For Centrist Republicans, Will Party Trump Concerns on ACA Repeal
There is a line from a song in the Broadway show, “My Fair Lady,” which goes, “She will beg you for advice, your reply will be concise, and she will listen very nicely then go out and do exactly what she wants!” Alan Lerner and Frederick Loewe couldn’t have known it when “My Fair Lady” premiered in 1956 but they might as well have been writing for contemporary battles in Washington D.C. That is, will enough Republicans have the political will to listen to constituents, experts, and their own consciences by opposing the administration backed plan to repeal the Affordable Care Act? While it may seem that way now, I’m not so sure when the time will actually come to to walk the plank.
I don’t use the term political coward lightly. There are reports that Republican Senators are rooting for Paul Ryan’s efforts to pass the Trump administration backed repeal to fail in the House. To be sure, these Senators are far from alone and, if there is one thing that is predictable in a place where predicting is conducted at your own risk, the bill will not pass in its current form in the House. But the reason these Republican Senators hope it doesn’t make it to the Senate isn’t altruism – it’s because they don’t want to be the ones who have the final say in handing a devastating defeat to a president of their party, or their Senate leadership. If it ultimately comes to that choice, I’m not convinced that they’ll do right by themselves. It’s sad that this is how major business is conducted in the nation’s capital and it’s even more disturbing that the “Mr. Smith’s” of Washington D.C., are few and far between but, that’s how it goes.
In fairness, I don’t want to imply that it’s only Republicans who play the game. I have seen Democrats cobble together the votes to approve a package or a nominee that they have deep reservations about (Bill Clinton’s economic package and the actual passage of ACA come to mind). You’ll remember Vice President Al Gore’s tie-breaking vote sent the Clinton deal into law. But that didn’t involve taking something away from people that was critical to health, much less potentially life-saving. And you can bet your bottom dollar it impacted far fewer than 24 million people. The ramifications for ACA are life and death and that’s not a partisan statement – it’s something Democrats and Republicans agree on – because they are all talking about repeal and replace, not simply repeal.
Which brings us to what we can expect from here. Obviously, the administration faces resistance from the right, particularly members of the “Freedom Caucus,” but my sense is something will be worked to have a sufficient number on board at the end of the day. Some have already signaled as much. The main hurdle for the administration is likely to be the many centrists Republicans (those three words are probably oxymorons these days) who have expressed reservations about the administration backed plan.
Some, such as Susan Collins of Maine, have outright stated that they will oppose the package outright due to the elimination of the Medicaid expansion. Up to nine GOP colleagues have said they will do the same, with the caveat that it be changed. But Collins and Alaska’s Lisa Murkowski did vote against confirming Betsy DeVos as Education Secretary only after receiving assurances that her nomination would go through. Would anything stop them fromtryingh to get a “pass” again if they knew the votes were otherwise there?
In the House, only one centrist, Florida’s Ileana Ros-Lehtinen has come out against the plan though a number of others are strongly leaning against it. A number of GOP Governors, particularly those from states that have taken part in the Medicaid expansion, have also urged rejection. The Congressional Budget Office (CBO) has issued its findings which, Ryan found to be “better than expected,” before the White House issued findings that were actually more dire than the CBO report. Beyond that, many ordinary Americans of all political stripes have been making their voices heard in ways that have illuminated the political dialogue like never before.
Will that have an impact in the end? To put it another way, will enough cave? Or will GOP leaders put just enough sweeteners in to make it look appealing, but in actuality could be just as detrimental? If that case, the devil really will be in the details. Either way, an issue this important requires an act of conscience rather than partisanship to put it over the top.
Incidentally, the administration’s austere – some say draconian budget proposal is also facing enormous resistance from crucial members of the Republican conference in both chambers but in that case, it’s safe to say that the give-and-take of the budget process will produce a somewhat different document. Whether that means anywhere near full restoration of Meals-and Wheels, the National Endowment for the Humanities and PBS, to name a few is unclear but there will be changes.
My concoction for not having to make a heart-wrenching choice is to just get the bill right in the first place. Millions of people depend on it. As is said in another Broadway hit, “Into the Woods,” “Opportunity is not a lengthy visitor.”