GOP's First Step to Kill Obamacare Launches Messaging War

GOP's First Step to Kill Obamacare Launches Messaging War
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Republican senators took a significant step toward repealing the Affordable Care Act in the late hours of Wednesday night, voting to advance a budget that sets up the process to repeal the health care law. Democrats, unable to block the budget, forced votes on a series of amendments intended to squeeze Republicans on divisive health care issues.

Wednesday night’s session, which trickled into the early hours of Thursday morning, was the first in what will likely be a series of messaging battles between Democrats and Republicans over the future of health care that is sure to continue as the GOP tries to replace Obamacare and be a major factor in the 2018 midterm elections.

The process – known in the Senate as vote-a-rama – allows an unlimited number of amendments to be attached to the budget resolution, though only a fraction receive votes and they are nonbonding.

Many of the amendments were proposed by Democrats up for re-election in 2018 in purple or red states that Donald Trump won last year.

Sen. Joe Manchin, D-W.Va., for example, proposed an amendment that would ban legislation that could weaken rural hospitals and health care providers. Manchin, one of the most conservative Democrats in the Senate, said on the Senate floor, “No matter what happens with the Affordable Care Act, we’re going to make sure that we protect rural hospitals and rural clinics.” 

Others amendments came from a score of vulnerable Democrats. Sen. Debbie Stabenow of Michigan proposed amendments to block legislation that would reduce access to maternity care coverage, prevent changes to Medicare, and ensure that the public had information on how plans to reduce the Affordable Care Act would affect their insurance.

Sen. Sherrod Brown of Ohio proposed an amendment against legislation that would undermine gains in children’s health care; Sen. Tammy Baldwin of Wisconsin proposed blocking legislation that would change the provision allowing children to stay on their parents’ health care insurance until age 26 (something most Republicans agree with) or increase premiums for young Americans with private insurance.

“The people of Wisconsin didn’t send me to the Senate to take away their health care,” Baldwin told RCP before the votes. “I think this allows us to really demonstrate who’s harmed by this repeal.”

Sen. Bob Casey of Pennsylvania introduced an amendment that would prevent legislation limiting or eliminating health care for someone with a pre-existing condition or place a lifetime cap on coverage for someone with a disability or chronic condition.

Democrats weren’t alone in proposing political amendments, though most from the GOP were responses to particular Democratic proposals. Sen. Dean Heller, R-Nev., one of the few Republicans considered vulnerable in 2018, proposed an amendment highlighting the failings of Obamacare and reinforcing GOP plans to repeal and replace it.

Republicans dispatched with most of the Democrats’ amendments along party lines, showing they weren’t concerned about the messaging effort or what Democrats considered difficult votes.

Colorado Sen. Cory Gardner, chairman of Republicans’ Senate campaign committee, said he thought Democrats’ efforts – emphasizing their push to preserve the Affordable Cart Act – would backfire.

“They have no strategy, they have no message,” Gardner told RCP during the votes. “They’re flailing around and it comes down to using silly political amendments to help America remember that they support Obamacare. They are doubling down on Obamacare tonight. What you will see are red state Democrats voting for Obamacare.”

Sen. Chris Van Hollen, the Maryland freshman tapped to lead Democrats’ campaign committee, pushed back on Gardner’s argument. He said the string of amendments Wednesday night would focus public attention on Republicans’ efforts, which he asserted would “create total chaos” in the health care system.

“It’s different when Republicans are firing with real bullets when it comes to destroying the Affordable Care Act,” he said, pointing to news reports of Trump voters who hoped he wouldn’t disrupt their health care. “Well, this is to highlight the fact they’re not kidding and what the consequences will be." 

For example, Van Hollen pointed to Manchin’s rural hospital amendment, co-sponsored by Sens. Heidi Heitkamp and Jon Tester, and said it was tied to concerns he had heard from people at those hospitals about the repeal. 

“These are amendments, but they’re all attached to some reality in these states,” Van Hollen said. “… This is all the first step in letting people know that a lot of people who voted for Donald Trump will really be hurt badly by repealing the Affordable Care Act without an adequate replacement."

For Gardner’s part, he argued the GOP would put forward a replacement, and it would be incumbent on Democrats to support it. “[If] they oppose it and decide they would rather have nothing rather than a replacement, this is not going to work out well for them.” 

Democrats can do little to save Obamacare beyond rallying public sentiment since Republicans, who have long railed against and promised to repeal the law, can complete those efforts without any Democratic support. The vote-a-rama Wednesday night was an opportunity for Democrats to try to plant flags on issues that will likely be major debates during the fight over a replacement.

Republicans on Capitol Hill are plowing ahead with repeal and continue to grapple with how and when to execute a replacement. President-elect Trump said in a news conference that his administration would submit a plan shortly after his nominee to lead the Department of Health and Human Services, Rep. Tom Price, is confirmed, and that it would be “repeal and replace… essentially simultaneously.” Trump, who ran on repealing the health care law but has offered few details on replacement since winning the election, said Democrats would continue to own the issue politically.

“Obamacare is the Democrats’ problem,” Trump said. “We are going to take the problem off the shelves for them. We’re doing them a tremendous service by doing it. We could sit back and let them hang with it. We are doing the Democrats a great service.”

Senate Minority Leader Chuck Schumer, in a speech on the floor ahead of the vote-a-rama, pushed back against Trump, arguing Republicans would lose “in the court of public opinion” if they repeal the law, and that the late-night vote “is the first step on the road to repeal, which leads straight into that box canyon.”

James Arkin is a congressional reporter for RealClearPolitics. He can be reached at Follow him on Twitter @JamesArkin.

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