The stage is now being set in Washington for a legislative blitz to repeal key features of the Affordable Care Act. As has been long evident, Republicans plan to use the budget process to do so because its special procedures don’t allow a Senate filibuster, usually the main choke-point for controversial legislation (ending a filibuster requires a cloture vote, which in turn takes 60 votes to go into effect). So the GOP can do pretty much anything it wants with 50 votes so long as it is (in the opinion of the Senate parliamentarian) germane to the budget. There has been interminable debate among wonks about which features of the Affordable Care Act are budget-germane, but it is clear Obamacare can be effectively disabled if not entirely swept away through this method.
Democrats fighting a budget-enabled Obamacare repeal can’t defeat or indefinitely delay the inevitable so long as Republicans remain united. But a quirk in the budget process will enable them to offer a lengthy series of shrewdly worded amendments that at best could split the GOP and imperil final passage of the repeal, or at least could put Republican senators on the record with controversial votes. The knowledge these votes are coming could affect how far Republicans go in demolishing Obamacare, and later on, what they feel constrained to include in the “Obamacare replacement” bill that would presumably be enacted before the repeal fully takes effect.
The flip side of the time limits for Senate debate in the budget process is that the number of amendments voted on without debate cannot be limited at all. This leads to the strange Senate institution of the “vote-a-rama,” a marathon series of votes on budget measures that can take days or even weeks to conclude. Exploiting the “vote-a-rama” will be central to the scorched-earth strategy Democrats plan to pursue as Republicans dismantle Obamacare. As Politico reports:
“They’re going to try to rush this through so fast that the American public can’t see what they did,” said Sen. Chris Murphy (D-Conn.). “It’s in our interest to make this process go long enough so that people can see what a debacle this is.”
Easy targets would be amendments that preserve preexisting condition requirements “for each individual major illness in this country,” Murphy said.
The unlimited vote process “presents a very good opportunity to delay and extend the debate, and put a really big national focus on the debate highlighting stories of real people who would be affected,” said Topher Spiro, vice president for health policy at the liberal Center for American Progress.
Democrats will get two opportunities to dramatize controversial features of the Obamacare repeal via a “vote-a-rama,” because there are two stages to the budget process. The first is the passage of a budget resolution (as a congressional resolution, it does not have to be signed by the president), which sets broad spending and revenue parameters for the fiscal year, and, more crucially, authorizes the preparation of a budget reconciliation bill to implement the resolution. Yesterday Senate Budget Committee chairman Mike Enzi, a Republican from Wyoming, introduced the budget resolution designed to authorize the repeal of Obamacare. It’s a vague, bare-bones measure that really just puts the ball into play. But the first Democratic-generated “vote-a-rama,” which will occur in a few days when Enzi’s resolution hits the Senate floor, will flesh out its implications and potentially add details to the “reconciliation instructions” that guide the next stage of the process.
Assuming the budget resolution survives the first “vote-a-rama,” which it will if Republicans have their act together, it will be briskly passed by the House, where both debate and the number of votes are strictly limited. The goal for that action (according to a timetable written up by Dan Diamond) is to get it done by Inauguration Day. Then, the next stage of the process begins as the House puts together and debates the reconciliation bill that will actually repeal Obamacare. It’s at this point that Republicans will have to answer the very tricky question about the effective dates for the various parts of the repeal: Is it two years down the road, or three, or four, or will it depend on the provision? Another key decision is whether the reconciliation bill is strictly limited to Obamacare repeal, or includes other hot-button budget-related measures like defunding Planned Parenthood (which was part of the “trial run” reconciliation bill Republicans sent to Obama for a certain veto last year).
The reconciliation bill will presumably be passed by the House quickly (though Freedom Caucus concerns will influence its shape), and then the drama shifts back to the Senate, where there will be another “vote-a-rama” before final passage, probably in March.
Democrats will do everything possible to coordinate the vote-a-ramas with messaging and grassroots activity. If, for example, Senate Democrats offer seven amendments during each vote-a-rama continuing preexisting-condition protections for people suffering from particular ailments, people suffering from these ailments will show up at the Senate and state offices of Republicans thought to be vulnerable to pressure. Amendments involving the ACA’s Medicaid expansion that has covered an estimated 16 million people will be dramatized by protests from governors and state legislators (possibly Republicans as well as Democrats) about the human suffering and state fiscal damage that might ensue. In general, it’s all about taking an obscure and speedy budget process and creating dozens of lurid, free-frame images of measures that will affect real people in a terrible way.
The goal is to make a very big noise that might, possibly, sway a handful of GOP votes in the Senate — and if not, to delay the process for as long as possible and inflict as much political pain on the GOP as they can.
And if Democrats succeed in mobilizing a public backlash to elements of the Obamacare repeal, then it’s even possible it will produce one of those classic Donald Trump tweets intervening in the process and complicating everything for Republicans. At a minimum we can expect Trump to remind his congressional allies that the whole exercise is a waste of time unless he signs the reconciliation bill that makes it all real.
All in all, the process of repealing Obamacare isn’t looking like the slam dunk Republicans probably imagined when they were promising it without consequences during the last six years. And Democrats possess the strategic advantage of having very little to lose that they didn’t already anticipate on the shocking night of November 8.