After the release latest draft of Senate Republican’s health care reform plan earlier this morning, it appears that Senate Republicans are now getting really close to a bill that could actually pass the Senate.
The Washington Examiner and several Capital Hill reporters have reported that Ted Cruz is now supportive of the bill after it added the controversial “Consumer Freedom" amendment and there are indications that Mike Lee might support it as well. Two Senators – Rand Paul (who I doubt will ever get to “yes") and Susan Collins have been strongly signaling that that they will vote no.
That means that Republican leadership cannot lose any more votes if they want to pass the bill. So it is still a near impossible task, but this is where Mitch McConnell’s legendary dealmaking skills come into play.
Remember, at this point in time Republicans likely will not be able to get any support from Democrats. The current law, with reforms from the Affordable Care Act in effect, is much more favorable to them than anything Republicans would ever put forward. Given the position that they are in, it would not make sense for them to work with Republicans on health care.
With a slim 52-seat majority in the Senate, Republicans are heavily reliant on their base to get anything done. Republican hardliners are historically less compromising than Republican moderates, so in order for Mitch McConnell to get something through, he has to put forward a very conservative bill to get their support. He then needs moderate Republicans to make compromises and trust that he is on their side.
The biggest concern that the moderates have is the cuts to Medicaid and the subsidies. But according to a report from MSNBC, Mitch McConnell is telling some of the moderates that those cuts will never go into effect.
In other words, he is telling the moderates to vote for this very conservative bill now and then he will allow the Senate to vote on increasing funding for Medicaid and the subsidies in the future. If their current health care reform bill goes into affect, then the Democrats would almost certainly vote for any bill that would increase funding for Medicaid and the subsidies. McConnell is likely playing his base and the Democrats. All he needs is this bill to pass, so he can have the leverage to put in place the more moderate reforms to Obamacare that he wants.
Republican hardliners would almost certainly freakout and attempt to punish him if he double-crosses them in the future, but he would have protection from a powerful ally – President Trump.
The president’s past remarks on health care have made it obvious that wants more government spending in health care. He even tweeted as much and he has a lot of support among the Republican base.
McConnell wouldn’t be able to allow the vote on upping the social spending right away, but later on in 2018 or a few years into the future he would likely pursue that. Fortunately, the bill has the deep cuts take place in the distant future, so he would have a lot of time to fix it.