Sen. Bill Cassidy held up bright red posters in a mostly empty Senate chamber Thursday for a presentation on how his ideas would pass the "Jimmy Kimmel Test," by helping people with preexisting conditions.
After the speech, Democratic Sen. Tim Kaine came to the floor and praised the wonkish Republican doctor from Louisiana. “I do applaud my colleague,” Kaine said. "Amen.”
The exchange was little noticed amid the uproar over FBI Director James Comey’s dismissal. But as Republicans try to repeal Obamacare on party lines, there are flickers of bipartisanship in the Senate — and they could become a lifeline if the GOP’s party-line efforts collapse and lawmakers come under pressure later this year to respond to crippled insurance markets and rising premiums.
Though Republicans guarantee there will be a partisan repeal vote at some point this year, some senators and aides believe the chances of failure are greater than success. Crafting a Plan B, they say, is wise.
“The stakes are high and the possibility for failure is high,” one Republican senator said of the partisan repeal effort. The senator said it would not be surprising if Republicans are forced to ultimately seek a deal with Democrats.
Talks between the two parties about a possible bipartisan plan have been sporadic. Other than Cassidy and Susan Collins (R-Maine) reaching out to Democrats lately, the chatter has cooled since the House passed its Obamacare replacement bill early this month with just a single vote to spare.
But several senators from opposing parties have been informally discussing possible fixes to Obamacare. Sen. Lindsey Graham (R-S.C.) has said repeatedly he’s uncomfortable with a party-line health care overhaul. "I hope for a bipartisan bill," Graham said shortly before the House passed its bill.
Collins said much the same in a recent interview.
“I really want us to have a bipartisan bill. I just think will be so much better. And we have better ideas," she said. "So that’s my goal. You end up with a better bill, you end up with better acceptance by the public.” Collins said a Democrat called her at 7:30 a.m. on Thursday to talk healthcare.
Cassidy and Collins’ efforts haven’t limited their talks to the handful of red-state Democrats whom the GOP once eyed as possible converts on health care. Sen. Tom Carper (D-Del.), for one, spoke to Cassidy in March about the Republican’s efforts and praised him for the outreach.
"Sooner rather than later, we’ll return to those discussions," Carper said.
In addition to Kaine and Carper, Sens. Joe Manchin (D-W.Va.), Heidi Heitkamp (D-N.D.) have spoken with Republicans in general terms about health care recently, according to several people familiar with the matter. Sen. Lamar Alexander (R-Tenn.), a leading figure in the GOP’s effort to repeal Obamacare, has also talked with Democrats including Kaine, though Alexander has mostly backed away since the House passed its bill last week. That plan would scale back Obamacare’s subsidies, slash its Medicaid expansion and give states the ability to allow insurers to charge more for people with preexisting conditions.
Any cooperation on health care undercuts both parties’ political strategy. Republican leaders are wary of handing any bipartisan accomplishments to the dozen-or-so vulnerable Senate Democrats up for reelection next year. And Democratic leaders want the GOP to fully own the beleaguered health care system going into the midterms.
So leaders in both parties are leaning hard on the rank-and-file not to cooperate. Senate Minority Leader Chuck Schumer (D-N.Y.) and his team want Democrats to refuse to work with Republicans until they drop the “repeal” crusade, while Senate Majority Leader Mitch McConnell (R-Ky.) is working only within his own party to craft a repeal bill that can pass with the votes of 50 of 52 GOP senators.
But not everyone is taking those marching orders to heart. Sen. Jon Tester (D-Mont.) and Kaine say the word “repeal” matters far less than finding a solution that improves upon Obamacare.
“Expecting them to all stand on the steps of the Capitol and say, ‘We’re dropping the word repeal as the price for sitting down together?’ That’s unrealistic,” Kaine said. “I don’t really care what we call it.”
Cassidy and Collins, meanwhile, have been pressing a bill that would keep intact significant parts of Obamacare for states that want to preserve it. The plan would likely need Democratic buy-in, though: Its provisions probably wouldn’t qualify for passage under reconciliation, the majority-vote budget tool that can be used to approve budget-related legislation along narrow party lines.
The duo met with GOP leaders this week about their bill but have been excluded from a larger working group trying to hammer out a GOP healthcare reform package. Theoretically, Republicans can repeal Obamacare without the support of Collins and Cassidy, but it would incredibly difficult. Doing so would mean keeping in line moderates like Sen. Lisa Murkowski (R-Alaska) and conservatives such as Sen. Rand Paul (R-Ky.).
“The only way you fulfill Trump’s contract with the American voter is through the Cassidy-Collins bill,” Cassidy said. Republican leaders “may leave us out” but “I don’t think they’re trying to.”
Talks across the aisle haven’t produced an actual proposal yet. And not all moderate senators have been included. Sen. Claire McCaskill (D-Mo.) said she hasn’t heard from a Republican about Obamacare since December, when Sen. Bob Corker (R-Tenn.) called her.
But she said that a failed Senate vote later this year would logically lead to collaboration among the chamber’s centrists. She said some Republicans are working on a fallback plan if their partisan effort crashes.
“They’re not repealing Obamacare, so they need to quit saying they are. They’re just changing it. I think all of us are open to changing it,” McCaskill said.
But even GOP senators who prefer a bipartisan solution say some Democrats are trying to have it both ways: They want to blame Republicans for trying to repeal Obamacare — and then jump in to look like bipartisan heroes.
“They’d really like to see us suffer a little bit on the political side before they start stepping in,” said Sen. Mike Rounds (R-S.D.), a supporter of the Collins-Cassidy bill. “Long term it would be better to do something side by side.”
Indeed, some of the chamber’s most conservative Democrats said that at this moment, they are unwilling to throw the GOP a lifeline until Republicans relax their anti-Obamacare rhetoric. Heitkamp, a moderate Democrat at the top of the Republican target list in the 2018 midterms, urged McConnell to drop his insistence on pushing through Obamacare repeal with only Republican votes.
And Manchin, another red-state Democrat up for reelection who has spoken with both Cassidy and Collins, said he’s told Republicans that a “repair under the existing framework we have, without saying we just have to repeal it,” would succeed. But "going down that road to say ‘repeal, repeal, repeal’" will fail, Manchin said.