The Senate health bill is almost an orphan with few real supporters

By Paul Kane

July 11, 2017

The Senate did not author the proverb about success having many fathers while failure is an orphan, but the words often typify how senators react to legislation that is struggling to win approval.

On Tuesday, after a roughly 90-minute huddle with his caucus, Senate Majority Leader Mitch McConnell (R-Ky.) began his weekly news conference on “the news of the day” — the struggling effort to pass health-care legislation that would repeal and replace portions of the Affordable Care Act.

For less than 25 seconds, McConnell gave a basic update on the timing of the legislation, never made the case for why Republicans should support it and then moved on for another minute to attack Democrats on unrelated issues.

That’s the way it has gone for the Better Care Reconciliation Act ever since it was unveiled nearly three weeks ago. In public appearances, and often in private GOP meetings, Republican after Republican outlines the reasons that they stand opposed to the legislation, as written, with almost no one taking up the mantle of defending a proposal that was unpopular from Day One.

Sunday’s political talk shows included four senators, two of whom, Sens. Ted Cruz (R-Tex.) and Bill Cassidy (R-La.), tried to sell changes in the legislation that they were demanding before promising their support. One senator, John McCain (R-Ariz.), pronounced that the legislation is “probably going to be dead.”

Only Sen. Lindsey O. Graham (R-S.C.) lent his endorsement to the bill — but even that was a tepid one at best. “I think this bill is better than Obamacare,” Graham said on NBC’s “Meet the Press.”

He then hedged by saying he was not sure it would pass and that a bipartisan effort might be a good fallback for Republicans.

Part of the Republicans’ hesi­ta­tion to directly promote their own health proposal is its uncertain fate, its unpopularity in repeated public polling and the sense that it might die on the Senate floor in what will be a politically embarrassing defeat for a party that promised to repeal the ACA the moment that Democrats approved it seven years ago.

Another problem is that McConnell chose a process to craft the legislation that has literally left the proposal orphaned.

By not going through the Senate’s precedent-bound process of “regular order,” the bill has bypassed committee hearings as well as the loving care that a legislative sponsor would normally provide. As a result, it has no real parent figure, no one invested in its success, no one primarily responsible for promoting it to other colleagues and the media.

McConnell avoided public scrutiny in the Finance, Budget and Health committees that normally would have taken up such a complicated matter. Instead, he assigned the task to an ad hoc group of Republicans who met in his office over the course of two months to come up with the nearly 150-page proposal.

The decision carried its benefits: While McConnell absorbed public criticism for the closed process, he limited the political risk and exposure to individual Republicans, and his senators got to keep their distance.

Now, however, there is so little investment in the legislation by rank-and-file Republicans that the questions continue to pile up about what changes need to be made. By late last week, the discourse had turned into a feeding frenzy, with even the most loyal Republicans openly questioning the measure while they were home over the Fourth of July.

“It’s worthy of a national debate that includes legislative hearings,” Sen. Jerry Moran (R-Kan.) said after a 90-minute town hall in rural Kansas. “It needs to be less politics and more policy.”

Eight years ago, House and Senate Democrats conducted a process that appeared brutal to the public at large. There were committee hearings and committee votes on the various iterations of the Affordable Care Act — and then a pause to hold closed-door meetings to do backroom deals, then more committee votes, then more backroom bargaining.

Republicans ridiculed Democrats for never reading the actual legislation, but in the end the ACA won approval. Three House committees and two Senate committees passed pieces of the bill, so that by the time the entire House and Senate considered their versions, those five committee chairmen served as ambassadors promoting the legislation — and dozens upon dozens of Democrats had already voted to approve portions of the bill.

There was already plenty of buy-in, and many Democrats were pushing to get the ACA over the finish line.

There is no such buy-in among Republicans in the Senate.

That was on display during the nearly 12 minutes they spent in front of the press Tuesday, with McConnell and five of his lieutenants rarely referencing the underlying legislation that they are trying to pass later next week.

They instead chose to continue to ridicule the ACA, warning that its insurance exchanges were imploding and that something must be done.

Two Republicans didn’t even bother talking about health care, opting instead to accuse Democrats of slow-walking President Trump’s nominees to sub-Cabinet positions — and to blame them for McConnell’s decision to cut down by two weeks a planned 40-day recess over August and early September.

Only Sen. John Barrasso (R-Wyo.), an orthopedic surgeon, devoted any time talking about some of the specifics in the legislation and what it would change from current law.

“We’re eliminating the mandates — the employer mandates and the individual mandates that people have to buy a government-approved product. We eliminate the taxes that raise the cost of insurance for the American public. And we lower premiums,” Barrasso said.

That was a better sales effort than McCain’s appearance Sunday on CBS’s “Face the Nation.”

“I fear that it’s going to fail,” McCain predicted.

If he’s right, it might be because the legislation was set up as an orphan from the outset.