Speaker Paul Ryan (R-WI) just barely jammed the American Health Care Act through the House of Representatives two weeks ago. Now he might need to do it all over again — and it could be even harder this time around.
If this second vote does need to take place, it will be a direct consequence of the rushed, haphazard manner in which Ryan slapped the bill together and got it passed. Originally, the AHCA — colloquially known as Trumpcare — was supposed to be engineered to pass through the Senate by reconciliation, a parliamentary maneuver that would allow Senate Republicans to bypass any threat of a filibuster and approve the law by a straight majority.
But not just any bill can be approved through reconciliation. And in Ryan’s haste to get AHCA out of the House, he might have created something that doesn’t make the cut.
We’ll know for sure next week when the Congressional Budget Office releases its updated AHCA analysis, which needs to be revised pending some last-minute changes made to the bill before the House vote. Experts believe the new CBO score needs to find savings of at least $2 billion in the updated bill in order for it to qualify for reconciliation, Bloomberg reported on Thursday. The same Bloomberg story noted that House Republicans have yet to formally submit the AHCA to the Senate.
The last CBO analysis found that, if passed, AHCA would cause 24 million people to lose insurance over the next 10 years. The updated analysis is unlikely to be much kinder, given that the most significant revision made since then was to allow state waivers on basic health care requirements.
Though it now seems to have backfired, scheduling a vote before the CBO had time to release a new score was by design. Their previous analysis had added fuel to the stunning backlash Republicans faced for introducing the AHCA, which dragged the law’s approval rating down to a mere 17 percent.
Even after his last-minute tweaks, Ryan was only able to get Trumpcare through the House by the most gossamer of margins. And if he needs to do it all over again, the next time might be even harder.
That’s partially because President Donald Trump is now embroiled in the biggest political scandal since at least Watergate. Multiple investigations of the president and allegations of obstruction of justice are likely to put a damper on any legislative priority that has its name on it. And House Republicans in vulnerable districts might feel more inclined to distance themselves from the party line in cases where the bill in question enjoys both Trump’s endorsement and widespread unpopularity.
The other problem facing Ryan is that there are three upcoming special elections in the month or so to replace outgoing Republican House members. In two of those races in particular — in Montana and in Georgia’s sixth district — there’s a real chance the seat could flip blue. And even one or two fewer Republican House members could spell death for Trumpcare.
Next time, just wait for the CBO score.