House Repeal Bill Critic Cotton Mum on Senate Version

House Repeal Bill Critic Cotton Mum on Senate Version
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Sen. Tom Cotton is holding his health care cards close to his chest.

After waging an aggressive and extensive public war against the House health care legislation when it was released several months ago, Cotton has kept almost entirely quiet about the Senate version, even as other senators announce their opposition and make public demands for changes that could earn their support.

Cotton hasn’t made any public comment about the measure since it was released last Thursday -- the press release on his Senate website the day GOP leaders unveiled the bill is one sentence linking readers to the legislative text. Normally one of the more visible GOP senators when it comes to cable TV appearances, Cotton hasn’t conducted any interviews since the Senate health care bill was unveiled.

Cotton also didn’t release a statement on the Congressional Budget Office score of the legislation Monday, and his spokeswoman declined an interview request from RealClearPolitics, citing obligations on the Armed Services Committee, which is holding multiple mark-ups of key legislation this week. The spokeswoman said Cotton is still reviewing the health care bill.

In most public whip counts on the GOP legislation, Cotton stands as undecided or uncertain. That’s in stark contrast to some of his counterparts. Four conservative senators came out against the bill -- as written -- the day it was released, and Dean Heller of Nevada announced his opposition to the draft legislation a day later. On Monday, a handful of Republicans said they would vote against allowing debate on the legislation without significant changes, which would effectively kill the measure before a vote could even be taken.

Several GOP aides expressed some surprise when asked about Cotton’s silence, though most declined to speculate on his thinking or position. One aide said the Arkansas lawmaker hadn’t necessarily been on the radar in terms of pushing for changes to secure his vote.

But Cotton was among several senators invited to dinner with Vice President Mike Pence Tuesday evening to discuss health care, Politico reported, a signal that it may take more work  to secure his vote. (Cotton’s spokeswoman didn’t confirm whether he would attend the dinner.)

The complete radio silence from the lawmaker stands in stark contrast to his response when the House released its version of the Obamacare replacement in March. The same week House Republicans unveiled their bill, Cotton went on ABC News’ Sunday program to warn that it wouldn’t pass the Senate, and could have “adverse consequences for millions of Americans.” He said his House colleagues -- many of whom he served with before joining the Senate in 2014 -- shouldn’t “walk the plank” for a bill that would fail the Senate.

Two days later, he appeared on Hugh Hewitt’s radio show and criticized both the substance of the measure -- he said it didn’t do enough to decrease premiums -- and the process, indirectly chiding Speaker Paul Ryan for trying to bring up health care bills separate from the repeal measure, which Cotton called “mythical.” Ryan later shot back at senators critical of the House product.

Later that week, however, Cotton again criticized House Republicans for rushing their legislation.

“To release a bill that was written in secret and then expect to pass it in 18 days I just don’t think was feasible,” he said on CBS’ “Face the Nation” in late March.

The Senate version, by contrast, was released Thursday after several weeks of negotiating in private, and a vote is expected by the end of this week. While other Republican senators have publicly criticized that quick turnaround, Cotton hasn’t weighed in on his conference leadership or the process, despite the legislation moving even faster than the House version did.

Cotton is also caught in the cross hairs of many  constituents in Arkansas. Donald Trump, who repeatedly promised to repeal and replace Obamacare, earned more than 60 percent support last year in the conservative state. Like all Republicans, Cotton won election to the Senate partially by running against President Obama’s signature health care law. One poll in April of 2014 showed that just 29 percent of Arkansans approved of Obamacare, while 62 percent disapproved.

But the state has also benefited from the Affordable Care Act, with more than 330,000 people there signing up for coverage under Medicaid expansion since 2013, and the uninsured rate in the state dropping by more than half -- from 22.5 percent in 2013 to 10.2 percent in 2016, according to Gallup.

A small group of Arkansans rallied against the health care bill last week, and another group orchestrated a sit-in in Cotton’s Little Rock office on Friday to protest the bill. But despite pressure in the form of a massive and angry town-hall crowd earlier this year, far before the Senate bill was released, Cotton didn’t walk away from his support of repealing and replacing the Affordable Care Act, the Washington Post reported at the time.

“Cotton is one of the savviest players in town, and he also has a very conservative constituency that relies on Medicaid,” said one GOP strategist who requested anonymity to discuss health care deliberations. “He’s in sort of a unique situation and I think that he is playing it exactly right. I also think that if he gets to yes, that’s the best possible outcome for him.”

Negotiations on the legislation are likely to continue this week as Majority Leader Mitch McConnell seeks to patch together 50 Republican votes to pass the measure, which would require Pence to cast the tie-breaker. While the bill is still likely to change substantially, Cotton has not said what modifications he would like to see to support it. But Josh Holmes, a former chief of staff to McConnell, said he expected that if Cotton had concerns about the legislation, he would be taken very seriously by leaders.

“As a general rule, you get a heck of a lot more done behind the scenes then you do out front, and part of that is the expectations that you build for yourself when you put yourself out as a key vote on something,” Holmes said. “I don’t think somebody has got to go out and light their hair on fire to be effective.”

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

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