Senate Republicans are disagreeing about when exactly to try again to fulfill their seven-year promise to repeal and replace Obamacare, and they have no plan for how to bridge the major ideological divisions among them.
Many Republicans said they are pivoting to tax reform and then will return to repeal afterward. However, some division already exists among lawmakers on the best step for taking up the repeal fight again.
Some favor adding Obamacare repeal to a budget resolution that would give them reconciliation authority to pass tax reform with only 51 votes. But others are wary of that approach since it might gum up the effort to overhaul the tax code.
Sens. Ron Johnson of Wisconsin and Lindsey Graham of South Carolina are urging Senate leadership to add healthcare to the tax reform budget resolution. The two senators were sponsors of the latest Obamacare overhaul effort with Sens. Bill Cassidy of Louisiana and Dean Heller of Nevada.
“We’re telling leadership we want the ability to address Obamacare and tax reform in the next budget,” Johnson told reporters after leadership pulled the bill Tuesday.
But members of Senate leadership were skeptical of that approach.
“I think that is going to be very challenging,” said Sen. John Thune of South Dakota, the third-highest-ranking Republican in the chamber. “I think tax reform is gonna have to ride on its own. Confusing those issues might make it complicated for both.”
Thune added a critical caveat that leadership won’t pick up Obamacare repeal again unless they 50 votes are locked in. Republicans could pass another measure to use reconciliation next year to pass a new Obamacare repeal bill with 50 votes since Vice President Pence can be the tie-breaker.
Those 50 votes have proven elusive as four repeal bills have failed. The Senate narrowly voted down a “skinny” repeal bill that gutted big parts of the law in late July.
The Senate also voted down a bill to repeal Obamacare and legislation to repeal and replace it.
The sponsors of the Graham-Cassidy overhaul say that their bill, which would give Obamacare funding to states through block grants and cuts Medicaid, eventually will become law. They were pleased that key senators opposed the bill because of the process, not the underlying policy.
Sen. John McCain, R-Ariz., who also voted against skinny repeal, opposed the legislation because it short-circuited regular order that includes multiple hearings and participation from Democrats.
Sen. Lisa Murkowski, R-Alaska, who opposed skinny repeal but didn’t take a position on Graham-Cassidy, complained about the process in a statement Tuesday.
“I think with better process and going through regular order and honing the bill, I think we have the votes. I really do,” Johnson said.
Republicans rushed to hold a vote on Graham-Cassidy before the Sept. 30 deadline expired to pass the legislation with only 51 votes.
However, several senators did have major problems with the policy, and for different reasons.
Conservatives such as Sen. Ted Cruz, R-Texas, and Mike Lee, R-Utah, were angry that the bill didn’t let states go far enough in waiving Obamacare regulations. Sen. Rand Paul, R-Ky., wanted to get rid of the block grants altogether.
On the other side of the ideological spectrum, Sen. Susan Collins, R-Maine, was opposed because of the Medicaid cuts and was concerned that there might not be enough protections for people with pre-existing conditions.
The ideological divide has bedeviled Senate Republicans throughout their attempts to repeal Obamacare. Thune said this summer that leadership was trying to find a “sweet spot” between conservatives and centrists, particularly those who hail from the 31 Medicaid expansion states.
That sweet spot is still elusive to Senate Republicans.
Sen. John Hoeven, R-N.D., said the Senate will try to pass tax reform by the end of the year and come back to Obamacare repeal afterward.
“When President Obama passed Obamacare, it took him into the second year and he had 60 [senators],” Hoeven said. “Keep that in perspective particularly as we focus on tax reform. If we get tax reform done by the end of the year, that is a big achievement.”
Sen. John Kennedy, R-La., said he wanted Republicans to start over on replacing Obamacare, with perhaps some of the same ideas, but for lawmakers to meet regularly and talk about specific concerns, outside of the regular caucus lunches. He said he didn’t like the way that deals were cut, in which some states were promised more federal funding.
“Let’s meet every night at 6 p.m. and go to 7:30 p.m.,” he said. “I’ll meet weekends. I’ll meet whenever they want to meet. Everybody can have a say and debate their issues. … That’s the way I would do it.”
Roughly a dozen GOP senators from both sides of the ideological spectrum met for several months outside of the lunches through a working group, and the resulting legislation wasn’t able to bridge the gap.
“It is frustrating that we haven’t gotten there yet,” said Cruz, a frequent lawmaker at those meetings. “I am frustrated and everybody else is frustrated.”
He added that the working group “that met for months forging compromises is how we have gotten as close as we are.”
Republicans remained optimistic they will succeed in repeal despite their fourth setback this year.
“We lost this battle, but we’ll win the war,” said Sen. Steve Daines, R-Mont.
Washington Examiner Senior Healthcare Writer Kimberly Leonard contributed to this report.
