- Chip Somodevilla/Getty Images
The release Thursday of a draft of the Senate Republican leadership’s healthcare legislation has set off a scramble to secure enough commitments for a vote that Majority Leader Mitch McConnell wants to hold next week.
Democrats blasted the bill, which was drafted in secret, while most Republicans took a more measured approach and left their intentions unknown, with many moderate members saying they were taking time to read the bill and analyze its impact.
Four GOP senators, however – Rand Paul, Ted Cruz, Mike Lee, and Ron Johnson – quickly announced they would not support the bill in its announced form, though they all remained open to negotiation.
The uncertainty and outright opposition put the bill short of the 50 votes needed to pass – only two Republicans can defect, since Democrats plan to universally oppose it. That puts the Better Care Reconciliation Act of 2017 in a dicey position from the start.
Greg Valliere, the chief strategist and a longtime political analyst at Horizon Investments, said in a note to clients Friday that the conservative members besides Paul were likely to relent since failure to pass the bill “would mean Obamacare wins.”
But in addition to Paul, Valliere identified another likely “no” vote from the GOP in Sen. Dean Heller, who is facing an uphill battle for reelection in 2018 in Nevada, which is trending Democratic.
If Paul and Heller were to vote against the bill, the decisive vote would most likely come from a moderate like Sen. Susan Collins of Maine or Sen. Lisa Murkowski of Alaska.
“Susan Collins’s popularity in Maine would surge if she votes no, and Lisa Murkowski in Alaska is on the fence,” Valliere wrote. “Throw in a handful of other shaky moderates like Rob Portman of Ohio, and McConnell is in trouble, with zero margin for error.”
Much of the outcome could hinge on the BCRA’s proposed cuts to the Medicaid program. Portman, Murkowski, Heller, and other key GOP senators represent states that expanded Medicaid under the Affordable Care Act. They have expressed concerns over the bill’s changes to the program, which provides low-income Americans with financial support to access health insurance.
As it stands, the BCRA rolls back the Medicaid expansion and includes deep cuts to the rest of the program, which could be a deal-breaker for those lawmakers.
Valliere pointed to public reaction, which has been heavily against the GOP’s healthcare overhaul. The House version of the legislation, the American Health Care Act, has the lowest support in polls of any major piece of legislation dating back to 1990.
“Polls support the opponents – and Barack Obama, still popular, will lead the charge,” Valliere said. “There are other wild cards: the CBO ‘score’ early next week; strong opposition from the AARP, whose members vote; potential parliamentary objections; Planned Parenthood funding; and a lack of enthusiasm among House Republicans, who stuck out their necks only to have Trump call their bill ‘mean.'”