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Is Reconciliation a Real Challenge to Obamacare?

Jordan doesn't think it's a problem that Obama would veto the reconciliation effort. (Bill Clark/CQ Roll Call File Photo)

   

Even if some Republicans don't really want to go there, even if it's an exercise in futility, many are convinced the guaranteed-to-be-vetoed process of budget reconciliation promises to put Obamacare at the center of the 2016 debate.  

And that, conservatives say, is exactly where they want it. Reconciliation is the optional legislative process by which Congress may seek to implement fiscal savings by "reconciling" tax and entitlement statutes with a budget resolution. It's a two-step process. The first step is to pass a budget resolution both chambers agree on (which is not subject to a presidential signature or veto.) The second step is to then pass a reconciliation bill that finds savings within the budget resolution's structure.  

Budget rules allow a reconciliation bill to avoid a Senate filibuster, so it is frequently used to pass policies that wouldn't survive that chamber's typical procedural hurdles. Its more recent use was to pass Obamacare and, before that, President George W. Bush's tax cuts. It is still subject to presidential signature or veto.  

If Obama vetoed a reconciliation bill that dismantles key elements of his signature health care law, proponents argue it would make it clear to 2016 voters that the only element missing from a successful repeal is a Republican president.  

Repealing all of the health care law through reconciliation is impossible. Reconciliation must be used to effect savings through changing taxes, spending or entitlements. Outside that purview puts it under the normal Senate procedural process.  

But staying within reconciliation's strictures might be difficult, given GOP leadership's penchant for avoiding Obamacare votes that could be tough for vulnerable Republicans. That doesn't mean it can't  or won't  be done. There is a way congressional Republicans could, theoretically, alter the Affordable Care Act so severely it requires replacement, budget gurus say.  

G. William Hoagland, a senior vice president at the Bipartisan Policy Center and a former GOP staff director of the Senate Budget Committee for more than two decades, told CQ Roll Call it wouldn't take much.  

"Shoot it full of holes so much that it dies," Hoagland said. "You don't have to kill it outright, but you put in on the recovery table and it doesn't recover."  

Hoagland cited two potential health care law changes that, according to the Congressional Budget Office, could each deliver roughly $1 trillion in savings over the next 10 years: the elimination of state subsidies and the halting of a Medicaid expansion.  

Politically, "Let's cut Medicaid by nearly $1 trillion" isn't as great an applause line as the "Let's repeal every last word of Obamacare" rallying cry Sen. Ted Cruz, R-Texas, has taken to using on the stump.  

But Republicans have already included instructions in their budget resolutions to report back savings. And, after there's a conference with the House and Senate, Republicans could come back with a proposal to eliminate those state subsidies — especially if the pending Supreme Court case King v. Burwell doesn't go their way.  

At this point, all of these potential actions are messaging. No one thinks President Barack Obama would actually sign a reconciliation bill dismantling a key component of Obamacare. It's essentially a joke in some GOP circles.  

"Oh yeah, we got to get it on his desk so he will veto it, and then he'll be stuck owning Obamacare, because nobody associates Obama with Obamacare yet," Rep. Thomas Massie told CQ Roll Call.  

The Kentucky Republican doesn't buy the argument Republicans ought to vote for the budget resolution to move along the process of reconciliation. "The last time I checked, his name is already on it," he said.  

Rep. Justin Amash, R-Mich., sees the budget vote similarly. "I think it's another promise to lure people into voting for something that is not that great," he said.  

When CQ Roll Call asked freshman Republican Rod Blum of Iowa if he bought the argument that Republicans could tackle the health care law through reconciliation, he made it clear that just because he's new, he's not naive. He rephrased the matter as a question of whether Obama would sign such a measure. To which the answer, according to Blum, is "not a prayer."  

So why do you keep hearing leadership dangle this carrot that they could actually use reconciliation?  

"I ask that myself," Blum said. "What's the point? He's going to obviously not sign it. So are we making a statement that we're against Obamacare? I think America knows that. I mean, I ran on that in my district."  

But there are conservatives who see a point. Arizona Republican Matt Salmon told CQ Roll Call that one of the key reasons he supported the budget resolution that passed the House last month was to get it to reconciliation.  

And House Freedom Caucus Chairman Jim Jordan, who worked with leadership to devise the procedural plan that eventually got that House budget over the finish line, made it sound as if the prospect of reconciliation was a crucial reason.  

Jordan said there were a lot of things conservatives could agree with in the House GOP budget, but the first thing he mentioned was "reconciliation on Obamacare, showing the American people we are committed to end[ing] this thing."  

Jordan didn't think it was a problem that Obama would just veto such a measure. "Keeps it focused, part of the 2016 presidential framework," the Ohio Republican said.  

And Jordan argued that Republicans had a responsibility to put it out there, to show Americans they are committed to repealing 2010 health care law.  

"And then when we get a new president, President Mr. Republican or Mrs. Republican, then we get rid of it," Jordan said. "That's how American politics works. So heck yeah I'm for that! I think that's a huge part of this."  

But all the reconciliation chatter assumes Republicans can get such a bill to the president's desk.  

For years, Republicans have talked about an Obamacare replacement bill that has never materialized. It's more difficult, politically, to own specific health care proposals than it is to just vote on repealing unpopular parts of the law. Why put vulnerable GOP senators and representatives in a tough position to vote on another messaging bill that will just get vetoed? Is it really possible to get a bill striking major provisions to the president's desk?  

"I think it's not only possible, it's what we told the voters we were all about," Jordan said. "It's why the Democrats have lost the House and lost the Senate in the last four years. So heck yeah it's important!"  

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