At 39, Tom Cotton is the youngest member of the Senate. He was elected from Arkansas in 2014 after two years in the House. And having served in combat in Iraq and Afghanistan as an infantry captain, he quickly emerged as an influential senator on military and foreign affairs.
Now he’s taken on health care and aims to create a consensus among Republican senators on the best way to repeal and replace Obamacare. It’s an ambitious task, especially for someone whose experience with the issue is not extensive.
Yet he stepped up as the most forceful GOP senator in opposition to the bill favored by President Donald Trump and House speaker Paul Ryan. When their bill failed to attract a majority in the House, his role as a key player on health care got a enormous boost.
Cotton didn’t like the Trump-Ryan plan from the moment he read it. “The bill wouldn’t work,” he says. “It wouldn’t reduce premiums.” Instead, by letting premiums rise in the first two years, it would have jeopardized Republican chances in the 2018 midterm election and the 2020 presidential race, he insists.
This is no small point. The measure rejected in the House is now being modified to eliminate premium hikes. Cotton says this can be done by wiping away Obamacare’s insurance regulations, especially the one requiring all policies to include 10 “essential benefits.”
While Cotton and Ryan agree on the goal of a health care system that’s patient-oriented and driven by free market incentives, their argument over the failed bill has delighted the media. This was the headline of a Politico story: “Cotton goes after Ryan agenda in battle of GOP heavyweights.”
Indeed, Cotton has been harsh in his criticism. He attacked the three-phase process in the Ryan plan. It is “nothing but politician’s talk,” he told Politico. “It’s all talk.” At one point, he said House Republicans should slow down and start over in drafting the bill to replace Obamacare.
When I interviewed Cotton last week, he didn’t let up in his criticism. Ryan’s third phase consists of legislative steps to improve the replacement to Obamacare. Doing so would require help from Democrats in the Senate to overcome a filibuster.
Cotton doubts the votes of eight Democrats, the necessary number, would materialize. If that many Senate Democrats are available, they should be recruited now, he suggested. With them on board, there’s no reason to use the stringent reconciliation process to get repeal and replace through the Senate, he said. A filibuster could be thwarted and full repeal passed by a simple majority.
In Ryan’s defense, he believes some Democrats will be open to a fresh approach once Obamacare is dead and gone. At that point, they would be willing to vote for popular measures to improve the Republican replacement.
He and Cotton agree on removing the “essential benefits” regulation, but would tackle it in different ways. With Ryan’s encouragement, Freedom Caucus conservatives and Tuesday Group moderates agreed to let each state decide on the required benefits. Cotton would eliminate them outright.
A factor in Cotton’s emergence is his relationship with Trump. He didn’t endorse Trump during the primaries. This was because several of his Senate colleagues and former Arkansas governor Mike Huckabee were running for the GOP nomination.
But Cotton was not hostile to Trump. In fact, he was the first person who mentioned to me last year that Trump was viewed favorably by a group of conservative intellectuals, some at the Claremont Institute in California. Cotton studied at Claremont under Charles Kesler, the editor of the Claremont Review of Books.
In March of last year, Cotton joined Trump at a crucial meeting in Washington. It was called to discuss how Trump might handle the nomination of a successor to the late Supreme Court justice Antonin Scalia. Trump asked for a list of conservative jurists from which he might select a nominee. Neil Gorsuch, then a federal appeals court judge, was on the list.
When the raunchy Access Hollywood recording was leaked last October, Cotton didn’t abandon Trump. Cotton urged him “to throw himself on the mercy of the American people. . . . He needs to take full responsibility for his words and his behavior, he needs to beg their forgiveness, and he needs to finally change his ways.”
If he were to balk, Cotton said, “then he should step aside and allow the Republican party to replace him with an elder statesman.” Trump basically followed Cotton’s advice during his second debate with Hillary Clinton. Ryan was tougher, saying he would no longer defend Trump, though he didn’t withdraw his endorsement of him as the Republican nominee.
Cotton talks frequently to Trump. They haven’t discussed health care, but I’m told they talk about many “other things.” And Cotton’s advice is sought by cabinet members, particularly on foreign policy and military issues. That he is well-liked by Trump adds to his influence.
Last week, Cotton was in demand by TV news shows to talk about Syria and China. He’s smart, decisive in his views, and knowledgeable. There aren’t many Republicans who can handle questions on foreign and military issues as convincingly as Cotton.
In the meantime, there’s health care to deal with. It won’t take a miracle to bring together Republican senators on a package of ideas that amount to a consensus. And Cotton is also eager to gain the support of health care experts from think tanks. In Washington, their opinions matter. Most of them were critical of the Trump-Ryan bill.
In its broadest terms, Cotton’s objective on health care is “to help those who were hurt by Obamacare while not hurting those who were helped by it.” He says far more were hurt than helped. Trump and Ryan would agree with that.
Fred Barnes is executive editor of The Weekly Standard.
