“Stealth and speed”: Senate Republicans’ health care strategy is a massive political gamble

Senate Republicans have not yet finalized, released, publicly debated, or held any hearings on their Obamacare repeal bill.

Yet they’re planning a vote on it next week.

Make no mistake, this is an intentional strategy. Majority Leader Mitch McConnell has calculated that Republicans’ best and probably only shot of repealing Obamacare is with a legislative strategy that combines stealth and speed.

First, there’s the stealth — McConnell’s staff has been crafting the Senate’s version of the American Health Care Act in secret, after weeks of private consultations and negotiation with several other Republican senators.

Then will come the speed — McConnell plans to bypass the committee process, bring the bill to the Senate floor, and hold a final up-or-down vote on it within days of its unveiling. Which means there will be remarkably little public deliberation or debate over that bill’s actual contents.

It’s a stunning process, and one remarkably different from the passage of Obamacare itself, which took many months and went through multiple committees. This bill would implement massive changes to a sector that makes up one-sixth of the US economy and if signed into law, it will greatly impact tens of millions of Americans.

And the tactics of speed and stealth may just be successful. Though it’s difficult to sift through the reporting on where a secret bill stands, it’s quite possible that the Senate GOP doesn’t want to be left holding the health care hot potato. After campaigning on repealing and replacing Obamacare for the better part of a decade, they may feel like they have to pass something.

But in acting hastily to solve a short-term political problem, the GOP will be taking immense risks with their long-term political fortunes if this already loathed policy that will likely hurt millions of Americans ever goes into effect.

Reconstructing the Republican decision to use stealth and speed

McConnell’s reasons for using stealth and speed are simple — these tactics maximize his chances of getting a health bill through, and even if the effort ends up failing, it gets health care out of the way so Republicans can move on to a tax bill. Here’s why.

  • Republicans control only 52 Senate seats, meaning they can’t beat a filibuster and advance any ordinary bill without substantial Democratic help. And GOP leaders calculated (probably accurately) that few Democrats would ever support something sold as a repeal of Obamacare.
  • Therefore, to pass the sweeping partisan health care and tax bills they want, McConnell and Paul Ryan decided they’d rely on the special budget reconciliation process, which requires only a majority vote and therefore can be done on party lines.
  • But the complex Senate rules on budget reconciliation essentially mean that they can’t do a health bill and a tax bill simultaneously — they need to do one first.
  • And they decided they’d do health reform first, for a variety of reasons I’ve explored at greater length elsewhere. (For one, they envisioned the health bill as a “repeal and delay” policy that would punt the hard decisions over replacing Obamacare until later, only abandoning that after backlash among members.)

So GOP leaders put health care first on the agenda, and planned to do it fast, along party lines. And then McConnell had to decide how, exactly, the Senate would go about crafting its bill — would he use the Senate’s traditional committee process, or bypass it?

It was back in February that I first heard, while interviewing a Senate Democratic staffer, that there was a rumor going around that McConnell wanted to skip the traditional committee process, instead bringing some modified version of whatever got through the House directly to the Senate floor.

You can see how this decision makes political sense. The committee process for Obamacare took many arduous months, which would have conflicted with the GOP’s desire for speed. That process itself was motivated in part by Democrats’ hopes of attracting Republican support for the bill, something the GOP has already ruled out this time around.

Furthermore, the GOP’s small margins, combined with the particular makeup of the two relevant committees, called into question whether they could even pass anything out of committee — for instance, the votes of Sens. Rand Paul and Susan Collins would both be necessary to pass a partisan bill out of the Senate Health, Education, Labor, and Pensions Committee.

So McConnell decided at some point that the Obamacare repeal bill would skip the committee process. Furthermore, he decided that rather than start work on a unique Senate proposal (as Democrats did in 2009), he’d wait and see what happened in the House of Representatives. When the House bill failed in March, this decision looked clever — McConnell had avoided tarnishing any of his members with a divisive and unpopular proposal. (In fact, many of them loudly criticized the House bill.)

But when the House took up its bill again and successfully passed an amended version in May, the pressure was all of a sudden on McConnell to deliver something, or be responsible for the failure of Republicans’ top partisan priority. And remember, the clock is still ticking, because the GOP wants to move on to tax reform.

So McConnell has spent the month and a half since trying to craft a proposal behind closed doors — first through a group of 13 Republican senators holding talks, and then through the even more opaque leadership-led process happening now. (Even Sen. Mike Lee (R-UT), a member of the 13-member working group, said this week that he didn’t know what was going on.)