The House of Representatives narrowly passed a health care bill Thursday that received no votes from Democrats and barely enough from Republicans. Speaker Paul Ryan and President Donald Trump say it’s a great victory — proof that they can deliver.
Other Republicans aren’t so sure. They worry that passing the controversial bill could come back to haunt the party, especially in the 2018 midterm elections. Here are the top four reasons why that could happen:
1. What’s the score? The bill passed without being “scored” by the Congressional Budget Office, meaning the official legislative scorekeeper has not estimated the basic facts and figures of the proposed new law: How much will it cost U.S. taxpayers over time? Will more Americans receive health insurance or fewer?
When the CBO scored the previous iteration of the American Health Care Act or Trumpcare, as it is now being called, it estimated that it would increase the number of uninsured Americans by 14 million in 2018 alone. That number scared off a number of potential GOP votes and the bill died without a floor vote.
This time, House leaders are gambling by pushing the bill through before the score is known. It is a high-risk gamble. High costs or high numbers of new uninsured Americans will not please voters. And voting before the score could look sneaky or hypocritical.
2. The Upper Body. In almost any form, Trumpcare’s fate in the Senate is uncertain at best. If the Senate fails to pass its own version, President Trump and Republicans from all factions stand to be embarrassed. If the Senate passes a very different bill from the House, the internal GOP debate over health care could go on for months. That will give insurance companies, hospitals, doctors and consumers heartburn that will be hard to soothe.
Some Republican senators are openly skeptical already.
“A bill — finalized yesterday, has not been scored, amendments not allowed, and 3 hours final debate — should be viewed with caution,” tweeted Sen. Lindsey Graham, R-S.C., hours before the House vote.
Republicans have an even slimmer margin of failure in the Senate than the House. They can afford to lose only three votes if they can’t find any Democrats to come on board.
3. Don’t let government touch my Obamacare. Obamacare has grown more popular for the past year, perhaps as a result of the long partisan debate over repealing it. In April 2016, only 38 percent of those polled by the Kaiser Family Foundation viewed Obamacare favorably, a figure that stands at 48 per cent now. There is nothing close to a majority clamoring to get rid of it. Growing numbers are beginning to worry about the prospect that having pre-existing conditions could again mean health insurance is impossible to get.
Furthermore, if the Trump administration permits Obamacare to “explode” in some states, as it has threatened, voters could be even more wary and worried about change.
4. November 2018. The reason Speaker Ryan pulled the last health care bill from the floor was not only to avoid an embarrassing defeat, he also wanted to spare his members from casting what could be a very unpopular vote come the November 2018 midterm elections. A “yes” vote on a bill or position stays on the record forever and that provides fodder for negative ads.
Many Republicans in the House are open about the risk, especially Republicans in districts where Trump did not do well.
“I would hope it gets changed over there,” Rep. Peter T. King, R-N.Y., said of the House bill’s fate in the Senate.
House Republicans have delivered President Trump his first major legislative win but at a potentially high cost to the re-election prospects of many of their own.
That is exactly why at the moment the bill passed, Democrats on the House floor were happily singing, “Na na na na, na na na na, hey hey, goodbye.”