Opinion: The GOP’s Big Health Care Winner — Mitch McConnell

House in flames but crisis avoided in the Senate

Senate Majority Leader Mitch McConnell remains untarnished by the GOP effort to repeal the 2010 health care law, Allen writes. (Bill Clark/CQ Roll Call)
Senate Majority Leader Mitch McConnell remains untarnished by the GOP effort to repeal the 2010 health care law, Allen writes. (Bill Clark/CQ Roll Call)
Posted March 24, 2017 at 6:45pm

There’s exactly one big winner in the Republican leadership right now: Senate Majority Leader Mitch McConnell

The Kentucky Republican, long known for his sixth-sense acumen as a political and legislative strategist, completely avoided the direct and collateral damage of the GOP health care debacle of 2017.

When President Donald Trump and House Speaker Paul Ryan promised that they would finally deliver on the GOP’s promise to repeal and replace Obamacare, McConnell sat back.

He watched quietly and patiently as several of his Republican Senate colleagues, most notably Rand Paul of his own home state, crossed the Capitol to stoke the already burning flames of the Freedom Caucus in opposition to the House’s “American Health Care Act.”

One longtime House observer noted that there had never been a time in recent memory when senators were more actively engaged in an effort to pass or defeat legislation in the so-called lower chamber. The most vociferous had been those who said the bill wasn’t conservative enough.

Avoiding conflict

But regardless of ideological stripes, the clear message from Republican senators had been this: Please don’t make us vote on a repeal and replace bill. McConnell didn’t rap anyone’s knuckles. He made no public attempt to rein in Paul or Arkansas’ Tom Cotton or Maine’s Susan Collins.

If you followed the tweets of his whip, Sen. John Cornyn, you’d have been hard-pressed to make the case that the Texas Republican was in any place other than praying that he wouldn’t have to try to collect votes on a replacement bill.

Here’s what he tweeted Thursday as conservatives were pushing for changes to the bill that would run afoul of the Byrd Rule, which governs which provisions can be considered under reconciliation rules: “FYI: The ‘Byrd Rule’ is actually a law.”

Never mind that the Senate could and would simply write its own bill that could be Byrd-proof and thus not subject to filibuster. Forget that the House would ultimately have to accept a version that could pass the Senate with a minimum of 50 votes plus the vice president’s tie-breaking “aye.” The repeal and replace bill written by the House had become so toxic that senators knew swallowing anything associated with it was political suicide.

As many as a dozen Senate Republicans said they wouldn’t vote for the House version or expressed reservations about it. They ranged the political spectrum within the GOP, coming from all over the country — from Maine to Alaska to Arkansas.

Each fashioned his or her reasoning to fit his or her state, but the message was clear: The Senate wasn’t interested in the House-written version of the AHCA. The subtext of that was that the Senate didn’t want to vote at all. If it couldn’t get through the House, the Senate wouldn’t have to worry about it. And each criticism had the effect of making Ryan’s vote-counting efforts harder.

And with good reason. The House wanted to cut Medicaid by $880 billion over a decade, turn relatively generous subsidies for health insurance purchases into paltry tax credits and route reductions in net investment income to the wealthiest Americans. There are some House districts in America where a vote for that elixir wouldn’t be fatal, but not many. In the Senate, it’s hard to think of a state where it would have been a popular vote. Instead, Senate Republicans were facing the prospect of eating a stink bomb and explaining to voters why they did it.

Fallout for Trump

The bill was a loser long before Trump called Bob Costa of The Washington Post on Friday afternoon to tell him that House leaders were going to pull the bill. Trump, who put in a half-derriered effort for the bill, and Ryan, who pulled out every stop, look both cruel and incompetent.

Neither one of them had the juice to get angry conservatives or timid moderates to walk the plank in the House. With his approval rating hovering around 40 percent, Trump can now expect to have even less influence on House members. And Ryan’s capacity to lead the House is, at best, in question.

One sign of the difficulty of the task they undertook: The chief cheerleaders for the bill were Vice President Mike Pence, Office of Management and Budget Director Mick Mulvaney and Health and Human Services Secretary Tom Price, none of whom would have voted for it when they served in the House. Pence led the opposition to the Medicare prescription-drug law in the House in 2003.

McConnell was supportive enough to evade being accused of tanking it himself, but his fellow Republican senators did his handiwork for him. Now, with everyone else in the Republican leadership looking impotent, McConnell is untarnished by the Obamacare repeal effort — and so are his GOP Senate colleagues.

If you want to know what Congress will or won’t do, watch McConnell.

Roll Call columnist Jonathan Allen is a co-author of the New York Times-bestselling Hillary Clinton biography “HRC” and has covered Congress, the White House and elections over the past 15 years.