passenger on this train.
He is not driving it, he doesn’t know much about it, he has been largely shouting directions from the caboose in ways that haven’t been particularly helpful. His Super Pac threatened to run ads against Dean Heller if he didn’t come on board, making it even more difficult for McConnell to get the Nevada Senator on board. The President would help the process more by enjoying the ride and allowing the Minority Leader to drive uninterrupted. There are about 52 Republican Senators who believe that they could do a better job as President than the current occupant. Trump would get more from the Senate by doing less talking, less tweeting, less cajoling and less selling. The Leader knows what he is doing. Let him do his job.