Conservatives in Congress are increasingly frustrated by what has been leaked about the Obamacare repeal legislation and by what they see as a lack of transparency, even as House Speaker Paul Ryan insists Republicans are all on the same page and predicts unity on a final vote.
For most congressional Republicans, what they know of the repeal is what they read in a leaked report on the purported bill last week. Sen. Rand Paul, R-Ky., made headlines by unsuccessfully trying to get a hard copy of the legislation.
Most Republicans don’t know what’s currently being put together.
“I think it’s mostly members of committees with jurisdiction. You’re talking about members on Energy & Commerce and members on Ways & Means. That’s probably as far as it goes,” said Jason Pye, director of public policy and legislative affairs at FreedomWorks, which has endorsed the replacement bill authored by Sen. Paul.
“Maybe the broader conference knows the general discussion of what’s going on,” said Pye. “The actual legislative text is what matters. That’s where the nuances come into play.”
FreedomWorks shares the frustrations of Sen. Paul and other lawmakers clamoring for details.
“I think Sen. Paul has a point that this entire process is being done largely in secret. Americans deserve to know what’s going on. Are we going to see Obamacare-lite or are we actually going to see a real patient-centered alternative,” said Pye.
What would real transparency look like?
“We should be having hearings as the bill is going through. Why not have debates on C-SPAN while it’s being discussed and being drafted?” asked Pye.
On Friday, Politico reported that GOP leaders hoped to vote on repeal later this month and they were prepared to “steamroll” conservatives into backing the plan.
“They say they have no problem steamrolling conservatives by daring them to vote against an Obamacare repeal that their constituents have demanded for years,” reported Politico.
“‘Conservatives are going to be in a box,” said one senior Republican lawmaker. Trump, the source predicted, eventually will “go out front and … tell the conservatives … they’re either for this or for keeping Obamacare,'” the report continued.
That’s a far cry from the assurance of unity Ryan offered at his weekly press conference on Thursday.
“We’re all working off the same piece of paper, the same plan. So we’re in sync – the House, the Senate, and the Trump administration – because this law is collapsing. You can’t just repeal it. You have to repeal it and replace it with a system that actually works. That’s exactly what we’re doing,” said Ryan.
“I am perfectly confident that when it’s all said and done we’re going to unify because we all, every Republican, ran on repealing and replacing and we’re going to keep our promises,” added Ryan.
Pye says FreedomWorks is just as eager to scrap Obamacare, but he says how it’s done is vital.
“The speaker said that the repeal and replacement of Obamacare is entitlement reform. That certainly should be the case but the problem is we’re repealing one entitlement and creating a new one. You don’t do that as conservatives, especially one who claims to be a fiscal conservative,” said Pye.
He says if the leaked version of the bill is accurate, there is a lot to oppose in there.
“We were surprised to see the Republican version of the individual mandate included in this bill. We were surprised to see $100 billion in new mandatory spending over the next ten years in this bill. We didn’t anticipate that. We didn’t anticipate the new Republican version of the Cadillac Tax in this bill. We weren’t old those thing,” said Pye.
In the end, will leaders twist enough conservative arms to pass the plan? Pye doesn’t think so.
“Leadership is really who’s in a box right now. If the 70 conservatives in Congress stick together, if you keep 41 of those guys and maybe a couple more, [leaders] don’t 218 votes to repeal and replace,” said Pye.
“They’re going to have to listen to conservatives in the conference. I’m sorry. That’s just the way it is. And right now, this Lee, Cruz, and Paul trifecta sticks together, [Republicans] only have 52 seats in the Senate. You’re going to get Democratic votes on either side. You have to listen to conservatives,” said Pye.
Conservatives are already explaining what they want, namely in bills offered by Sen. Paul and Rep. Mark Sanford, R-S.C.
“It puts individuals on the same playing field as employers. It gives states the option for flexibility through Medicaid, allowing them to seek waivers from the Department of Health and Human Services. It expands [Health Savings Accounts] to the point at which you can pay your health insurance premiums out of that,” said Pye
“Those are patient-center alternatives and consumer-friendly alternatives that improve the health system and truly empower Americans to make their health care choices,” said Pye.
If conservative ideas are now adopted into the replacement bill, Pye suspects Republicans may abandon the effort to pass a repeal and replacement together. He says passing a repeal similar to the one President Obama vetoed last year might be where the GOP factions find common ground.
“I know everybody wants to get this over with now and I do as well, but there is no difference, fundamentally, between what we did in 2015 and what we should be doing now, other than the disagreements over replace. If we can’t figure out replace, let’s come back another day, but let’s go ahead and start the process on repeal,” said Pye.