How the D.C. process helped block Obamacare’s repeal

Republicans spent more than six years proclaiming their desire to repeal Obamacare before legislation targeting that goal fell apart on Capitol Hill.

Did GOP lawmakers lack the competence to move Obamacare repeal legislation? Did they simply lose their nerve once they gained control of both chambers of Congress and the White House? Tevi Troy‘s latest Commentary feature suggests that a complicated legislative process played a larger role.

For a bill to reach the president’s desk, it must (of course) pass both the House and the Senate. The only way a bill can even come up for passage is for senators to vote explicitly beforehand to end their formal debate on the measure. This is called “cloture.” Senate rules require a supermajority of 60 votes to achieve cloture. Republicans hold the Senate majority with 52 votes. What this means in practice is that while they can likely secure passage for any bill that reaches the floor, Republican efforts will be stymied because Democrats can refuse to end debate and leave the bill hanging forever in endless-debate limbo.

There is, however, one type of legislation that can be passed with a simple majority: a budget reconciliation bill. The budget-reconciliation process was designed (in 1974) to allow simple majorities to pass budget resolutions. Clever and able parliamentarians have seized on the reconciliation process to usher through bills unable to reach the 60-vote cloture threshold. Most notoriously, Obamacare itself passed using reconciliation. …

So Republicans wanted to use the budget reconciliation process to deal with health care reform.

Republicans decided to write two budget resolutions in 2017—one involving health care and the other involving tax reform. They decided to go with health care first—and under the arcane rules of the resolution process, they had to file “budget instructions” formally declaring that their first budget move would center on health care. Once they did this, they could not alter the sequence.

GOP leaders have been criticized for this, including by President Trump, who said as the health-care bill plunged into chaos that he was sorry they hadn’t gone with tax reform first. The thing is, the approach made sense. First, Ryan knew that Republicans were united in their desire to repeal Obamacare, whereas there are heated disagreements within the Republican caucus on the kinds of tax cuts and reforms the GOP should pursue. More important, the repeal of Obamacare would have generated significant budgetary savings (initially calculated around $350 billion) that would have been immensely helpful in offsetting the cost of a later tax-reform bill.

Think this is hard to explain in a 10-second sound byte? Wait, there’s more.

Now, to confuse matters, some more arcana—this time to explain the haste with which the bill was introduced and was to be voted on. Under the budget-resolution process, Republicans were aiming to finish their first package before mid-May. Why? Because the instructions governing a health-care reconciliation package would “expire” once the House initiated the second budget process on tax reform. (Don’t ask.) In other words, the bill had to get through the House and then the Senate and be harmonized between them before going to the president’s desk—all in a matter of two months.

It was this need for speed that led Ryan to introduce the bill hurriedly and insist on a House vote within 17 days. Almost no one aside from procedural experts understood the necessity of this haste, and Ryan’s action led to breathless accusations by Republicans who didn’t like its provisions that he was “rushing things through” and moving forward “in the dead of night.”

Why didn’t they like it? Again, the rules governing reconciliation tell the tale: The bill simply couldn’t do what Republicans seeking Obamacare’s full repeal and replacement needed it to do. Every provision in a reconciliation bill must be “germane” to the federal government’s budget. Thus, the Ryan bill could only change taxes and spending. It could not address central concerns of health-care policy. All the larger goals that go along with an anti-Obamacare approach—regulatory relief, purchasing insurance across state lines, association health plans, tort reform and the like—could not be included in the bill the leadership was pressuring GOP members to support.

If the situation sounds hopeless, please read the rest of Troy’s article. He offers practical recommendations for lawmakers interested in resurrecting the Obamacare repeal campaign.

Mitch Kokai / Senior Political Analyst

Mitch Kokai is senior political analyst for the John Locke Foundation. He joined JLF in December 2005 as director of communications. That followed more than four years as chie...

Reader Comments