Two days after a Republican Florida federal court judge voided the entire health care law, the multi-front Republican war against it continues in the Senate, where members will vote today on whether or not to just repeal it, full stop.
Simultaneously, Republican members are trying to sneak grenades into the heart of the law, crafting modifications which they admit are meant to destroy it.
But that presents them with a conundrum when they head back to their states and districts and face constituents who stand to benefit from the law right now — seniors who are entitled to free checkups, and young adults, who can now stay on their parents’ insurance until they turn 26, for example. Republicans can chose to help those constituents navigate the law — answer their questions constructively, encourage them to seek those benefits — or they can let their political agendas interfere.
Different strokes for different folks.
“I’m a practical guy. I believe redoing the bill and replacing it is the best for everybody. Until that day comes, if you have a legitimate need under the current structure, I’ll help you meet it,” said Sen. Lindsey Graham (R-SC). “It’s like the stimulus funds — I voted against it but, you know.”
A number of provisions in the bill, Graham says, he’d like to see in a successor law.
“There’s some things in there like parents being able to keep their kids on insurance while they’re going to school — that’s good stuff. There are things that I do [promote].”
Not everybody shares that ethos.
“No, I don’t,” said Sen. Bob Corker (R-TN). “I personally believe there’s a very good chance that the Supreme Court will say that this bill in fact is not constitutional. And my sense is we may be back at the drawing board doing something that is very much different than this as it relates to health care reform.”
“I don’t think I’ve ever — I know that I have not encouraged people to do that,” Corker added.
As part of his bid to undermine the law, Sen John Barrasso (R-WY), along with Graham, wants to allow states to opt out of its key provisions, thereby undermining its efficacy. Instead of pointing his constituents to the good stuff now, he envisions states providing similar benefits on their own once the law fails.
“75 percent of the people in Wyoming want this repealed. This is a direct affront to their rights. That’s what they’re focusing on,” Barrasso said. “There are things that the states can provide. And they can opt-out [of the law] and get it within their own states.”
The fact that many of the constituents of the law’s opponents have already benefited from the reform hasn’t gone unnoticed by the law’s supporters. “[Mitch] McConnell should go door to door in Kentucky and tell thousands of seniors to cough up the $250 donut-hole checks they received from the new health care law to buy their prescription drugs,” said Ethan Rome, executive director of Health Care for America Now, in a statement.
There hasn’t been such partisan warfare about a bill or law since, perhaps, Republicans (and a few Democrats) passed Medicare Part D — the prescription drug benefit — back in 2003. In a fight that in some ways mirrored the health care reform debate Democratic principals trashed the bill and the legislative process until the moment it became law. There was no talk of “death panels” but it was no secret that Democrats hated that bill, wanted to do it themselves — make sure it was paid for, close the doughnut hole, and otherwise improve it.
Once it passed, though, things changed.
At the time, Sen. Sherrod Brown (D-OH) was ranking minority member on the House Energy and Commerce Committee’s Health Subcommittee. He was one of the Medicare bill’s most vocal critics, but he changed tone after his constituents served to benefit from it.
“It was the law of the land, and you set out and you do the best for the people you represent,” Brown told me after the State of the Union address. “I worked with senior centers. I recall I sent out missives of some kind… to seniors and senior groups to make sure that they could benefit from this under the law, but again, making sure that the drug companies and insurance companies watching them, that they weren’t gaming the system with higher premiums and taking people off formularies, and all the things that the drug and insurance companies are pretty good at doing.”
In Republican Ohio today, Brown sees a different dynamic.
“All I can see is a bunch of conservative Washington politicians who have been benefiting for their whole political careers… from tax-payer financed health insurance taking benefits away from seniors and taking benefits away from families,” he said.
Brian Beutler is TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight, and the debt limit fight. He can be reached at email@example.com.