Politics & Government

Lindsey Graham looks ahead on health care, and sees an ally in Trump

From left, Sen. Lindsey Graham, R-S.C., Sen. John Barrasso, R-Wyo., Sen. Bill Cassidy, R-La., Senate Majority Leader Mitch McConnell, R-Ky., and Majority Whip John Cornyn, R-Texas, speak to reporters as they faced assured defeat on the GOP's latest attempt to repeal the Obama health care law.
From left, Sen. Lindsey Graham, R-S.C., Sen. John Barrasso, R-Wyo., Sen. Bill Cassidy, R-La., Senate Majority Leader Mitch McConnell, R-Ky., and Majority Whip John Cornyn, R-Texas, speak to reporters as they faced assured defeat on the GOP's latest attempt to repeal the Obama health care law. AP

After his nonstop effort of the last several weeks to repeal and replace Obamacare – and after he conceded defeat – Sen. Lindsey Graham settled in Tuesday night for a long, restful sleep.

“But guess who called and woke me up in the morning?” the South Carolina Republican asked.

It was President Donald Trump, Graham’s one-time nemesis on the 2016 campaign trail who has become an unlikely ally and frequent caller to the senator’s cell phone.

“He said, ‘We’re gonna do this, we’re gonna get the votes,’” Graham, in an exclusive interview with McClatchy, recalled of the conversation. “He said, ‘We’re gonna do this next year for the good of the country, the good of the party.’ He was really upbeat, and he sent out a nice tweet today.”

Graham said he will meet with Trump on Thursday at the White House “to plot a strategy to move forward.”

The senator finds himself in an odd position. After weeks of saying his bill had momentum, it became clear Monday it lacked the 51 votes to move forward. While that should have meant a humiliating defeat, Graham has emerged emboldened and more confident than ever that the country hasn’t seen the last of his health care bill.

Looking back at the unlikely events leading up to this point, it’s not so difficult to see why.

The seeds of the idea were planted in a conversation at the Senate barber shop in either late spring or early summer. Graham could not remember the exact date, only that it was “a month or two” before the Senate would take a series of doomed votes during the last week of July on various proposals to repeal Obamacare.

Graham happened to be getting his haircut at the same time as former Sen. Rick Santorum, R-Pa., who had an idea: Why not distribute health care spending through block grants to the states? That’s what a Republican Congress did in the 1990s to overhaul the nation’s welfare system, which ultimately won the signature of Bill Clinton, a Democratic president.

Graham was intrigued. A foreign policy and defense specialist, Graham had never worked seriously on health care before, though he had some history of supporting states’ rights in this arena.

He’d introduced a bill several years ago with Wyoming Republican Sen. John Barrasso that would have let states opt out of the Affordable Care Act. It went nowhere. Earlier this year, Graham was the third co-sponsor of legislation offered by GOP Sens. Bill Cassidy of Louisiana and Susan Collins of Maine that was promoted as the “centrist” alternative to the current law. It didn’t have enough conservative sweeteners to win support in a fractious Republican caucus.

Graham approached Collins and Cassidy with Santorum’s idea. Collins did not join the effort, but Cassidy, a doctor in public hospitals before he became a member of Congress, quickly came on board.

They agreed on a framework grounded in what Graham called “political tradeoffs.” While they would keep the current law’s taxes on the wealthy to fund the block grants, they would repeal the financial penalties for individuals and employers who don’t buy health insurance for themselves and their employees.

With Cassidy taking the lead on drafting the policy, Graham became the pitchman while also getting a crash course in the wonky details of the health care system.

“He’s a pretty smart guy, and very wily, and as an attorney I’m sure he’s used to thinking about things that he may not be familiar with but are familiar to his case, and he brought all those gifts to bear,” Cassidy told McClatchy.

By the time the two men were ready to unveil their proposal in July, the Senate was preparing to vote on a series of proposals to repeal and replace Obamacare. At that point, Graham and Cassidy only had bullet points and endorsements from a small number of governors, but it was enough to get some people excited, especially once leadership’s proposals failed.

Senate Republicans were unable to garner enough support for their latest health care bill, titled Graham-Cassidy, and postponed the vote. Co-author of the bill Sen. Bill Cassidy noted that he’s “disappointed” during a press conference on Sept. 26.

Many political observers consider the turning point for Graham-Cassidy to have come late this month, when the lawmakers officially unveiled the bill text. The very same day progressives were launching an energetic bid to pass a “Medicare for all” plan Graham said was tantamount to socialism.

But Graham said the moment where the political winds picked up for the block grant proposal was actually earlier than that, when Sen. Dean Heller, R-Nev., who is considered among the most endangered incumbents up for re-election in 2018, announced his support.

“Once we got Heller, then we were a real thing,” Graham told McClatchy. “It was a turning point. “Because Heller was a person in play. We didn’t know how he was gonna vote on health care. And then Heller went to [Senate Majority Leader Mitch] McConnell and said, ‘I like Graham-Cassidy. I can get behind this.’”

In other words, Heller showed that Graham-Cassidy was worth the political risk.

“He said it was great politics,” Graham said of Heller. “He said, ‘I can tell Republicans I’m for federalism, tell average Nevadans we’re going to get more money for our state.’”

Ultimately, it didn’t work out so easily for Heller, or for any of them. The story, in effect, ended on Tuesday, when it became clear there weren’t enough votes to pass the bill and GOP leaders announced overhauling the nation’s tax code would be the next legislative battle.

Graham still isn’t willing to quit, insisting that with the White House’s help he, Cassidy and others will be able to get this over the finish line sometime next year. He knows now how to attract wavering senators like Heller, and maybe there’s a way to win over Collins.

Health care will continue to consume some public attention in the weeks ahead, with Trump intending to soon sign a massive executive order that will allow individuals to purchase health insurance across state lines. Any health care news over the next several months, in fact, could be useful to Graham as he seeks to keep the pressure on Republicans to finish the job they started.

He’s convinced Obamacare is hurting the country, including South Carolina, where only one insurance provider exists on the state exchanges.

“The truth of the matter is, the system is not working, and I feel a real need to up my game here,” he said.

As Republicans work to keep their majorities on Capitol Hill in 2018, Graham believes he knows what it will take.

“Here’s what this debate taught me: Democrats are very good at pushing their agenda. They are very good at rallying. They have a tremendous will to get their way,” Graham explained. “Republicans are national defense strong, we want an entrepreneurial economy, but on health care we’ve played defense. This debate taught me our ideas need to be broad, they need to touch people in a personal way.

“What this debate taught me is when it comes to the Republican Party, it’s not enough to be against stuff,” he said.

Emma Dumain @emma_dumain