Politics

Senate GOP: Knowing Health Care Plan Is ‘Luxury We Don’t Have’

Uncertainty surrounds floor strategy for Republicans’ health care effort

Many members in Senate Majority Leader Mitch McConnell’s conference do not know what they would be considering days before a key vote . (Tom Williams/CQ Roll Call)

By JOE WILLIAMS and LAUREN CLASON

Republican senators left Washington no closer to a deal on their health care effort, with no idea what measure might be brought up for a vote early next week or whether the chamber could even clear a key procedural hurdle needed to begin consideration of any legislation.

It is a startling admission for GOP lawmakers, who for the past seven years criticized Democrats for what they said was a secretive process to advance the 2010 health care law as much as the actual policy itself.

And despite hopes that the Senate would serve as the last bastion of robust debate for a House-passed measure with rock-bottom public approval ratings, Senate Majority Leader Mitch McConnell has kept the veil of secrecy so tight around the effort that even his top lieutenants are unaware what the strategy is.

“I don’t know, somebody probably does. But I don’t know,” Misouri Sen. Roy Blunt, the Republican Conference vice chairman, said when asked what the plan for next week is.

Senate Majority Whip John Cornyn of Texas, the chamber’s No. 2 Republican and a close McConnell ally, echoed his comments.

Cornyn emphasized the importance of starting the voterama process overall, despite its inherent unknowns. “You can’t debate something that you don’t initiate the debate on. And everybody can offer endless amendments.”

“It’s a luxury we don’t have,” he said when asked about the desire among members to know the plan before a vote is taken.

The uncertainty surrounding the entire process, which has divided members within the conference and even brought on questions about McConnell’s leadership ability, appears to be weighing on members.

“I’m beginning to fear it’s taking on some of the characteristics that Obamacare took on when it was passed,” Sen. Bob Corker of Tennessee said of the process. 

Members say a late-night huddle earlier this week — which occurred just one day after McConnell pronounced the effort effectively dead — created new momentum, but the issues that have dogged the conference for weeks remain.

“We all know we have positions, a lot of them are hardened positions, but in order for us to break through, we’ve got to have some more creative ideas and some different approaches,” Sen. Shelley Moore Capito of West Virginia said on Thursday. “We need to put all these new ideas on the table, because the old ideas aren’t working.”

Capito is one of several members who have expressed deep concern over the proposed changes to the Medicaid program included in the most recent draft.

Leadership, in an attempt to bring those holdouts on board, is considering pouring billions more in funding to help those states that expanded Medicaid under the health care law.

The conference is still looking for the breaking point needed to turn the effort around. That could come from a proposal by Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana that would effectively give states a massive block grant to manage their individual insurance markets.

It was a key topic of discussion at Wednesday’s meeting. 

Aides and lawmakers also say some members with concerns over the current proposal could come out in support of the Graham-Cassidy approach and that leadership is taking preliminary steps to examine how it could be added to the latest draft.

There could also be support coming from outside Capitol Hill.

“I have never felt more optimistic than I am right now,” Graham said. “I think we’ll know from the governors early next week whether or not they support this approach.”

But many in the Senate are unclear exactly what would be in that proposal, or whether it is even workable in the context of what has been developed over the past few months.

McConnell appears ready to trudge forward with a procedural vote early next week on the House-passed repeal-and-replace measure. Should that garner the votes necessary to advance, the chamber will launch its vote-a-rama, the process under which nearly unlimited amendments can be offered on the Senate floor.

Leadership is pleading with members to vote to at least reach that stage of the debate. Some are receptive to the idea.

“If you vote on this motion to proceed, there is going to be dozens and dozens and dozens of amendments, that’s where the bill is crafted,” Sen. Michael D. Crapo of Idaho said.

When asked about the possibility that many, if not all, of those amendments are likely to fail, he said “Oh yeah, that also happens.”

“It’s a very common thing … that when you get into the floor consideration, the resolution of issues continues to occur. So yes, a lot of it happens beforehand, but the whole process of debating and filing amendments and working on the floor is exactly that, to craft a bill,” Crapo said.

Despite the challenges before them, members remain optimistic a deal can be reached.

“Everybody just has a different view. I think we’re all pretty dedicated to repeal and replace, so that’s the mission, so we’ll just see if we can get there,” Capito said.

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