WASHINGTON ― A Friday procedural vote to repeal Obamacare has Republicans from different corners of the House GOP conference ― leadership, conservatives and moderates ― all scrambling to position themselves for upcoming negotiations over the future of health care.
Leadership aides insist they feel good about this vote, which is the first step in eventually repealing the 2010 law. But this initial vote could still be threatened by a small group of conservatives, and an even smaller group of GOP moderates, insisting on additional details of what that eventual repeal would look like.
Republican leaders are pushing through these early repeal steps while revealing as little information as possible about what an Obamacare alternative would look like, knowing there’s far more agreement in the conference over getting rid of Obamacare than there is over what to replace it with. Even initial details of the repeal ― like when it would take effect, how much of Obamacare it would kill, and whether it would ultimately (as Speaker Paul Ryan has said) defund Planned Parenthood ― are being kept under tight wraps.
Which is why conservatives and moderates, united in their desire for more details but divided on what those details should look like, are trying to find out who is going to get rolled in the Obamacare repeal and, more importantly, the replacement.
Ryan insists those issues will be worked out in due time through committees. But Republicans know any legislation of this magnitude requires agreement at the top levels of the House, Senate and the White House, and some lawmakers are looking to use leadership’s need for votes on this first budget resolution as a way to extract concessions.
House Freedom Caucus Chairman Mark Meadows (R-N.C.) may have secured a big one on Thursday. Although Ryan said Thursday that he and President-elect Donald Trump are “in sync” on the timing of a repeal and a replace ― “essentially simultaneously,” in Trump’s words ― there’s quite a bit of open interpretation as to what that might mean. Part of that replacement could be the Health and Human Services secretary offering new guidance on health care, while the repeal resolution could also do small components of a health care alternative. Ryan has also said that a replacement wouldn’t be a “one and done bill kind of thing,” which would seem to belie the idea of a replacement immediately following repeal.
But Meadows told The Huffington Post Thursday night that Ryan committed to bringing a replacement within days of the repeal vote, not weeks.
If true, that would give House and Senate Republicans a pretty clear picture about what they’re voting for when they ultimately repeal the health care law. However, some House Republicans are hearing that a repeal would have a three-year delay until it’s enacted, which is more time than conservatives had wanted to give Obamacare.
While conservatives feel like they lose on that, GOP moderates might feel like they win. Those Republicans were looking like they could vote against this first budget resolution in significant numbers on Wednesday, but leaders seem to have quelled that rebellion for now. A source with knowledge of how those moderates were voting suggested that leadership now only expects around three or four defections ― Reps. Charlie Dent (R-Pa.), Tom MacArthur (R-N.J.), John Katko (R-N.Y.) and maybe Martha McSally (R-Ariz.).
That would mean that conservatives would have to put up around 20 votes to sink the repeal resolution. It’s not an impossible number, but it is challenging for the House Freedom Caucus and some like-minded conservatives, especially after conservatives groups said they would “key-vote” in favor of the resolution, and Trump tweeted some praise for the Senate.
Leadership allies sent around the tweet to undecided members on Thursday, and Republicans, who are already afraid of incurring Trump’s twitter wrath, seem to have taken note. (One conservative member suggested Ryan may have worked with incoming White House chief of staff Reince Priebus to get Trump to tweet the kind words as a warning shot.)
Either way, there are certain to be some far-right Republicans voting against the Obamacare budget resolution, which would deem the addition of more than $9 trillion in debt over the next decade as “appropriate.” In the words of fiscal hawk Rep. Walter Jones (R-N.C.), “How the hell can I vote for that?”
The question is whether Freedom Caucus leaders ultimately vote for the repeal resolution, particularly if the resolution will be agreed to on Friday. Meadows insists he’s still undecided, as does former Freedom Caucus Chairman Rep. Jim Jordan (R-Ohio), even though Jordan was whipping members against the resolution on Wednesday.
“Pick your metaphor,” he told HuffPost Thursday night, “but I like the rural metaphor: Once you open the barn door, the horse is running, right? We’d like to know where the horse is going.”
“Once it’s running,” Jordan continued, “you can throw apples at it, and you can yell at it, but mostly we’re concerned that when the horse runs, it runs to a spot that fully repeals Obamacare.”