Today is the biggest day for congressional Republicans in years: this afternoon, the House of Representatives is expected to vote on the American Health Care Act, their chance — seven years in the making — to repeal the Affordable Care Act and replace it with a law of their own.
Republicans have run — and won — on this promise every election cycle since 2010. Now, with unified control of government in D.C., they have their chance to make good on it.
But their bill is on life-support as it hurtles toward a monumental vote on the House floor, and it’s not because of Democrats: for a hard-line faction in the House GOP, the bill is too moderate, “Obamacare Lite” in sheep’s clothing. For a group of Republican moderates, the bill is too conservative for them to support.
That’s produced a real rarity on Capitol Hill: utter ambiguity as to whether a bill that comes to the floor will pass — much less a bill with the potential to define this Congress, and the Republicans who serve in it. It’s possible the AHCA could pass, but it seems likely it could fail, and there’s even a chance it could be pulled before it even reaches the floor, forcing the GOP back to the drawing board. [Update: GOP leadership, spurred on by President Trump, pulled the bill on Friday afternoon as it became clear there was not enough support. In a press conference, Speaker Ryan did not say there were plans to revive the bill in the near future.]
But there’s no uncertainty among Minnesota’s three Republican House members: all are expected to vote yes on the AHCA. Whatever happens, the GOP reform effort could significantly impact the political fortunes of each of them.
Leadership’s man
The man with the most to lose today is 3rd District Rep. Erik Paulsen. The Eden Prairie Republican is on the Ways and Means Committee, the tax-writing committee with a lot of sway on health policy, and he has talked for years about getting rid of Obamacare, on the stump and in the capitol.
What’s more, Paulsen is a strong backer and a friend of Speaker Paul Ryan. The former Ways and Means chairman is looking like he’s betting it all on the AHCA, and he’s counting on good soldiers like Paulsen to go to bat for him. Paulsen has spent the week tweeting cheery talking points about the bill from his official account — one of which got over 500 overwhelmingly critical replies.
Paulsen voted for the AHCA in Ways and Means earlier this month. Because of that, he’s already tied to it, even if it falls on the House floor today.
If it passes, Paulsen will have to answer for it back home, which could be trouble. Hillary Clinton won the 3rd District by ten points in 2016. Paulsen won big in his own race, but if public opinion turns against the AHCA — it’s already polling at an abysmal 17 percent nationally, per Quinnipiac — that could spell big trouble for him in the 2018 midterm.
A model produced by FiveThirtyEight, Nate Silver’s political data journalism outlet, estimates that just 10 percent of people in CD3 strongly support the AHCA, while 41 percent of people strongly oppose.
Lewis: failure to pass is ‘dereliction of duty’
Today is the most important day in Rep. Jason Lewis’ young political career so far. It could end up being the most important one, period.
The former talk radio jock from Woodbury pulled off an unlikely win against Angie Craig in 2016 on a platform centered around repealing and replacing Obamacare.
Lewis serves on the House Budget Committee, where he voted to advance a version of the AHCA, so like Paulsen, he’s already tied to this bill in a lasting sense.
Since then, Lewis has been whipping fellow GOP freshmen to vote in favor of the bill. MinnPost caught up with Lewis on Friday, where he said that not passing the AHCA would be a “dereliction of duty.”
“This is what I came here to do, and I’m going to do it,” Lewis said. He expressed disappointment with his Republican colleagues to his right and left who aren’t backing the bill. “This is almost a quintessential case of letting the perfect become the enemy of the good, I would argue very good,” he said.
If the AHCA passes and becomes more unpopular, Lewis has a similar problem as Paulsen: though CD2 narrowly went for Donald Trump, the FiveThirtyEight model places opposition to the AHCA at a similarly strong level as CD3.
Paulsen and Lewis have both gambled — big — that backing the AHCA will play well in their districts, making it worth the risk. But given their loyalties, committee posts, and campaign promises, they were under pressure to support it to begin with.
If the AHCA doesn’t pass, Paulsen and Lewis will have to explain to constituents why they couldn’t make good on promises to reform health care. If it does pass, their fortunes hinge on how well those constituents receive the law.
Emmer, team player
Rep. Tom Emmer has the least to lose, in any event. Emmer has grown into a consummate team player in D.C., and reliably votes with GOP leadership, which he is close to as a member of the influential Steering Committee. Donald Trump’s White House has also enthusiastically backed the AHCA — the president is basically daring the House to not pass the bill — and Emmer is the most vocal Minnesotan Trump supporter in D.C., so his support of the health care bill makes perfect sense.
Like Lewis, Emmer has been wheedling members and whipping votes for AHCA. Friday morning on the House floor, Emmer had an animated conversation with Idaho Rep. Raul Labrador, a member of the House Freedom Caucus, the deeply conservative bloc opposing the bill.
Unlike Paulsen and Lewis, Emmer doesn’t have a competitive seat. Whatever happens, he likely won’t have to answer for it in November. But if it does pass, GOP leadership — and by extension, Emmer — will look good, at least in the short term.
The big caveat here is that other branch of Congress, the U.S. Senate, where the AHCA in its present form is all but dead on arrival. GOP senators, from moderates like Maine Sen. Susan Collins to conservatives like Kentucky Sen. Rand Paul, have said they don’t support it, and there are enough in opposition to ensure the AHCA would be toast.
House GOP leadership, though, just wants to get the thing out of their chamber, and worry about reconciling House and Senate differences later — even if the Senate’s changes would make the bill even more unpalatable to House conservatives. They may not get that far.
Correction: This article previously misstated which presidential candidate won the 2nd Congressional District.
I actually find it a good thing that the
GOP is fighting over this bill to get it right. I personally would like to see the ACA repealed and replaced but if individual members don’t believe in the new legislation don’t vote for it. Obamacare came about because the Dems either blindly followed their leadership (I didn’t see 1 Democrat admit to reading the whole bill before voting) or they horse traded their vote, Cornhusker kickback and Louisiana Purchase either way the disaster that is Obamacare was voted in.
Let the Death Spiral continue on ACA and make the Dems bring solutions to the table. Let’s see if increasing the Individual Mandate to thousands of dollars sits well with Americans. As I’ve always said about Govt give aways, the folks getting it for free are happy, the folks paying double to pay for the “free” are not too happy. I have not heard any Dems coming up with solutions to fix ACA so if the GOP can’t repeal & replace it, let the Dems fix their mess.
Republicans ran on the promise to “fix it” if given power. They got it and don’t know what to do. Now you tell us that it’s the Democrats responsibility to fix it.
There have been Democratic proposals to modify and fix aspects of the ACA. But they did not get any traction with Republicans because they were so focused on repeal. And the Republicans controlled the committees.
As to reading the bill and the legislative process, there were 79 hearings in the House regarding the ACA before passage. For the Republican AHCA, there were 0. The AHCA was voted out of committee without even seeing the CBO assessment.
What Table?
Just what table should Dems bring solutions to? Trump & Ryan did not seek any Democratic input for TrumpCare. Nor were they interested in any. Just seeking Democratic support would have been seen as treasonous by Breitbart, et al.
By way of contrast, Obama bent over backwards to get some, any, GOP support for the ACA. In fact, he compromised right out of the box, pushing a Heritage Foundation plan. And how many GOP votes did that get him?
The GOP had nine years to get this right, and they have completely failed to close the deal. Sad!
If you are expecting an effective solution out of the Republican “repeal and replace”, you weren’t really paying attention to what was proposed. The proposal was “do less” battling with “do even less”. As health care costs will continue to rise, and the various insurance markets are crippled by Republican measures, the current state of affairs will be owned by the Republicans who, like all political parties, campaigned on making people’s lives better. Standing by, watching things fail, is never a winning strategy.
Seriously?
..and who is in charge? Who ran on not only Repeal, but Replace? Who knew it was so complicated (Nobody- according to the republican President), Did I mention Who is in charge? House? Senate? President?
The party of obstruction now has to govern. Massive fail on their first test!
24 million
Emmer, Lewis and Paulsen need to explain why they wanted to take insurance away from 24 million Americans in order to fund tax cuts for their wealthy donors. It’s as simple as that.
It appears that the ultra-right-wing Republicans in the so-called Freedom Caucus were able to show Donald Trump that you can’t govern with sound-bite slogans that have no policy details attached to them and that maybe you need to include some Democrats as you develop legislation.. Famous for not having the patience or the interest to develop nuanced policy positions, Trump is now washing his hands of health care. He doesn’t even want o consider tweaking the ACA, which is the way to improve it and help the people get health care.
That
Trump/Ryan failure is probably good for tens of millions of Americans who came late to the realization that “repeal and replace” would be devastating to their personal health care situation. They finally came to the realization of what Obamacare had been doing to improve their lives, save their lives. And they wanted to keep it. The overwhelming majority of Americans favor keeping Obamacare now, and now they know something about it beyond the dumb Republican attack line about not being able to keep your doctor.. Some good came from this struggle: Education of the public about what insurance is, how it works, how the federal government protects them with programs like Obamacare.
It’ll be interesting to see with whom, exactly, Trump now decides to “negotiate” on his signature sound-bite promises and whether that includes the Democrats with whom he and the majority of the American public actually share goals.
Explosion
President Trump now believes that health care policy in America now should be allowed to “explode”. I really would like to know if Minnesota’s congress people agree with him.
–Hiram