Republicans in the House kept their promise to repeal Obamacare on Thursday by passing the American Health Care Act (AHCA). The bill was destined to be controversial — substantial changes to popular aspects of Obamacare were required in order to get ultra-conservative representatives on board. Not surprisingly, those changes have prompted widespread criticism of the AHCA, which will make the job of the Senate GOP even harder. When they return from recess, Republicans will need a certain number of votes in the Senate to pass the AHCA, and at least 50 of their 52 GOP senators will need to vote "yes" on it.
Those senators have their work cut out for them. The upper chamber is generally far more moderate than the House; it's unlikely the AHCA concessions demanded by far-right representatives in the Freedom Caucus will be approved by the Senate. And many senators have signaled they will use the current AHCA simply as a launching pad for crafting their own legislation. "I turned the volume off some time ago and have no idea what the House is even passing," said Sen. Bob Corker. He is hardly the only Republican senator to dismiss or take issue with the current House bill. In fact, getting the Senate GOP to the minimum 50 vote threshold could be a "near-impossible" feat, according to Sen. Orrin Hatch.
Ideologically, the senators upon whom the AHCA now depends represent varied and at times contradictory visions of the GOP. The three most conservative members — Sens. Ted Cruz (R-Texas), Mike Lee (R-Utah), and Rand Paul (R-Kentucky) — will probably want to keep the House bill as is, or even introduce further cuts and deregulation. On the other hand, Sens. Lisa Murkowski (R-Alaska) and Susan Collins (R-Maine) are far more likely to oppose the bill for defunding Planned Parenthood, among other problems they see. "All of the demographic factors don’t play well with the approach the House is taken,” Murkowski said of how the House's original AHCA bill would impact her state's sparse and aging population.
And there are other hurdles for the AHCA — many, in fact. Perry Bacon, Jr. gives a rundown at FiveThiryEight of challenges for the legislation as it moves to the Senate and beyond. They include: Republican senators from Medicaid expansion states who would be voting against their own constituents; analysis of the new bill from the Congressional Budget Office (CBO) and outside groups that could "spook" hesitant senators; Republicans from blue states who care about re-election; and, the many and vocal groups opposing the AHCA.
The AHCA fight is now the Senate's problem. And for many Republicans in the upper chamber, it's shaping up to be a big one indeed. If they are able to secure the necessary 50 votes, it will likely be by crafting a substantially different bill.