Senate Republicans are finally having their long-awaited “come to Jesus” moment on Obamacare.
After years of promising to repeal the President’s crowning health care achievement, even doomed efforts that are essentially political shows are being thrown in to turmoil by the political and policy realities that surround the law. Republicans took over Senate nearly a year ago, and now their first meaningful attempt to get a repeal measure on Obama’s desk is being thwarted by the desire of some Republicans to protect the law’s expanded Medicaid program — a major target of conservative scorn.
The resistance of at least a handful of Republicans to a repeal measure that would dismantle the expansion reflects a growing realization — even in red states — that Obamacare is here to stay and attacking one of its most popular provisions is politically damaging. No longer are Republicans just coming up short when it comes to how to replace Obamacare. Some are now openly admitting that fully repealing it isn’t really feasible.
Senate Majority Leader Mitch McConnell (R-KY) promised in December that the chamber, under his control, “will go at that law — which in my view is the single worst piece of legislation passed in the last half century — in every way that we can.”
After numerous tantrums by conservatives, McConnell is moving forward with that promise 11 months after the GOP assumed control of the Senate. He has chosen a procedural maneuver known as budget reconciliation because it only requires 51 and thus is free from the threat of Democratic filibuster. As President Obama would undoubtably veto the bill, the effort is a symbolic measure to assure conservatives that lawmakers will be ready and waiting to do it again if a Republican wins back the White House.
Ironically, however, the complexities of the process — which requires that any reconciliation bill decrease the deficit — has only confirmed what policymakers and Democrats have been saying: that pulling out Obamacare by the root would adversely affect health care consumers and would add to the country’s budget woes. It also highlights the lack of GOP consensus on how to replace it, as Republicans run into the same underlying economics that the law itself grapples with.
Republican leaders may be short of even the 51 votes required due to the GOPers publicly balking at attacking the Medicaid expansion.
“I am very concerned about the 160,000 people who had Medicaid expansion in my state. I have difficulty with that being included,” Sen. Shelley Moore Capito (R-WV) told The Hill, as the Senate weighs a plan to move forward a repeal effort that would reverse the expansion.
Sens. John Hoeven (R-ND) and Sen. Steve Daines (R-MT) also hedged on supporting anything that attacked Medicaid expansion, according to The Hill report, as did another unnamed Republican senator, who called it “problematic.”
Meanwhile an anonymous GOP aide speaking to The Hill earlier this week acknowledged repealing Medicaid expansion would be “complicated” for some Republicans.
This turnaround didn’t happen overnight. Capito — who previously served in the House — has been warming up on the Medicaid expansion since her campaign for Senate last year, and there have been signs of other Republicans backing away from a full-on repeal.
But now, thanks to some GOP lawmakers’ softening on the issue, what was supposed to be Republicans’ best shot for putting a repeal measure on the president’s desk is in jeopardy. While some Republicans are asking the GOP to scale back on the repeal, other more conservative lawmakers — particularly those running for president — are pushing the Senate to go farther than the semi-repeal bill the House GOP already passed, and that includes getting rid of the Medicaid expansion.
The problem with that position is that more and more red states are opting into the Medicaid expansion, and what was once an abstract opposition to an Obamacare provision for politicians now amounts to taking away coverage from tens of thousands of constituents. Montana’s move to become the latest state to expand Medicaid will benefit at least 45,000 residents, for instance, and in North Dakota, some 19,000 people gained access to Medicaid after Republican Gov. Jack Dalrymple signed legislation in 2013 to expand the program.
And it’s not just national lawmakers who are coming to terms with this reality.
Incoming Gov. Kentucky Matt Bevin (R) — who, before his successful gubernatorial race, mounted a primary challenge to Sen. Mitch McConnell that accused the Senate Majority Leader of being too soft on Obamacare — had to walk back his promises to dismantle the state’s Medicaid expansion before being elected last week.
The challenge currently facing Republicans is how they reconcile their inability to reverse the course on Medicaid expansion with their quest to kill Obamacare, full stop.