The buzz at the Capitol this week has been all about budgets, hurricanes and immigrants, and next week’s big topics are likely to involve defense and national security. Virtually no one is talking about Obamacare anymore.
Except for Sen. Lindsey Graham.
The South Carolina Republican is on a lonely crusade to repeal and replace Obamacare, even though Republicans failed dismally this summer to get that done and the GOP has moved on to other weighty matters such as keeping the government funded past Sept. 30 and increasing the nation’s debt limit.
Graham disputed the notion he’s on a fool’s errand.
“Here’s what would be crazy for a Republican: The promise of repealing and replacing Obamacare for seven years, throwing your up hands and saying, ‘Sorry, we can’t do it,’” Graham told McClatchy this week. “This idea has never been tried. It’s the best idea to replace Obamacare. It’s never been given a shot.
“You want to kill the Republican party?” he continued. “You want to have us divided forever? Walk away from the promise to repeal and replace Obamacare without taking your best shot.”
Graham’s idea to replace the 2010 Affordable Care Act was conceived with Sen. Bill Cassidy, R-La., and developed too late to be considered on the Senate floor alongside other proposals back in July. Their plan would send money spent on Obamacare back to states in the form of block grants, funded through maintaining the current law’s taxes on the wealthy.
The proposal eliminates the requirement that individuals and businesses buy health insurance for themselves and their employees or face financial penalties, and protects those with preexisting conditions from being denied care. It would also repeal the much-maligned taxes on medical device producers.
Graham has a reputation for leading on multiple issues simultaneously, using his clout to elevate pet projects large and small. At any moment he could be speaking about the threat of North Korea or the need to punish Russian leader Vladimir Putin for interfering in the 2016 presidential election.
On Wednesday, the same day he met Vice President Mike Pence to discuss health care, Graham was making appearances on several television and radio programs to tout his bill to codify the Deferred Action for Childhood Arrivals program, an Obama-era executive order protecting certain young undocumented immigrants from deportation.
Health care policy, however, is new for Graham, and his window for advancing legislation in a complicated arena is rapidly closing. Authority to pass health care legislation in the Senate with 51 votes – a procedural maneuver known as reconciliation – is set to expire on Sept. 30.
Even if Graham can introduce a bill this week and get it analyzed by the nonpartisan Congressional Budget Office quickly, he will face a major challenge in trying to convince GOP leaders, demoralized by the defeat of repeal and replace this summer, to put the measure back on the calendar.
He faces skepticism from Republicans in his own congressional delegation.
“It seems like an extremely heavy lift to me,” said Rep. Tom Rice, R-S.C.. “I would say the chances aren’t very high that the Senate can get it done if they couldn’t do it in July. They voted on four packages: Their package, our package, a full repeal, and a ‘skinny’ repeal. And they couldn’t get that done. That you could get something done at this point seems pretty remote.
“But I mean, he’s a senator. Maybe he knows better than I do,” added Rice, who as a member of the Ways and Means Committee played a role in crafting the House GOP’s original Obamacare replacement proposal – and appears to have emerged from this debate feeling especially bruised.
“l think it’s a reasonable idea,” said Rep. Mark Sanford, R-S.C., of the block grant idea. “But I would just say right now, whether in Washington or even in the district, people are much more focused right now on the debt ceiling, the budget, taxes … there seems to be a pivot with the Republican base, with people moving on with concern about what’s going to happen on tax policy.”
Graham’s strategy for getting support is to find governors who support it. Graham figures governors will put pressure on their lawmakers to back it, too. He counts his home state Republican Gov. Henry McMaster, along with Scott Walker of Wisconsin and Doug Ducey of Arizona, as among those who have endorsed the block grant approach.
But it’s not clear how many governors are ready to publicly sign onto the Graham bill, let alone how many governors can convince their senators to agree. McMaster has not said publicly whether he endorses the proposal.\
And the Senate Health, Education, Labor and Pensions Committee is moving ahead with a series of hearings that Democrats and Republicans on the panel hope will culminate in a cross-the-aisle plan to stabilize the rocky Obamacare insurance markets rather than scrap the law and start fresh. Ray Farmer, the South Carolina insurance director and secretary-treasurer of the National Association of Insurance Commissioners, is scheduled to appear before the committee next week.
At the very least, Graham has stirred conversation.
White House Counselor Kellyanne Conway told Fox News that President Donald Trump was “ready with pen in hand to sign health care reform if, say, Graham-Cassidy moves forward.”
House Freedom Caucus Chairman Mark Meadows, R-N.C., added the proposal had “real merit.”
On Thursday, Cassidy told reporters that Senate Majority Leader Mitch McConnell, R-Ky., has said he would allow a floor vote on a new health care bill if 50 Republicans were in favor – and that he and Graham were very close to that number.
“He just said he would,” Cassidy pointed to Sen. John McCain, R-Ariz. McCain had said the day before he would vote for the block grant proposal but later backtracked, clarifying he needed to study bill text first.
McCain cast the decisive vote that doomed health care overhaul efforts in July. The other two Republicans who voted “no” votes at that time, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, aren’t likely to support a plan that can’t guarantee sufficient Medicaid coverage, a criticism of the Graham-Cassidy gambit.
The climb is steep and the odds are high. Why does Graham persist?
The answer was easy for fellow South Carolina Republican Sen. Tim Scott: “He’s a very intelligent, very engaged member who believes there’s a reason why we’re here: To solve problems to the extent we can get them solved.”
Graham, on a local radio program last week, also put it simply: “It may be the most consequential thing I ever do for the country.”
Brian Murphy of McClatchy’s Washington Bureau contributed to this story
Contact: Emma Dumain at firstname.lastname@example.org