Obamacare Repeal Continues to Circle the Drain Despite GOP's Best Efforts

After last November’s election, I made the case that Obamacare was not as doomed as many expected in the wake of Trump’s surprise victory. Almost four months later, Obamacare is actually in better shape than anticipated. In their newly released legislation, Republicans have already given up on complete repeal of Medicaid expansion (freezing it in 2020 instead) or the elimination of subsidies to help purchase insurance (substituting refundable tax credits, which are essentially subsidies). And this is the House GOP leadership plan—this is supposed to be the hardline conservative version of the bill! Obviously the bill is still terrible, but considering all the over-the-top boasts we’ve heard from Republicans, it’s quite the comedown.

And what’s more, there’s a good chance this bill can’t even pass the House. Previously, I focused on the difficult Senate math for the GOP, but repeal has almost as many problems in the House. Even though it’s theoretically easier to pass legislation through the lower chamber, it’s easy to forget the House GOP caucus is a hot mess. In recent years, the GOP majority has had to pull scheduled votes on controversial bills or rely on Democratic votes to get “must-pass” legislation through. That’s not the sign of a healthy, well-functioning majority. (In parliamentary-style legislatures, these votes could have brought down the whole government.)

In particular, the ultra-right-wing House Freedom Caucus has 30 members. With a Republican majority of “only” 237 seats and 218 votes needed for anything to pass, the Freedom Caucus has more than enough votes to thwart any GOP legislation it doesn’t like. And it doesn’t like a lot of things, primarily anything that would make legislation less crazy and more amenable to Republicans in competitive seats. The Freedom Caucus definitely doesn’t like the GOP leadership bill, and apparently they’re not going to like any bill that helps Americans with health insurance in any way.

In the past, the GOP had relied on Democratic voters in order to maneuver around the Freedom Caucus. But Nancy Pelosi isn’t going to save John Boehner or Paul Ryan this time.

When Barack Obama was still in office, any bill that actually had a chance of becoming law needed Democratic support anyway, so GOP leadership always had a safety net. That’s gone now.

So if Republicans move their bill closer to what the Freedom Caucus would like to see (if in fact such a thing exists), they risk losing the votes of vulnerable GOP members who don’t want vote for a bill that could cost them re-election. And if leadership fails to move rightward, the nihilists in the Freedom Caucus will happily kill the legislation and slap each other on the back for their ideological purity. Only a skilled politician and vote counter could thread that needle and, as I said, Pelosi’s not coming to the rescue. 

Of course, the GOP still has a large numerical majority, and they can afford almost 20 defections before they have to worry about losing a vote on the floor. They may well be able to cobble something together that they can ram through. But even if they do, it will most likely be DOA on the Senate floor.

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