McConnell In Difficult Spot With Latest Health Care Push

Senate majority leader tasked with shepherding bill he had no role in writing

Senate Majority Leader Mitch McConnell is in an unfamiliar position of pushing a health care repeal bill that he had little role in crafting. (Tom Williams/CQ Roll Call)

Senate Majority Leader Mitch McConnell is counting on an 11th-hour attempt to repeal the 2010 health care law and change directions on a disappointing year for Republicans.

Having put health care on the back burner after lacking the votes this summer, McConnell has thrown his weight behind a proposal from GOP Sens. Bill Cassidy of Louisiana, Lindsey Graham of South Carolina, Ron Johnson of Wisconsin and Dean Heller of Nevada.

While no vote has been scheduled, it has reignited discussions in the chamber on the GOP’s seven-year campaign to gut the law. And the legislation puts McConnell in a difficult spot.

Now that he has endorsed it, the Kentucky Republican is invested in a proposal that, if successful, would exist primarily because of work outside his leadership team.

“We kept working on it, so now we have this possibility,” Johnson said Monday.

Republican members are quick to cite the efforts of Graham and Cassidy, in particular, to get the legislation this far, and there is little talk about the influence of GOP leadership in the chamber.

“They’ve been having thoughtful engagement with the senators and governors,” Montana Sen. Steve Daines said of the bill sponsors.

Heller said momentum should build behind the proposal because it is what Republicans promised, to begin with.

“This is the bill that should have come forward first. This is our third bill. The first one was repeal without replacement. The second one was replacement without repeal,” the Nevada Republican said. “Finally, we have a bill that repeals and replaces.”

Heller said conversations with Nevada Gov. Brian Sandoval about the bill have been “a work in progress,” and he had a call into the governor’s office Monday.

But if this measure fails, it would be yet another defeat akin to the previous failure, after which McConnell essentially conceded the repeal effort was dead. That spurred attacks from President Donald Trump and condemnation from conservatives.

Many Republican members, however, declined to put any blame on leadership turning away from health care.

“I’m not interested in what happened before. I’m interested in what happens now,” Sen. John Kennedy of Louisiana said.

In hindsight, however, some Republicans would have preferred a different course than the route McConnell chose.

“Here we are at the end of September. What’d we say when we were looking for everybody to stay here in August? We said we need to stay here in August … and leadership agreed with us and then a deal [was] struck to get more confirmations and we didn’t stay here,” Georgia Sen. David Perdue said.

Further putting McConnell in a tight spot is the fact that the Congressional Budget Office will not be able to provide a full analysis of the measure’s effect on the deficit, health insurance coverage or on premiums before Sept. 30. That represents the deadline for the GOP to advance the bill through the budget reconciliation process, which enables the party to pass it with a simple majority. 

The CBO said Monday it would aim to offer a preliminary analysis of the proposal by early next week.

Unfamiliar position

The current health care debate is the latest in a string of vulnerable positions that McConnell, renowned for avoiding such situations, has found himself in.

In the past several weeks, Trump has sidelined the majority leader on major deals, choosing instead to align with Senate Minority Leader Charles E. Schumer.

McConnell is also facing a potentially devastating loss in the upcoming Alabama primary runoff for former Sen. Jeff Sessions’ seat. Polls have shown appointed Sen. Luther Strange trailing former Alabama Supreme Court Chief Justice Roy Moore. McConnell has invested significantly in the race, backing Strange over Moore, who, as a candidate, has refused to back McConnell and has called for his ouster as Senate majority leader.

And it’s been an otherwise lackluster year for the Senate. The sole victories for Republicans have been the appointment of Justice Neil Gorsuch to the Supreme Court — a significant win that McConnell had to alter chamber rules to achieve — and the rollback of several Obama-era policies.

And with details of an in-development tax overhaul effort still private, the majority leader appears to be angling for a long-shot win on health care on a bill he had no hand in writing or advancing thus far.

Instead of leading the conference on the effort as he is accustomed to, McConnell is now acting as a shepherd for the legislation from Cassidy, Graham, Heller and Johnson, none of whom are in leadership or chair committees with substantial jurisdiction over health care.

McConnell is jumping in at the last minute to try to wrangle the remaining votes needed and prodding the CBO into accelerating its review of the proposal.

“The leader asked CBO to prioritize the score on the legislation. We expect regular staff briefings and member discussions to continue,” McConnell spokesman David Popp said in an email.

It is a far cry from the private deal-making that characterized prior Republican attempts to overhaul the law, with lawmakers shuffling in and out of the majority leader’s office.

And aside from a decidedly come-from-behind victory to achieve a long-sought goal of repealing the health care law, it’s a potential no-win situation for McConnell.

If the effort is successful, praise will lay with Graham and Cassidy.

But if Republicans are unable to garner the votes necessary to pass the bill, the failure will bring to the forefront, yet again, the GOP’s inability to fulfill a promise that has dominated the party’s messaging since 2010.

It could spur again questions about McConnell’s leadership abilities and will almost certainly put pressure on the GOP to succeed on the tax effort.

Niels Lesniewski contributed to this report.

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