When it was his turn to speak at the jubilant press conference celebrating the House’s historic vote to begin the process of taking healthcare away from millions of people, Paul Ryan took a shot at the Senate, which will take up healthcare repeal next.
Everyone was so worked up after the House narrowly passed the AHCA that you could have almost forgotten that they had only just begun the process of repealing and replacing Obamacare. But this sarcastic aside stood out as the only moment in an absurd press conference that acknowledged simple Schoolhouse Rock reality: For this bill to become a law, the Senate has to pass it.
Trump and Ryan obviously have an extremely high opinion of this bill. “Premiums are going to be coming down. Deductibles are going to come down,” Trump said. “More importantly it’s a good plan and ultimately that’s what it’s all about.” (The CBO is expected to report that the bill will increase premiums and deductibles; also, no one who wasn’t standing within six feet of Trump on Thursday thinks the “plan” is good.)
But the Senate, which currently holds the fate of Obamacare in its hands, does not seem to be too excited about what they’ve just been passed along. Instead, Senate Republicans have decided that they are going to write their own bill, though they say they’re going to consult the House’s version. “The safest thing to say is there will be a Senate bill, but it will look at what the House has done and see how much of that we can incorporate in a product that works for us in reconciliation,” Senator Roy Blunt, R-Mo. said on Thursday.
Senate Majority Leader Mitch McConnell has indicated that he won’t bring a bill to the floor that doesn’t have the votes—the clear subtext here is that the House bill obviously does not have the votes to pass the Senate.
At the very least, this means that the health care debate is going to be drawn out. “There’ll be no artificial deadlines” in the Senate, Lamar Alexander told The Huffington Post. “We will make sure we know what our bill costs when we vote on it. The mood, at least in the Republican caucus, is we’d like to get to yes if we can. Now we have many different opinions, and no one doubts this is difficult.” The Senate, for instance, is more likely to push to keep Obamacare’s Medicaid expansion, something that is probably a nonstarter in the House. If the Senate does pass its own version of the bill, it would get sent to a conference committee which would try to find a compromise.
Given the mood in the House, particularly in the Freedom Caucus, a compromise between the Republican House and the Republican Senate seems unlikely. Donald Trump may think that the AHCA is “something very, very incredibly well-crafted,” but it’s going to either change substantially or die.