Back from the dead...

How the GOP brought Obamacare repeal back from the dead

Every step of the way has been agonizing, and Tuesday was no exception.

By BURGESS EVERETT , SEUNG MIN KIM and JENNIFER HABERKORN

As Mitch McConnell strode to the Senate floor on Tuesday, with no votes to spare to keep the GOP’s Obamacare repeal campaign alive, he knew where everyone in his conference stood. Everyone, that is, except for Ron Johnson.

The ornery Wisconsinite had been needling the Senate majority leader for weeks, accusing McConnell of a “breach of trust” in selling a health care plan to his caucus. So when Johnson sprinted to the Capitol basement after a party lunch for a meeting with FBI director nominee Christopher Wray, just as a critical procedural vote got underway, Republicans had no idea where he would land, said a person who knows the senator well.

When he finally emerged, Johnson headed to McConnell’s desk on the Senate floor. The two engaged in a tense, 10-minute face-to-face talk. McConnell’s face turned increasingly red, and the GOP leader threw up his hands multiple times.

“Sen. Johnson, like others, had some objections to the process, which is admittedly cumbersome,” said Senate Majority Whip John Cornyn (R-Texas), who was hanging around the McConnell-Johnson conversation, with his arms crossed and a grimace on his face. “He was expressing some of his frustration. But I’m glad he voted to proceed to the bill.”

That McConnell even got to this point was remarkable. Just a week ago, the GOP’s repeal-and-replace effort was practically declared dead, as the GOP leader himself said it was “pretty clear” there weren’t 50 votes for a health care bill. But Tuesday’s dramatic roll call — capped by Sen. John McCain’s return to Washington less than a week after a cancer diagnosis and a tie-breaking vote by Vice President Mike Pence — allows President Donald Trump and his fractured party to continue their long-shot campaign to scuttle the Democratic health care law they’ve spent seven years railing against.

Yet every step of the way has been agonizing, and Tuesday was no exception.

Ten minutes after McConnell and Johnson began chatting, McCain entered the chamber and provided the 49th vote. Only Johnson remained. Left with the option of being the Republican who killed Obamacare repeal or the one who saved it, the Wisconsin senator quickly flipped a thumbs-up into the air to vote yes.

“It wasn’t really a matter of prevailing; I just wanted him to understand I wanted to proceed to be a positive influence on the process,” Johnson said of his conversation with McConnell. He laughed heartily when asked whether he seriously considered voting no: “Sure … you’ve got that binary choice.”

In the end, it was McConnell’s binary choice argument that reeled in the 50 votes. McConnell relentlessly laid out his reasoning to senators ranging from conservative Sen. Rand Paul (R-Ky.) to vulnerable incumbent Sen. Dean Heller (R-Nev.): A vote against even debating Obamacare repeal is a vote to keep it in place.

It worked on the likes of Heller and Sens. Shelley Moore Capito (R-W.Va.) and Rob Portman (R-Ohio), all of whom had indicated to leadership they’d be willing to vote to proceed to the bill over the past 48 hours. McConnell then prevailed on Paul, his Kentucky colleague, on Tuesday morning to at least vote to debate the measure, promising he’d get his vote on what he calls “clean repeal.” Paul flipped from a hard “no” to a “yes.”

But even with Johnson, Paul and some centrists on his side, McConnell had no margin for error.

Sen. Susan Collins (R-Maine) had aired her objections for days, and Sen. Lisa Murkowski (R-Alaska) was also viewed as a lost cause. She privately relayed to colleagues during the GOP party lunch on Tuesday that she would be a “no” on the floor, according to multiple senators.

One of the final holdouts was Sen. Mike Lee, a conservative Utah senator who believed GOP leaders had listened to his ideas for weeks only to ignore them in the end.

On a Delta flight from Salt Lake City to Washington on Monday afternoon, Lee sat in the middle seat, furiously texting about his latest thinking in the health care debate, according to an eyewitness who sat next to Lee and described the messages to POLITICO.

In one text, Lee told a recipient that he might still vote to proceed to the repeal debate, but that it was “still too early to do so in good conscience because we’re not being told anything.”

“This leadership line of pass something, anything, is dangerous and potent,” Lee typed out in another message, written in a large enough font that fellow passengers could easily read his words, according to the eyewitness. In another text, Lee wrote: “This bill is nothing more than bailing out insurance companies with a few minor reforms thrown in for good measure.”

Lee’s office did not dispute the messages when asked about them by POLITICO. He has aired similar complaints publicly, though in milder language.

“We are not going to authenticate any of these statements; doing so would only encourage the most boorish, voyeuristic behavior in an already too-uncivil town,” a spokesman for Lee said. “Sen. Lee has been having honest discussions with people in the White House and Senate about health care. If one narrow part of one of those conversations was observed by a third party, it would only show how thorough the senator has been in his deliberations.”

Ultimately, Lee chose to advance the Obamacare repeal measure, hesitating a little when he proclaimed “aye” during the tense vote that stayed open for a half-hour. So did Republican Sens. Jerry Moran of Kansas, Capito, Portman and Heller — all GOP holdouts over the past several weeks who sided with their party on Tuesday. Democrats were silent at the desks, refusing to vote until all Republicans had.

McConnell received a boost from an erratic player in the debate: Trump himself. The president had confounded Republican leaders for weeks, changing positions on a near-daily basis. But after McConnell’s latest draft had been abandoned by Moran and Lee and failure looked certain, Trump hauled the entire Republican Conference to the White House.

Capito, Portman and Heller had been begging GOP leaders for weeks to revamp their approach to Medicaid, sweating the political and practical fallout that would accompany a vote to dramatically cut future Medicaid spending by hundreds of billions of dollars. They hoped McConnell could be persuaded to add $100 billion in spending aimed at blunting those cuts, but leadership was caught between them and fiscal conservatives.

Yet in front of McConnell and the rest of the caucus, Trump told Republican senators that “we’re going to add this money to the bill,” according to two sources familiar with the matter. Portman huddled with McConnell and Cornyn on Monday, with the Ohio senator declining to tell reporters his intentions on the bill.

But leaders already had reeled him in, and on Tuesday his amendment was included in the initial round of votes. It won’t succeed, but it gives more centrist senators an avenue to express their support for more spending for low-income Americans.

“I have a commitment from our leadership to support it,” Portman said.

Even then, however, the whip count was fluid. With two “no” votes assumed, a third “no” could have caused many more GOP defections, given the resistance among Republican senators to going along with a process with no clear idea what the end product would be. Republicans needed a boost.

On Monday afternoon, senators began buzzing that McCain could return after receiving a brain cancer diagnosis less than a week ago. Cornyn said McCain’s doctors were being consulted, and Sen. Roger Wicker (R-Miss.) mused optimistically about the possibility of a surprise appearance.

Late Monday, McCain’s office confirmed the news: Less than two weeks after having a blood clot removed from above his left eye, he would be back in the Senate.

Finally, McConnell had the momentum.

“He deserves a lot of credit for coming back,” Sen. Orrin Hatch (R-Utah) said of McCain.

With McCain back, McConnell’s allies began cautiously predicting victory. The Arizona senator helped deliver the win in classic fashion, excoriating the process his party was employing for the health care repeal — right in front of his Republican colleagues.

Let the committees “hold hearings, try to report a bill out of committee with contributions from both sides,” McCain said, to a loud ovation from Democratic senators who stood up and applauded. After that died down, McCain added: “Something that my dear friends on the other side of the aisle didn’t allow to happen years ago.”

The Arizona senator left open the question of whether he would help his fellow Republicans eventually pass a bill now that debate has begun. And though clearing Tuesday’s procedural hurdle was almost certainly McConnell’s most hard-fought victory of the year, passing legislation is another matter.

The end goal is likely a stripped-down repeal of Obamacare’s individual and employer mandates and the law’s medical device tax, perhaps with more add-ons. The GOP will now pass whatever can garner 50 votes, no matter how scaled-back McConnell’s ambitions of repealing Obamacare “root and branch” have become.

Their hope is to get something to the House and get it off the Senate’s plate. With any luck, senators say, they will end up in a bicameral conference and finish the job later this year. And now that McConnell has won a vote to proceed to an uncertain outcome, no one is counting him out.

“I was surprised that there was just two of us in the end,” Collins said of her and Murkowski’s opposition. “But that’s OK. We’ll proceed from here and see where we end up.”