Republicans Prepare to Take Next Step on Health Care Blindfolded

Senate Republicans still don’t have 50 votes to pass any piece of legislation dealing with Obamacare, but they may nevertheless vote to proceed to debate on health care legislation Tuesday with no apparent endgame in sight.

“I don’t have a clue what we’re going to be voting on,” Wisconsin senator Ron Johnson complained to reporters Monday. Johnson was not alone among GOP senators in expressing such confusion, but Senate majority whip John Cornyn of Texas said that was simply a “big misunderstanding.”

While enough senators have expressed opposition to the Senate’s current “repeal-and-replace” bill and the 2015 “repeal-and-delay” bill to prevent the passage of either bill, Senate majority leader Mitch McConnell’s plan, as outlined last week, is to open up debate on health care and vote on as many different health care bills and amendments as senators want.

“We’ll proceed to the House bill, but everybody who wants a vote—whether it’s on the 2015 bill or Cassidy-Collins bill or the Graham-Cassidy bill, everybody’s going to get a chance to vote,” said Cornyn. As of Monday night, it was unclear how several senators would vote on the motion to proceed, including Lisa Murkowski of Alaska, Mike Lee of Utah, Dean Heller of Nevada, Jerry Moran of Kansas, Rob Portman of Ohio, and Shelley Moore Capito of West Virginia. The office of John McCain announced Monday night that the Arizona senator would return to work Tuesday, despite his recent diagnosis of brain cancer: “Senator McCain looks forward to returning to the United States Senate tomorrow to continue working on important legislation, including health care reform, the National Defense Authorization Act, and new sanctions on Russia, Iran and North Korea.” McCain’s office didn’t say how he would vote on the motion to proceed on health care.

With all 52 GOP senators expected in attendance on Tuesday, it will take at least three Republicans to block a health care bill from coming to the floor. Susan Collins of Maine appeared to be the only Republican senator who was a hard “no.”

“I’m a ‘no’ on proceeding to the 2015 bill to repeal and replace within two years, or to the House bill, or to the first version of the Senate bill, or to the second version of the Senate bill,” Collins told reporters Monday night.

“I hear there may be a third version of the Senate bill, but I don’t know what’s in it,” Collins added. If the Senate proceeds to debate on health-care and after it finishes it’s “vote-a-rama” on various amendments, a final compromise bill could come to the floor. It’s difficult, but not impossible, to see 50 Senate Republicans ultimately rallying behind some bill dealing with Obamacare. As the latest issue of THE WEEKLY STANDARD reports:

It’s a tall order, but it’s conceivable that eventually something resembling the Better Care Reconciliation Act passes the Senate and the House and is signed into law by President Donald Trump. Collins and Paul appear certain to oppose any version of this bill, so step one to getting 50 votes involves gaining Mike Lee’s support, which doesn’t look to be all that difficult. Lee said he’d vote for the bill if it included Texas senator Ted Cruz’s “consumer freedom amendment,” which would allow insurers that sell Obamacare-compliant plans to sell plans that don’t adhere to Obamacare’s costly regulations. The bill did include a modified version of the amendment that Cruz said was good enough to win his vote but Lee found unacceptable. The policy dispute is technical and complicated (the bill required a single insurance pool instead of one high-risk pool and another for everyone else). If that specific policy dispute can be resolved, step two would involve spending enough money on Medicaid to assuage the concerns of moderate senators. Throughout the process, conservatives have made it clear that they would be willing to tolerate more spending and even keeping some of Obamacare’s taxes on the wealthy to get regulatory relief that would re-create a real insurance market that brings down costs for middle-class Americans who don’t have employer-sponsored insurance. Even if conservatives and moderates compromise, wild cards like Moran would still need to be won over.

But as of Monday night, it was unclear if Cruz’s amendment would be included in any final compromise legislation, and the measure hadn’t even been scored by the Congressional Budget Office, as required by Senate rules.

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