Too Quiet

If you looked over this week’s congressional schedule you’d see a listing of “housekeeping” bills, for the most part. The House has already passed — by an overwhelming majority — further sanctions against Russia and a Veterans Assistance bill and the only contentious issue remaining for the week has to do with reporting on the security clearance backlog.

Meanwhile in the Senate, Monday saw the confirmation of a Deputy Secretary of the Interior.

The big issue, sucking all of the oxygen out of Capitol Hill, is healthcare. The Senate voted, on Tuesday, to proceed with H.R. 1628 “The American Healthcare Act” by a vote of 51–50 and every bit of evidence suggests that this is going to be a long, hard fought battle with nearly all of it fought in the Senate.

The Stakeholders

In order to avoid a Democratic filibuster the GOP has to move the repeal through the Senate under budget-reconciliation rules. There are a lot of procedural hurdles to clear, but as long as they stick to that process the Republicans need only 51 votes to clear the chamber and repeal the bill. So how does the Republican side of the Senate stack up? Where does your Senator fit into this debate? Let’s survey the Upper Chamber of the United States Congress.

The Right-Wing Policy Wonks

Rand Paul (R-KY)
Ted Cruz (R-TX)
Mike Lee (R-UT)

These are Senators that see themselves as setting a conservative policy agenda. They reject Obamacare but can’t support a repeal that doesn’t also replace the bill with something that preserves access to insurance. They’re unlikely to get behind a straight repeal.

If these are your senators, talk to them about what a post-Obamacare healthcare system should look like.

The Pragmatists

Susan Collins (R-ME)
Rob Portman (R-OH)
Shelly Moore Capito (R-WVa)
Lisa Murkowski (R-AK)

These are Senators who are balancing their politics against reality at home. As opioid abuse sweeps rural America, these senators are seeing their constituents increasingly dependant upon Medicaid funding to access health services and fight their addictions. They are likely to insist that any replacement preserve or improve access to Medicaid or comparable services for addiction.

If these are your senators, talk to them about Medicaid and what the program should look like 4–8 years from now in these addiction-ravaged areas.

The Republican Class of 2020

The last iteration of healthcare considered by the Senate would have phased out support for some 11,000,000 Americans getting healthcare through the Obamacare Medicaid Expansion in 2020 and any repeal effort is going to have a date at which it takes effect. If replacement does not improve coverage for those 11 million, the political consequences for these senators could be dramatic.

Luther Strange (R-AL)
Dan Sullivan (R-AK)
Tom Cotton (R-AR)
Cory Gardner (R-CO)
David Perdue (R-GA)
Jim Risch (R-ID)
Joni Ernst (R-IA)
Pat Roberts (R-KS)
Bill Cassidy (R-LA)
Thad Cochran (R-MS)
Steve Daines (R-MT)
Ben Sasse (R-NE)
Thom Tillis (R-NC)
Mike Rounds (R-SD)
Lamar Alexander (R-TN)
Jon Cornyn (R-TX)
Mike Enzi (R-WY)

If any of these are your senators, talk to them about what the transition between Obamacare and a replacement or repeal will be like. The short-term impact of the bill is likely to be more concerning for them than the long term vision.

Everyone Else

This is not to say that the remainder of the Senate — both Democratic and Republican — is not important in the process but that they are unlikely to be the fulcrum upon which the issue turns. Democrats have a vested political interest in preserving the signature legislative accomplishment of the Obama era; Republicans have an interest in overturning it for exactly the same reason.

Democrats are very unlikely the cross the aisle and vote with Republicans on this issue and, with President Trump’s popularity sinking ever lower, the difficulty of holding the politically vulnerable Republican coalition in the Senate together grows by the day. Thus motion on this bill and the future of the Affordable Healthcare Act, rests in the hands of the Senators enumerated above.

Tell Congress what you think!

Text RESIST to 50409 to tell your representatives what you think about this, or learn more about the Health Care issue by catching up on Caitlin Martin’s ongoing coverage of the issue below.