The GOP's secret plan to repeal Obamacare won't work

The basic political problem he faces is simple: Republicans are in agreement that Obamacare should be repealed and replaced, but their agreement breaks down over what it should be replaced with.

A bill that keeps too much of Obamacare's spending will alienate conservatives who believe they were sent to Washington to pass a "full" repeal. A bill that cuts too much makes moderate Republicans squeamish, especially those who come from states that depend on expanded Medicaid.

So The Wall Street Journal reported early this week that Ryan's plan is to steamroll those objections: Bring a bill that comes down somewhere in the middle to the floor, and dare members on the conservative and moderate ends of his caucus to vote no.

Will that work? Maybe. But all you have to do is Google "Boehner pulls bill" to see how efforts to force unpalatable "must-pass" legislation through the House havegone years.

Based on his past experience trying to herd the Republican caucus, former Speaker John Boehner says he doesn't expect repeal and replace to happen.

But Ryan seems to intend to try, and Republican members of the House Energy and Commerce Committee are working on a repeal and replace plan in secret — a fact that has drawn objections not just from Democrats who want to protect Obamacare, but also from Sen. Rand Paul, the Republican from Kentucky, who fears the plan they are developing will amount to "Obamacare-lite."

Paul joined many House Democrats on Thursday in demanding the release of the draft bill. He brought a photocopier with him through the halls of the Capitol complex, saying he wanted to make copies of the bill widely available.

Objections from the right and the left

The problem with Ryan's approach is, sooner or later, the committee has to release the bill text, at which time it will face predictable objections from both the right and the left.

You can see some of the likely objections from Republicans' right flank in Thursday's tweets from Paul. Conservative Rep. Mark Meadows of North Carolina asked,

The big problem is the Senate

In recent years, fights over "must-pass" legislation in the House have tended to end with Republican leadership having to shift bills far to the right to secure passage, which would tend to mean greatly reducing spending and subsidies.

Maybe, by doing that, Ryan will be able to get a bill through the House. But what about the Senate, where the Republican majority is narrower and the caucus is more moderate?

Several Republican senators have expressed significant reservations about whether the replacement plan will do enough to protect those who depend on the Affordable Care Act. They have been adamant about the need to have a full replacement in place before repealing Obamacare.

Republican Sen. Lisa Murkowski, for example, says she won't vote for a package that scraps the Medicaid expansion as long as Alaska lawmakers want it.

This makes me think it's very unlikely that a bill that can be rammed through the House can also pass the Senate — and therefore that it is unlikely that Ryan's strategy will lead to enactment of legislation.

But maybe that is what Paul Ryan is up to.

As Brian Beutler of the New Republic notes, forcing a bill down the throats of House Republicans only to see it die in the Senate is not an effective strategy for repealing Obamacare. But it could be a very effective strategy for getting conservative voters to blame the Senate, not the House, for Republicans' failure to repeal Obamacare.

The missing variable is Trump

The one thing that would lead me to change this view that Republicans are not headed for repeal would be if Donald Trump weighed in strongly to pressure Republicans in both chambers to vote for a specific bill they have major reservations about.

Complicated legislation involving lots of tradeoffs tends to pass when the president brings pressure to bear on his party in Congress, as with the Medicare prescription drug benefit under George W. Bush or the Affordable Care Act itself.

So far, Trump has shown no inclination to do that — in fact, he has warned his party against the trap of taking ownership over problems in the health care system. He settled none of the major internal Republican disputes over healthcare policy in his address to Congress on Tuesday.

Politically, he's wise to talk a big game about healthcare while avoiding getting his fingerprints on it too much. But it's not a strategy that augurs for actual repeal and replacement.