On Obamacare, don’t get distracted by Ted Cruz & Rand Paul: Focus on the moderates

I had mixed feelings when I heard that four of the most right-wing members of the U.S. Senate –– Ted Cruz, Rand Paul, Mike Lee and Ron Johnson ––were opposed to the current version of the Obamacare repeal bill. Any obstacle to 50 votes in the Senate is one I support, but the prospect of Mitch McConnell “improving” the bill by meeting the demands of the most extreme wing of the GOP was hardly comforting.

I was much happier to see Sen. Dean Heller of Nevada announce his opposition. The words he used to describe his position reflected the narrative that Democrats should hope the American public buys:

“I cannot support a piece of legislation that takes insurance away from tens of millions of Americans,” he said.

Heller also specifically noted that he could not support a bill that wouldn’t “protect Medicaid expansion states.” He said that standing next to Nevada GOP Gov. Brian Sandoval, perhaps the most enthusiastic GOP supporter of the Medicaid expansion. As I explained yesterday, the Medicaid expansion is by far the most important part of the ACA and Democrats should be putting much more of a spotlight on it in their efforts to defend the law.

I hope that Heller’s statement means that he cannot be persuaded to support the bill through a couple superficial concessions. This back-and-forth between Republicans about how quickly the repeal bill should eliminate the Medicaid expansion, for instance, is nothing more than bickering over PR. A senator whose state has benefited from the expansion cannot claim to be looking out for his constituents if he accepts any plan that eventually eliminates it.

Assuming Heller is a sincere nay, we only need two more Republicans to find their conscience or at least become convinced that voting to end health care for millions is politically untenable.

My guess is that Susan Collins, the closest thing that remains to an old-school moderate Republican, will not be able to support the current bill. It’s just too bad that because of its knuckle-dragging governor, Maine is the only northeastern state that has not expanded Medicaid. As a result, the harm done by repealing the ACA will be less evident in Maine than in most other states.

The next most likely opponent of repeal might be Lisa Murkowski of Alaska. Her state expanded Medicaid and Murkowski, one of only a couple pro-choice Republicans left in the Senate, has been adamant about protecting Planned Parenthood funding, although it’s unclear whether the final bill will including a provision relating to PP.

Susan Collins (right) and Lisa Murkowski. Credit: Politico

There are a few other senators who are definitely hesitant to vote for the current bill, either due to personal beliefs or because of the enormous benefit their state has derived from the Medicaid expansion. Those include Shelly Moore Capito of West Virginia, which benefited enormously from the Medicaid expansion, Rob Portman of Ohio and Corey Gardner of Colorado, among others. The New York Times actually has a useful graphic showing Republican senator’s position on the ideological spectrum and what they’ve said about the bill so far.

We can’t just hope that the GOP’s right-wing torpedoes the bill. It’s by putting pressure on the moderates (they’re hardly moderate but whatever)–– or at least those who have to answer to moderate voters –– that we have the best shot of saving health care for tens of millions of people.