Two Republican Senators have started what may be the beginnings of a civil war within the Republican party over the struggle to repeal Obamacare.
After the Republican-led House of Representatives barely managed to pass their American Health Care Act (aka “Trumpcare”) to replace Obamacare, the action has switched over to the Senate. For the bill to become law, both houses of Congress need to pass the same legislation.
Given the rejection of the first version of Trumpcare, and the fact that the revised version of the bill was rushed through the House without an analysis by the non-partisan Congressional Budget Office, the more deliberative Senate decided to take a different approach to health care reform, despite President Trump’s and their House colleagues’ premature victory dance.
Progressives were cautiously optimistic when it was announced that the Senate would draft their own version of health care legislation from scratch rather than use the House bill as the foundation. The possibility that the Senate could come up with a bill that would eliminate the worst failings of the AHCA in regards to its refusal to protect people with pre-existing conditions and causing people to lose affordable coverage remains a desperate hope for the Democrats.
That hope was severely diminished when Republican leadership in the Senate announced a thirteen-man commission to draft the legislation, a commission that is comprised of literally thirteen white men with no participation by women or minorities.
While the commission does have a few members who are not on the farthest right-wing fringes of the Republican Party, fears that the group will not be responsive to the health care needs of more than half of the population have inspired a rival group of moderate Republicans to create their own working group to draft health care policy.
The group is led by Senator Susan Collins (R-ME), who is a former state insurance commissioner, and by Senator Bill Cassidy (R-LA), who is a doctor and a former Democrat. Both Senators have attacked the House-passed legislation as inadequate and have been meeting twice a week to come up with their own alternative.
While the bill that finally reaches the Senate floor will certainly be whatever the official health care group approves, the Republicans’ thin majority means that it is unlikely to pass if two Republican Senators oppose it and Democrats remain united in their opposition to repealing Obamacare. This gives Senators Collins and Cassidy considerable leverage with their colleagues on the official committee over the contents of the final bill.
Senator Collins has been vocal in her opposition to defunding Planned Parenthood, and Senator Cassidy has said that any health care bill would need to pass the “Jimmy Kimmel test” to make certain that any child born with health issues would get the care that they need.
The approach that the two rogue Republicans want to take differs greatly from the main committee, who are only concerned with reducing the costs of Medicaid to fund tax cuts for the rich. In contrast, Collins and Cassidy’s plan would keep the taxes from the Obamacare program funding Medicaid, but allow states to opt-out of Obamacare and design their own health care systems while receiving the same amount of federal funding.
Meanwhile, with Trump too busy with fending off the investigation of his collusion with Russia to learn the intricacies of health policy, the Senate Republicans shouldn’t expect any Presidential leadership to help them bridge their internal divisions.
It may be the start of a civil war over health care in the Republican party, but at least for now it means that Obamacare will remain intact until they overcome their differences.
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