Mitch McConnell has sidestepped the Russia controversy that’s dogged Donald Trump all year and eluded the wrath rained down on Paul Ryan over the GOP’s Obamacare repeal effort.
But the health care reform battle is now squarely in McConnell’s court: He will decide the contents of the Senate’s plan, most likely behind closed doors. And he is on the hook for getting something through a sharply divided Senate Republican Conference in the midst of an increasingly imperiled presidency.
McConnell’s role will come into sharp relief this week, with Trump out of the country and the Russia spotlight shifting somewhat away from Congress after the naming of a special prosecutor. The Congressional Budget Office on Wednesday will deliver a highly anticipated report on the House health care bill that is expected to show it would cause huge coverage losses. That will provide a new round of ammunition to Obamacare supporters, even as it allows the Senate to truly start writing its own plan.
So far, McConnell has led a series of closed-door meetings with senators, where they’ve mainly aired their grievances with the House bill without making substantive progress, according to attendees. In the coming days, McConnell will have to move to break the impasse.
“He’ll have to make some decisions. I’m sure it will be with the recommendation and input from our members, but there will come a point in which we’ve talked some of this stuff to death,” said Sen. John Thune (R-S.D.), a close McConnell lieutenant. “He’s made it very clear, at the end of this we’re going to have to vote.”
McConnell (R-Ky.) is handling the situation so far in his typically cautious manner, feeling out his conference but offering no positions of his own. A 13-person working group he appointed has swelled at times to more than 20 Republicans so that each member can feel his or her voice is getting heard and is a part of the process; McConnell also has made health care the topic of each of his conference’s thrice-weekly lunches.
The GOP leader is treating the frequent gatherings on health care like a focus group that will inform what he and Sens. Lamar Alexander of Tennessee, Orrin Hatch of Utah and Budget Committee Chairman Mike Enzi of Wyoming will write when they put pen to paper.
“Mitch right now is listening very carefully. He’s being very careful not to weigh in, thinking that this needs to come from the membership,” said a GOP senator. “He’s not trying to force a particular point of view.”
McConnell’s strategy is to keep the debate within his conference for as long as possible. There will be no public hearings as a bill is drafted, according to several Republican senators and aides, and he’s imploring senators not to leak.
In the House, Republican leaders were accused of ignoring input from many members on the front end, which engendered resentment and opposition once the proposal was unveiled. McConnell knows a take-it-or-leave-it approach — House leaders were ultimately forced to accommodate a series of last-minute changes — wouldn’t fly in the Senate.
“We’re not subject to cajolery very much. So people are going to genuinely feel comfortable, not just that we’re doing something that the president wants,” said Sen. Roger Wicker (R-Miss.). McConnell will focus “in the field of persuasion rather than coercion. His job is to bring us to a comfort level.”
Only the faintest outline of a plan is taking shape: Senators are working to make the House bill’s tax credits more generous and to find a way to wind down Obamacare’s Medicaid expansion more slowly, all within the limits of what’s allowed under the majority-vote budget reconciliation procedure. The Senate is expected to repeal many Obamacare regulations but not go as far as the House did in rolling back protections for people with preexisting conditions.
A vote on a final bill could occur as soon as June but no later than July, said Senate Majority Whip John Cornyn of Texas. Still, some doubt that aggressive timeline.
“We’re not there yet,” said Sen. Lindsey Graham (R-S.C.). “As a matter of fact, we’re a long ways from there.”
Sen. Lisa Murkowski (R-Alaska), a key moderate vote in the health care debate and a critic of the House bill, said senators are “all analyzing lots of different options” in the working group and other informal groups — such as a collection of lawmakers from states that expanded Medicaid — but at this point, “people are in different places.”
It will be up to McConnell to write the legislation that bridges those gaps.
In the end, said Sen. Shelley Moore Capito (R-W.Va.), the bill “probably comes out of the leadership office for us to react to.”
The idea, according to several lawmakers, is that if the relatively ideologically diverse working group can agree to get behind a bill, that would get the GOP close to 50 votes. From there, McConnell would have to wrangle the last several votes.
“It’s pretty easy to put together 46 or 47,” said Sen. Roy Blunt (R-Mo.). “It’s getting to 50 that’s a challenge.”
Some Republican senators were privately hoping it would never reach this point. They would have preferred that the House bill fail, to spare them having to take up a measure they believe would cause too many people to lose insurance and do too little to lower premiums.
McConnell wants to have a vote on an Obamacare repeal bill, whether it passes or not, so the Senate can move on to tax reform and spending bills.
“We’re on a track to write a bill and vote on it,” Alexander said. Whether it will be successful, “I can’t say,” he added.
The CBO score will bring some much-needed focus. The Senate will have to find as much in savings as the House bill did, or more, setting the parameters for lawmakers but also constricting their choices.
Also this week, the Trump administration and the House have to provide the courts with an update on a lawsuit involving funding for Obamacare cost-sharing subsidies. Many Republican senators want the payments — which the House argued in a 2014 lawsuit were being made illegally — to continue so that insurance markets don’t collapse before the repeal bill can move forward.
Trump has told aides he wants to halt the funding, but a final decision hasn’t been made.
Once the CBO score and lawsuit are clarified, McConnell, his staff and key committee leaders will try to strike as soon as they have an idea what can pass. In the minds of Republican leaders, the time is drawing near.
“We’ve been talking about this for seven years … everybody’s got a good idea, and that’s wonderful, and it helps us come up with a better product,” Cornyn said. “But at some point you’ve got to fall behind one bill instead of saying, ‘Well, I have a better idea.’”