Sen. Ted Cruz, R-Texas, on Wednesday said Republicans needed to “finish the job” on repealing and replacing Obamacare in 2018, and he is pushing his colleagues to use one last reconciliation bill before the midterms to deliver on their long-running promise.
In a meeting with the Washington Examiner in his Senate offices, Cruz said he has had long conversations with the Republican senators who blocked legislation last time around, and still thinks they can get something across the finish line. He also said there has been talk of asking the Congressional Budget Office to rescore repeal legislation now that the individual mandate is off the books, which is expected to drive down the CBO’s estimate of the number of individuals who would be uninsured under Republican legislation.
“The biggest unfinished task is Obamacare,” Cruz said, reflecting on what Congress did in 2017 and his priorities for 2018. “We need to finish the job. I still believe it is possible to bring Republicans together. I think we got very close last time and that’s something I’m continuing to devote a lot of time trying to unite our fractious conference and build consensus to get at least 50 Republicans on the same page.”
Hailing the passage of the tax law that repealed the penalties for not purchasing insurance, Cruz acknowledged, “That doesn’t get the job done. [Obamacare is] still causing enormous problems — driving up premiums, making it harder for people to access quality healthcare. We need to deliver on that promise, but getting rid of the individual mandate was a big victory and it was a part of repealing Obamacare.”
He said, “the only way to proceed with serious reform or repeal legislation is through reconciliation and so my hope is that we’ll take up another budget reconciliation in 2018 to deliver on both Obamacare and Dodd-Frank.” Given the united opposition of Democrats, he takes it as a given that no major legislation will pass unless it’s by a simple majority.
In a wide-ranging conversation, Cruz talked about the ideological diversity within the “narrow and fragile” 51-vote Republican Senate majority, and how that made it challenging to reach an agreement.
He said that what last years failed efforts showed was that Republicans had 45 or 46 "solid" votes for legislation to overhaul Obamacare, and that a few additional senators were “gettable.” But each time, they came up just short of 50 votes needed to pass something with Vice President Mike Pence ready to break any tie.
Cruz said he has spent “considerable time” in discussions with the “no” votes about ways to address their concerns.
“My view is the way we get to 50 is to focus on lowering premiums,” he said. “I think lowering premiums is a win-win for everybody. It’s a win for conservatives, a win for moderates. The number one reason people despise Obamacare is that premiums have skyrocketed.”
During the 2017 healthcare fight, one of the big roadblocks was that conservatives such as Cruz wanted to lower premiums and promote competition by attacking Obamacare’s vast regulatory infrastructure, which made other Republicans nervous.
Cruz noted that some more centrist Republican senators support efforts to lower premiums through various measures to pump more money into insurance companies, which Cruz described as “essentially massive taxpayer bailouts for the insurance industry.” He said, “I think doing that without addressing the underlying problem for consumers is a mistake. I think it’s possible some structure like that can be part of a broader repeal effort. But doing that freestanding I think would be unwise.”
At the same time, Cruz said the repeal of the individual mandate would aid efforts to pass a more comprehensive bill.
One of the stumbling blocks during last year’s healthcare push was that the CBO estimates of the increase in uninsured under Republican bills, which was substantially attributed to the repeal of the mandate. For instance, in one score of a draft of the Senate bill in June, the CBO found that 22 million fewer would be uninsured, and that 15 million of that would be due to the repeal of the individual mandate.
Now that the mandate is off the books, any CBO score would have to compare repeal and replace legislation against a new reality in which no mandate exists, which in turn could make any estimate more favorable.
In pushing individual mandate repeal in tax reform, Cruz said, “I and several other people made the case that it made going back to Obamacare repeal in 2018 easier to accomplish. Because of CBO’s screwy scoring, they projected that not having the IRS fine people because they can’t afford insurance would lead to 15 million people not to purchase it. And that, in turn, dominates all the headlines ... That made it harder to get 50 Republicans on the same page, because more than a few senators get really nervous when they see nasty headlines.”
In any revived repeal effort, Cruz is advocating that Republicans start smaller.
“The way to get there is not to start off with a big comprehensive behemoth and try to squeeze everyone in it,” he said. Instead, he is advocating starting with “consensus ideas” that can get 50 votes and start “assembling from the bottom up.”
He said, “Getting to 50 is not going to be easy, but I think it was an essential campaign promise Republicans made for seven years, and we need to keep working until we get the job done.”