Health care reform

Congress' Libertarianish Members Might Sink the GOP Obamacare Replacement

"I think there are going to be some very confusing votes in here," Rep. Thomas Massie predicted in January. Here's how we got from there to here.

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Jeff Malet Photography/Newscom

On January 13, a week before Donald Trump would take the oath of office and just days after the new session of Congress opened, Republicans in the House passed a budget resolution that was the first step, GOP leaders said, to repealing and replacing Obamacare. The bill passed, 227-198, with just nine Republicans defecting from the party-line effort.

Among those nine "no" votes were the two founding members of the House Freedom Caucus: Reps. Justin Amash (R-Michigan) and Rep. Raul Labrador (R-Idaho). Another "no" came from Rep. Thomas Massie (R-Kentucky), who isn't a member of the Freedom Caucus but shares many of the small-government, libertarian leanings of the group.

"We got a category five hurricane coming when you have to reduce to practice, the differences between Donald Trump's agenda and Paul Ryan's agenda," Massie told Roll Call after the vote. "I think there are going to be some very confusing votes in here."

How right he was. That January 13 vote was the first sign—a telling one, in retrospect—that the Freedom Caucus and other libertarian-leaning members of Congress (like Massie and Sen. Rand Paul of Kentucky) would become the biggest stumbling block to passing the House GOP healthcare plan. That bill is scheduled to receive a floor vote Thursday that, if the Republican leadership can cobble together the votes, would approve the American Health Care Act (AHCA) as part of that budget resolution that initially cleared the House on that Friday the 13th.

With the House vote on the AHCA looming on Thursday, Republican leaders can afford to lose 22 votes from their ranks. As of Wednesday evening, vote tallies tracked by various media outlets suggest anywhere from 23 to 29 Republican lawmakers intend to vote against the bill—enough to delay the vote or force significant changes to the bill. A significant number of those "no" votes come from Freedom Caucus members, including Reps. Dave Brat (R-Virginia), Mo Brooks (R-Alabama), Paul Gosar (R-Arizona), Jim Jordan (R-Ohio), and Mark Sanford (R-South Carolina), among others.

Freedom Caucus members have been skeptical of the AHCA almost since the moment it was publicly unveiled. "It's Obamacare in a different format," Jordan told The Atlantic on March 6, just shortly after Republican lawmakers got their first look at the proposal.

Amash was on the same page:

Though the Freedom Caucus never took an outright position on the bill, the handful of individual members who promised to vote against the bill have succeeded in at least complicating the Republican effort to get a majority. "I don't think there is any tinkering that will get us to 218," Labrador predicted in an interview with CNN.

There's still time for that to change, however, and House Republican leaders were reportedly considering substantial rewrites to the AHCA on Wednesday night. Depending on what changes, some of those expected "no" votes could swing to "yes" votes before the bill hits the floor.

Massie is less likely to be swung. On Wednesday, he tweeted a picture indicating that his vote had changed from "no" to "hell, no."

Rep. Mark Meadows (R-North Carolina), chairman of the Freedom Caucus, told CNN on Wednesday that he was still a "no" and other members of the group promised to sink the bill even after meeting with President Donald Trump at the White House. By late Wednesday night, though, Meadows' resolve seemed to be wavering as conservative Republicans and the Trump White House continued to negotiate.

While obviously not a member of the House Freedom Caucus, Sen. Rand Paul (R-Kentucky) has been bird-dogging his like-minded colleagues in the lower chamber over the healthcare bill. He led reporters on a search for the bill, crossing from the Senate side of the Capitol to the basement room on the House side of the complex where it supposedly was being drafted. He was turned away at the door by a House GOP staffer.

After finally laying eyes on the bill a few days later, Paul didn't hold back. "This is Obamacare light. It will not pass. Conservatives are not going to take it," Paul told Fox & Friends. He said the bill would "do nothing" to bring health care costs down or to restrict the steady rise of premiums and took to Twitter to issue a beat-by-beat takedown of the proposal attacking it for keeping several elements of the Affordable Care Act intact, including subsidies for buying insurance (which would become a refundable tax credit in the House GOP plan) and the so-called "Cadillac Tax" on top notch insurance plans.

Paul will be central to the AHCA's prospects in the Senate—if it gets there. As of Thursday morning, it's impossible to say whether it will.

Opposition from conservative and libertarian-leaning Republicans in Congress has been bolstered by criticism from right-leaning and free market think tanks.

Michael Cannon, director of health care policy for the Cato Institute, said the proposal was "worse than Obamacare" when it was first introduced. Even after mild changes in the past week, Cannon on Tuesday was unmoved. "The amendments do not even come close to fixing the problems with this fatally flawed bill," he wrote. By expanding a provision that would replace Obamacare's health insurance subsidies with tax credits, Cannon said, "it will make the bill resemble Obamacare even more."

The Heritage Foundation has opposed the health care bill since it was introduced. Freedom Works, a conservative group with a direct line to the grassroots organizers that helped elect many of the Freedom Caucus members (and plenty of others) sent a letter this week calling for the bill's defeat. Club For Growth, which funds conservative campaigns, launched a $500,000 advertising effort this week targeting 10 moderate Republicans who have supported the health care bill.

Pushing a major entitlement reform through Congress without support from the liberty-minded crowd is no longer as easy as it once might have been.

NEXT: Brickbat: Take It Off

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  1. That sound you hear is the chickens coming home to roost.
    Buk-buk-buk-bukaaaww!

    1. I though Obama was in Hawaii. I did not know he went into a roost. Good impression of Obama though. I always thought Obama sounded more like…
      Arrested development chicken

      1. hahahahaObama

  2. Update on the Rachel Dolezal of libertarian opinion journalists:

    Nick Gillespie’s privileged white immigrant ancestors hardest hit

    1. Yokel’s Yokel Takes Break From Chicken Love To Approvingly Cite Washington Post; Absolutely No One Hard Hit At All

      1. What happened to #s1-5?

        1. “Not entirely successful.”

  3. But Trump said it would be something wonderful. Why they no like wonderful?

    1. Something about the Emperor having no clothes.

    2. Don’t you “wonder” why they couldn’t come up with something better?

      So, there you go: it’s “wonderful”.

      1. It’s also awesome, in that i am in awe of the depth of bullshit required to think this plan represents progress in any direction.

  4. Okay, i sort of like Massie now.

  5. Reason, your bar for “libertarianish” is incredibly low.

    1. That’s why it’s “ish,” which is Latin for “sorta.”

    2. If you’re inclined to seek out freedom-ish types among willing participants in Leviathan, i suppose you takes what you can get.

    3. Not nearly as low as the bar the Trumpetarians are using.

  6. Keep in mind this is only phase one of the plan, you have phase two – which is really not a phase – and then phase three a lot of the goodies are added in. The end result is when you’re at phase one, phase two, phase three, it’s going to be great.

    Translated from the Trumpese this is almost literally:

    Step One – Fiddle around with Obamacare
    Step Two – ???
    Step Three – Profit!

  7. Donald J. Trump
    ? @realDonaldTrump
    So-called “Congress” has no balls. Maybe traitors? Sad!
    6:40 AM – 23 Mar 2017

    1. The sad part is I had to go check and see if that was real or not.

      1. It’s funny ‘cuz it might be true.

  8. “Congress’ Libertarianish Members Might Sink the GOP Obamacare Replacement”

    Let’s hope so.

    1. Let’s hope not. With 22 votes, they don’t have a snowball’s chance of implementing anything (and I doubt they have much that’s positive to offer either) so all they can do by sinking the GOP plan is to save the GOP from owning that failure and facing the electoral consequences for its failure.

      Positive reform will only occur when both parties own their own putrescent meadow muffins.

  9. We were in this situation in the 1990s w.r.t. Hillarycare. It’s a defect of representative democracy/republic that the representatives have very crude tools to divine the will of the electorate. However, when Wofford won a special election to the US senate campaigning on health care, that was taken as a signal the country wanted socialized medicine. However, many compromises w interest groups were made to try to get a bill passed, & they couldn’t unite behind 1, so Hillarycare never passed & the status quo continued. Opposition came from both the “left” & the “right”, so nobody could tell whether the people wanted medicine more socialized, less socialized, or just differently socialized.

    History repeats, only now the ACA is the status quo. My general sense is we’ve got to do something fast just to stir the pot & keep the status quo uneasy.

  10. Fuck. Where is the nearest Democrat to blame. They have absolutely no power? Fuck!

    1. You seem to think we’re Republicans. You keep being wrong.

  11. Funny that all these ‘libertarianish’ Congresscritters have an (R) after their names. Surely there must be some (D)s who are willing to support liberty by opposing this re-codification of multiple onerous aspects of Obamacare?

    Surely there must be at least one?

    1. There are, but Libertarians are getting smeared with a Republican brush so they don’t use the term.

    2. The Democrats are just assumed to be united against it, so no one talks to them. Republicans have enough votes in the House to pass it without Democratic support, so the ball is in their court to get their shit together and write something they all support. Even after 7 years, they have not even come close to doing so.

      It’s like they never actually expected to be in power or something.

  12. Why can’t they just let Obamacare die on the vine and let the Democrats own it? Can’t get out of their own way.

    1. A reasonable person could ask them why they, with complete control of the government, couldn’t fix it. Choosing the status quo is an affirmative choice!

      1. You can’t “fix” stuff with government. The best you can hope for is to leave it alone and cease screwing it up.

      2. Obamacare doesn’t need fixing, it’s got everything the Democrats wanted, so it must be perfect.

    2. Because claiming that it’ll die on its own is a myth

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  14. Lol.

    No, this disaster of a bill will pass. It will be passed with no more than 12-15 house critters and 2 senate critters voting for it.

    There is no Libertarianish there is only Republican

    And reason.com Republicans will love the bill that will be passed without a score

  15. It’s things like this which make me wish Rand had won the republican nomination …

  16. So, in the one article I’ve seen so far on Reason mentioning that the Freedom Caucus is attempting to torpedo this monstrosity there is somehow no mention whatsoever of Trump’s threat to primary anyone who’s against him on this.

    Figures.

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  18. The GOP should thank God if the bill dies. It will be no better than Obamacare but it’ll be THEIR God awful bill instead of the Democrats’ God awful bill.

  19. Why not try piecemeal fixes? Not every issue requires a thousands-long bill.

    First, define what you want. Then, try small stuff first: Like “We’ll allow insurance policies to be sold over state lines”. See what happens. If that resolves the issue, then it’s done quickly and easily. If it doesn’t, then see what else can be done.

    But I suspect expanded risk pools will do far more to lower costs with insurance than anything else.

    1. Bureaucratic inertia makes it extremely difficult to pass anything of any size, so it’s a much better strategy to pass as much as possible in one shot.

    2. Lol at you kids thinking state lines increases costs.

      Name me one country with “free-market” healthcare.

      Oh, you can’t? Ok.

  20. Lol at you kids thinking state lines increases costs.

    Name me one country with “free-market” healthcare.

    Oh, you can’t? Ok.

    Wonder why.

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