Health care repeal quickly gets messy for GOP in Congress

Credit: Jamie Dupree

Credit: Jamie Dupree

While Republicans have long talked about a quick repeal of the Obama health law, the first week of the 115th Congress was a fresh reminder that while the GOP is united in its opposition to Obamacare, there is no agreement on what should replace that system, as Republicans began to tussle with each other over what to do next.

Here are some snapshots from the halls of Congress:

1. Republicans have not settled on a single replacement plan. The Obama health law was approved almost seven years ago, and while Republicans are overflowing with ideas on what they would change, there isn't one plan out there which could get a majority in either the House or Senate if a vote were held this week. "We're going to repeal it, and at the same time replace it," said Sen. Jim Inhofe (R-OK). "And that's the tricky thing." And GOP lawmakers are starting to realize it's not an easy pull.

2. The transition from Obamacare to Trumpcare. One thing that is getting a lot of discussion among Republicans is how long to have a transition period between the current system, and whatever Republicans are able to get through the Congress, and signed into law by President Trump. Some are talking about a transition period that would last several years to work out the bugs in the system. "We're trying to figure out how to do that," said key Rep. Pat Tiberi (R-OH), who told reporters Thursday that the transition period could last, "one, two or even three years." That's getting a lot of attention from GOP lawmakers of all stripes.

3. There could be trouble within GOP ranks. First it was Sen. Rand Paul (R-KY) saying he would vote against a Senate budget plan that is the first step for repeal. Then, members of the House Freedom Caucus started making rumblings about not being on board with emerging GOP repeal plans, worried that overall spending might not be cut by Republicans. Asked if he would support the current plan, Freedom Caucus chair Rep. Mark Meadows (R-NC) was blunt. "I doubt it," he told reporters. His group will meet Monday night to decide whether they will demand changes next week. Paul has made it clear he wants to force choices now, and not vote repeal - and then wait to forge a replacement.

4. Democrats look to sow doubt and derail GOP repeal bid. As Republicans try to get their side together on one page, Democrats are doing their best to voice their complaints about the repeal effort, and looking for any cracks in the Republican coalition that they might exploit. For the most part though, Democrats know they are fighting an uphill battle if Republicans can stick together. "What is being talked about here is essentially tearing the house down," complained Sen. Ron Wyden (D-OR).

5. Making America Sick Again. Get used to that line, because the Democrats are going to use it over and over in coming weeks, trying to riff off the campaign slogan of President-Elect Trump. The first vote this past week on a budget outline in the Senate was a messaging amendment on this exact line, as Sen. Tim Kaine (D-VA) - who ran unsuccessfully with with Hillary Clinton - forced a vote on a non-binding resolution that would block approval of any legislative item that might be "Making America Sick Again." It lost on a 58-42 vote.

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6. Will Democrats work with Republicans on reform? Democrats have to make a calculation in coming weeks and months - do they just oppose everything the GOP wants to do on health care reform, or do they see if they can find a way to broker a deal that would improve the current system? It's not an easy answer. President-Elect Trump at one point this past week appealed for a bipartisan deal - but that was a few minutes after he called the Senate Democratic Leader a "clown."

7. Both sides roll out a host of horror stories. Each party is doing its best to find stories from back home to buttress their arguments for and against changing the Obama health law. For Republicans, it is mainly stories of people paying astronomical amounts for their health insurance, featuring high premiums and high deductibles. For Democrats, they emphasize the threat of people losing their health care coverage, and the stress that brings to their lives. It will be dueling sob stories for months to come.

8. First set of key votes loom next week in Congress. The House and Senate will face their first votes on the "budget resolution" in coming days, the budget blueprint that will lay the groundwork for future votes to repeal parts of the Obama health law. As mentioned above, there are already rumblings from Republicans in both the House and Senate that they might not be on board with what others want to do - watch closely to see how the GOP leadership tries to cajole those lawmakers, and make sure this repeal effort doesn't hit an early pothole.

From my years of covering Capitol Hill, one thing is obvious - this will not be an easy road for the GOP on repeal - and replacement - of the Obama health law.

Stay tuned.