Can Republicans Get an AHCA Bill to the President’s Desk?
Republicans have a problem in getting an AHCA bill to the President’s Desk, not just because of the different factions within the party, but how those factions differ between the House and Senate. The problem the Republicans have comes from how senators and representatives are elected. Senators run statewide, so those from states that are not deep red have to be more moderate to get reelected. Many representatives run for reelection in safe, gerrymandered districts where the only threat to reelection is a primary opponent to their right.
In order to pass the bill, they have to pass the exact same version in both the House and Senate, before getting the signature of the president. The House bill was scrapped by the Senate, and they are currently writing a new bill in secret, which means it has to be passed by the House before going to the president. If it passes the Senate, goes to the House and is amended in any way, then it goes to reconciliation.
In the House they were only able to pass the AHCA bill by making it more mean, and getting the support of the ultra right-wing Freedom Caucus. Even then, they were a few votes short. They got those votes by convincing a few moderate Republicans in the House that the bill would be thrown in the trash by the Senate. When the bill went to the Senate, they did exactly that. In the Senate, the best chance for the bill to pass is with the support of a handful of moderate Republican senators from swing states. So if the secret Senate version passes, the GOP will have passed two different versions of the AHCA bill. One in the House written to appease the extreme right, one in the Senate to appease moderates.
To overcome this problem, McConnell might try to make the Senate bill just mean enough to appease the faction on the right. That would leave just a handful like Cruz, Lee and Rand who really just want a repeal of ACA with no replace. McConnell might calculate that they will not block a repeal, even if they don’t like the replace. Then his problem will be the moderate like Collins, Murkowski and Heller, swing-state Republicans from states where Medicaid was expanded. They are more difficult for McConnell to appease. If he moves too far left to get their votes, he loses not only those on the right in the Senate, but any chance of the bill passing in the House.
In order to go to the president’s desk, both the House and Senate must pass the exact same bill. While not impossible, it is no easy task. The House was unable to pass their version until they made it more mean. Conventional wisdom is that the Senate cannot pass their version unless they make it less mean. There is no indication thus far that they can agree on an appropriate level of meanness.