After the healthcare repeal bill failed, House Speaker Paul Ryan said he was proud of the bill and of the “long, inclusive, member-driven process that we had.”
Freedom Caucus members chafed at this characterization.
Mark Meadows, chairman of the conservative platoon, said he was “surprised that the narrative that is out there is that this was an inclusive, member-driven initiative … I’m surprised at that because even the members on the committees of jurisdiction would indicate that they read about the bill first when it was leaked to the press.”
So who’s telling the truth?
It turns out they both are. And understanding the process by which the ill-fated American Health Care Act came into being — simultaneously collaborative and centrally managed — helps give us a clue about what hasn’t worked in the GOP to date.
Speaker Ryan and the White House didn’t create a small inner circle that unilaterally wrote the bill and forced it on members. They began with frameworks and ideas that had come from Obamacare-replacement working groups years ago. Then House leadership invited comments and concerns from all Republican members, holding open-door office hours, more or less.
This wasn’t a mere formality. Leadership changed the bill to address member concerns. For instance, GOP leaders removed a provision curbing the tax break on large employer-based insurance plans. (This change wasn’t an improvement, but it was responsive to member concerns.)
Then, keeping all his members’ concerns in mind, Ryan hashed out a bill and introduced it, before declaring that the only alternative was keeping Obamacare.
So it wasn’t unilateral, and the process did involve listening to and adapting to concerns. So why did so many Republicans buck? Why did Freedom Caucus members demand the bill be dragged rightward? Why did moderates demand the bill be dragged leftward? And if Ryan was losing members both Left and Right while still falling short of 216 votes, is there any way he could have gotten to 216?
The relevant distinction here is between is between an open door and an open process, between listening to someone and giving that person agency—between Ryan’s office hours and, say, the committee process.
When Democrats passed their complex overhaul of the health sector, they used the committee process. The chairmen of three House committees—Education and Labor, Energy and Commerce, and Ways & Means—spent months crafting a “discussion draft,” which they published in June 2009.
Education and Labor held a hearing on the bill in late June. Ways & Means held a hearing the next day. Energy and Commerce held three days of hearings at the same time. From these hearings, leaders crafted a bill. Then the bill went back to these committees for markup, when members could debate and vote on amendments.
The House Energy and Commerce Committee passed the Affordable Health Care for America Act in October 2009. Speaker Nancy Pelosi even allowed pro-life Democrats a vote on their amendment to limit federal subsidies of abortion.
In the Senate, whose bill ultimately became law, multiple committees had a say, too.
Obamcare wasn’t any sort of model of public and open lawmaking (much of the negotiating was behind closed doors), but it was more participatory than the GOP bill was this year. In years past, committee markups were where real action happened.
A participatory committee process has all sorts of drawbacks, including how much time it takes. But here’s the major upside, if you’re a party leader: If a member gets to propose his amendment, make the case for it, and put it up for a vote, he’s far more likely to stick around even if he loses than if he feels his objections were never considered.
It’s a central idea of democracy: Everyone gets his say, but even the losers go along with the final decision. This is the idea behind party unity. And a conservative or a moderate dedicated to replacing Obamacare might not like the final shape of the final GOP bill, but if he felt he got a fair shake, he may go along with the final product.
Speaker Ryan has tried nobly to not only replace Obamacare but also to figure out how to govern the GOP in this new era of decentralized fundraising and no earmarks. The process of the first Obamacare replacement didn’t work. Maybe the answer lies not in innovating, but in trying something old-fashioned: The committee process.
Timothy P. Carney, the Washington Examiner’s senior political columnist, can be contacted at [email protected]. His column appears Tuesday and Thursday nights on washingtonexaminer.com.
