The Republican Party's rising Senate prospects are forcing House Republicans to craft a health care agenda that could function as a feasible legislative blueprint for overhauling Obamacare in January 2015.
The Republican-controlled House has approved legislation to repeal the Affordable Care Act and reform aspects of the law several times, only to see the bills die in a Democratic-led Senate that is committed to preserving the law. That dynamic would change if Republicans win six Democratic-held seats and assume control of the Senate in November, as appears increasingly possible.
With authority over both chambers of Congress, Republicans would be empowered to pass legislation that would repeal Obamacare and replace it with conservative health care policy. President Obama would veto the legislation, but Republicans could respond with targeted bills to reform provisions of the health care law that they find particularly onerous. This is the sort of clash House Republicans have been itching for since winning control of the House in 2010.
House Republicans are drafting a comprehensive Obamacare alternative. The agenda is still under construction, but the plan could include proposals to reduce fraudulent malpractice lawsuits, allow consumers to purchase insurance across state lines and encourage small businesses to pool resources and lower the cost of insurance they offer to their employees. Like Obamacare, Republicans vow that their plan would prevent insurers from denying coverage based on a pre-existing medical condition.
The leadership hopes to pass legislation this year, but at least wants to produce a set of health care principles that its members can run on in the midterm campaign. The latter outcome appears to be the more likely conclusion given the challenges of producing a plan that rallies a broad majority of House Republicans without undermining their criticism of Obamacare.
Now, with more Senate races becoming competitive, Republican House members and strategists say it’s imperative that the developing agenda accomplish two goals: prepare voters, grassroots activists and members for the course a GOP Congress would chart on health care, and serve as an outline for legislation so that the party could hit the ground running in January if it controls Congress.
Rep. Phil Roe, R-Tenn., a physician who co-authored an Obamacare alternative that has been embraced by the conservative Republican Study Committee, said Republicans will find it difficult to reach a consensus on health care legislation in 2015 if they don't initiate an internal debate and settle on policy parameters before the November elections. “I think the leg work has to be done this year,” he said.
The rosiest projections for the GOP show that as many as a dozen seats could be in play on Nov. 4. But even under that scenario the party still would be short of a filibuster-proof 60-seat majority. Most Senate legislation requires 60 votes to proceed, and Democrats voting as a bloc could stymie the conservative agenda of a united Republican Congress.
But that would not affect the expected GOP effort. Only Obama’s veto pen could blunt such legislation.
Democrats muscled Obamacare through the Senate in 2010 using “reconciliation,” a parliamentary tool intended for use with budget legislation that keeps opponents from filibustering. Republicans protested at the time, saying the health care bill constituted broader policy and did not qualify for reconciliation. The Democratic majority overruled them. With the precedent established, Republicans intend to use reconciliation to repeal Obamacare and push through their alternative.
“House and Senate Republicans would focus on [legislation] that creates reconciliation vehicles — probably multiple reconciliation vehicles,” a veteran GOP lobbyist said.
In the House, Majority Leader Eric Cantor, R-Va., is leading the effort to write his caucus' Obamacare alternative, which is a part of his larger effort to build a governing agenda for his members to campaign on that falls under the theme “an America that works for you.”
The possibility that the Republicans might flip the Senate is influencing House GOP leaders’ decisions as they plot health care strategy for the 2014 campaign and 2015 congressional session, according to GOP members and other Republican sources. A major goal is to place the various current Republican proposals under one health care umbrella, while ensuring that this year’s campaign rhetoric matches next year’s legislative agenda.
In particular, House Republican leaders believe their caucus must have a plan for how to respond after Obama inevitably vetoes a bill that would fully repeal and replace the Affordable Care Act. They anticipate that Americans will demand that something be done to fix a law that voters have never embraced. Following through on these targeted reforms would require negotiations with the White House.
One House Republican, who requested anonymity to be candid, told the Washington Examiner that GOP leaders are trying to anticipate the political and legislative terrain so that the caucus is ready to act in January. But the member cautioned that preparing the rank and file and getting them to unite behind a specific strategy is going to require a considerable amount of education. “They’re two seasons behind,” the Republican said.
Senate Republicans are wary of exhibiting overconfidence about the elections.
But if their prospects are still bright heading into the fall, they could begin to work with House Republicans on plans for a joint health care agenda. Congressional staff might be enlisted to sketch out legislation and preparations made to hold committee hearings in January as a prelude to floor votes. The bulk of the prep work probably would occur after the November election.
“It’s much easier to achieve that and to do it with a policy that’s right and that works if in fact we’re in control of both bodies,” said Sen. Richard Burr, R-N.C.