GOP health care bill faces showdown week in the Senate

Almost everywhere I went this weekend and ran into someone I knew, there was one question asked by just about everyone - whether it was at the pool, on the golf course, or grilling burgers in my back yard - "Will the Republicans get their health care bill through the Senate this week?"

Let's take a look at what the GOP has to do to get that bill approved.

1. A test for the Senate Majority Leader.  The hamburgers had barely touched the grill on Sunday evening, when my father - a veteran of many legislative showdowns on Capitol Hill - asked whether I thought the GOP could get the health bill approved in the Senate by the end of the week. My answer is much like where we were with the House bill at the beginning of May - I can see the GOP passing this by the narrowest of margins, and I can also envision the bill getting delayed because of concerns among GOP Senators.  Remember, the House had a couple of false starts before finally mustering a majority for the Republican health plan.

2. President Trump warming in the bullpen.  Just like he did when he cajoled reluctant Republicans in the House to get on board with a GOP health care plan, the White House has already had the President reaching out to GOP conservatives who aren't quite sure they really want to vote for this overhaul of the Obama health law. Over the weekend, the President again made clear - that despite concerns over individual provisions in the bill, and how it might change health insurance options in the individual market - this is better than the current Obamacare situation. Expect to hear that argument a lot more this week from the White House.

3. There really is no role for Democrats. Just like in 2009 and 2010 as the Obama health law made its way through the House and Senate - when Republicans did not have the votes to leave their imprint on the bill - Democrats are simply on the sidelines, as they lob verbal grenades at the GOP on an hourly basis. It's important to remember this week that Republicans have almost no margin for error, as just three GOP Senators could tip the balance of this debate if they refuse to back the Republican health bill. All Democrats can do is watch from the sidelines, and hope they have an impact.

4. Have you read the bill? Why not? The GOP health bill is just 142 pages long - but even if you sit down to read it, I guarantee that most of you won't be able to figure out what it says. Why? Well, that's because it is basically an amendment to the underlying Obama health law, and if you don't have that language on hand, you won't really know what the Republicans are trying to change, and how. The original Affordable Care Act was well over 2,000 pages long - and the reason that this GOP bill is so short is simple - it just amends the Obama health law - this is not "repeal and replace" by any measure.

5. The GOP Senators who might vote 'No.' If I had to list a group of Republicans to watch, my morning line would look this way:


1) Rand Paul - most likely to vote "No" at this point

2) Dean Heller - Nevada Senator said on Friday that there must be changes


3) Mike Lee - said this weekend he thinks the bill doesn't significantly reform health care. But I still wonder if he gets to "Yes" with some late changes.

4) Susan Collins - CBO report is important, plus Planned Parenthood. Still not sure she votes "No."

5) Lisa Murkowski - Planned Parenthood & bill details important. Important one to watch.


6) Ted Cruz - Yes, I know Cruz has said he has concerns. So did the Freedom Caucus in the House, but most of them ended up voting for the bill.

7) Ron Johnson - Same thought for the Wisconsin Republican as Cruz. Can't see either of them being the 51st vote against the bill.

8) Bill Cassidy - No matter what he said to Jimmy Kimmel, I still think it is unlikely that Cassidy votes against the Senate bill. But we'll see.


9+) I see all sorts of other Senatorial names mentioned like Portman, Cotton, Isakson, Rounds and Capito.  Maybe Capito and Portman might have concerns on Medicaid that could cause some troubles, but it still seems like most GOP Senators are ready to vote for this bill.  It will come down to just a couple of Republicans - three "No" votes would be enough to derail this plan.

Clearly, the GOP leadership - and the White House - has some legislative arm twisting to do in coming days.

If this plan stays on track, it could well be voted through on Thursday or Friday.  And if that happens, I wouldn't rule out the GOP thinking about bringing it right to the floor of the House for a final vote.

But we'll see if we actually get that far.  Stay tuned.  It will be a very interesting week in the halls of Congress.

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