And key Republican leaders are confident that pressure will eventually weaken the holdouts. Old-timers recall the 2003 vote on the Medicare prescription drug benefit, during which leaders held open the vote for almost three hours while a whip team blocked all the exits from the House floor until they had twisted enough arms.
.. Yet the debate over the repeal bill is the latest sign that Republicans and Democrats are miles apart on health care, and there’s little indication the two parties can bridge that gap anytime soon. In a floor speech Thursday, Lloyd Doggett (D-Texas) trashed Republicans’ work on health care, calling their efforts not just a “crumbling and destruction of health care, but also a crumbling of our democracy.”
.. Do nothing and blame the Democrats
Trump said it himself just weeks ago: “I say to Republicans, if you really want to do something good, don’t do anything. … Let it be a disaster.”
Republicans could shelve their quest to overhaul the health care system, hope Obamacare premiums keep spiking and insurers keep fleeing marketplaces and bet they won’t pay the political price in 2018. Trump has already expressed his misgivings about taking ownership of health reform, and privately assured conservative groups that he can pin the whole mess on Democrats if the repeal effort fails.
Who’s Afraid of the Senate Parliamentarian?
Why is Ryancare so sick? In short, it’s a House bill written under Senate rules.
.. Under the Congressional Budget and Impoundment Act of 1974, the reconciliation process would allow Senate Republicans to avoid a Democratic filibuster and repeal and replace Obamacare with a simple 51-vote majority. Nonetheless, the House GOP-leadership bill excludes popular, important, conservative measures because Democrats might try to disqualify them for having a “merely incidental” budget impact.
.. Cruz added: “And even if the parliamentarian arrived upon that erroneous interpretation of the statutory language, the Budget Act of 1974 gives the authority to resolve this question to the vice president of the United States, Mike Pence.”
.. If a Trump-backed House bill guaranteed every illegal alien a free weekly visit to the doctor of his choice, Democrats would explode in rage: “Racists!” they would erupt. “Trump is Satan and the Republicans are his demons! Weekly medical visits? Why not daily? And how dare these Nazis deny undocumented employees the pleasure of house calls?”
.. If the parliamentarian agrees with the Democrats, however, Vice President Pence can ignore her advice and rule the bill in order. If so, Senate Democratic leader Chuck Schumer of New York may attempt to overturn Pence’s decision with a three-fifths majority. Schumer would need to rally all 48 Senate Democrats and twelve Republican senators to reach 60 votes.
.. Ryancare and its discontents could demolish the prospects for securing a 60-seat, filibuster-proof GOP Senate majority. Even worse, Republicans could shrink or even sink their House majority, perhaps returning Nancy Pelosi to the speaker’s chair. It is unfathomable that two months into a unified Republican government, such a nightmare scenario is being discussed. And yet it is, all because the highly intelligent, truly diligent, and dangerously cautious Paul Ryan has fallen victim to a virus that makes him think like a Senate Democrat.
Speaker Paul Ryan Loses Another Non-House Freedom Caucus Conservative in RyanCare Fight
Losing conservatives like Barletta and North Carolina’s Rep. Ted Budd mean that in addition to losing a close vote, Ryan now has to worry about losing in a landslide that would threaten his grasp on the gavel itself.
.. “Under Obamacare, a half a million people received a total of $750 million in health care subsidies, even though the recipients could not prove their lawful presence in the United States,” he said. “I cannot vote for a replacement plan that fails to address this problem.”
White House moves to tweak health care bill to win over conservatives
White House budget director Mick Mulvaney is working with Rep. Mark Meadows (R-N.C.), chairman of the hard-line conservative coalition, to strike Obamacare’s lengthy list of essential benefits that health plans now have to cover, according to a senior administration official.
Some Republicans have long argued that insurers should be able to sell skimpier coverage that, for example, wouldn’t cover maternity or mental health services.