Health Care

Paul Ryan Is Trying to Save Himself

If the House never votes on repealing Obamacare, he's the most obvious scapegoat.

Duck!

Photographer: Justin Sullivan/Getty Images

As I write this, House Republicans and President Donald Trump are scrambling around to find some health care bill, any bill, that they can call "repeal and replace" and pass as scheduled on the House floor on Thursday.

QuickTake Obamacare

What's really going on? Speaker Paul Ryan, 47, is desperately trying to avoid blame for the top Republican agenda item failing. And he's hooked a foolish, inexperienced president to go all-in with him.

The basic problem is that Republicans have spent years building up expectations for repealing Obamacare without coming up with two crucial parts of their solution: An alternative that they agree on, and the votes in the Senate to impose whatever they want-- if they could agree on what they want. 1  

Today, the problem boils down to a simple numbers game in the House. With no Democrats voting to scrap Obamacare, Republicans can only afford to lose 22 of their own votes. And while most mainstream conservatives are apparently willing to go along with whatever Ryan produces, satisfying the radical conservatives in the House Freedom Caucus threatens to lose too many votes from relatively moderate conservatives, and vice versa. As of now, they're losing votes from both sides.

It doesn't help that the bill that Ryan pushed through committee polls very badly. Or that the new president pushing the bill publicly is unpopular. Or that members of Congress probably don't trust that president. 

And it surely doesn't help that the bill appears doomed in the Senate, despite Majority Leader Mitch McConnell's pledge to rush whatever comes out of the House straight to the Senate floor (perhaps with changes drafted by him), avoiding the committee process. That raises the possibility that individual House Republicans could wind up with a double whammy -- blamed by their constituents for failing to repeal and replace Obamacare, but also hit with attack ads because they will have voted against the many popular provisions of the Affordable Care Act. 

No wonder New York Times columnist Ross Douthat suggested that whatever winds up in the bill, Republicans just oppose it

So why is the bill still moving forward towards a vote as early as Thursday night, even though there's no final version of the bill and even though there's no sign that anyone actually likes it? 

As far as I can tell, it's because Ryan and the rest of the Republican leadership has a strong interest in ducking blame. Conservative activists, fueled by conservative media, are going to be furious if a unified Republican government can't manage to kill off Obamacare. And they're going to find scapegoats. If a bill never even comes up for a vote in the House, Ryan will be the most obvious target to choose. 

If, however, the bill dies in the Senate, then partisans might be deflected towards blaming Democrats for filibustering, or at least (from Ryan's perspective) blaming McConnell for the failure. Or the Republican Senators who would vote against it. Anyone but him.

Even if the bill winds up failing on the House floor, it's possible Ryan could pin the blame on Republicans who voted against it, although that's a tricky one given that they could turn against him -- and that he would be forcing every House Republican to take a tough vote. That's because key Republican groups are splitting for (Chamber of Commerce) and against (Heritage, Club for Growth), which won't encourage House Republicans to have warm and cuddly thoughts about their Speaker. 

(Will Trump, who is still popular among Republicans, save Ryan? Perhaps -- but it's also entirely possible that Trump, despite spending March trying to pass the bill, could turn around and claim he had always opposed the "Congress" bill and predicted it would fail, while touting his own soon-to-be-unveiled terrific bill that gives everyone perfect coverage at lower prices).

Whatever happens, the last few weeks have been strong evidence that Ryan has utterly failed to fix the dysfunction in the House Republican conference that plagued Speaker John Boehner. But perhaps Ryan can at least prevent himself from becoming Conservative Enemy #1. At least, that seems to be what he's trying to do. 

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

  1. To be specific: Senate passage requires defeating a filibuster, which takes 60 votes, or using the reconciliation procedure, which allows the 52 Republicans to win but can only be used for some of the things they want to do. 

To contact the author of this story:
Jonathan Bernstein at jbernstein62@bloomberg.net

To contact the editor responsible for this story:
Mike Nizza at mnizza3@bloomberg.net

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