Senate Republicans have been trying to rush through a vote on their health-care bill because it's now or possibly never do it.
Unfortunately for Republicans, things stand closer to “never” than “now.” They just delayed a vote because at least four Republican senators say they will vote down even a procedural vote to allow an up-or-down vote on health care. That's enough to stop this bill in its tracks.
So, what options do Senate Republican leaders have to try to find a deal on their health-care bill? A couple of not-great options. Like:
1. Keep negotiating and try to bring it up for a vote in the next week or two
But: The longer this bill stews, the more time Republican senators have to stew over it. There's a reason Republican leaders wrote this bill in secret and only gave the Senate a week to look it over. They don't want senators to go home next week for the Fourth of July holiday and get berated by voters. It's a process that tends to make lawmakers less — not more — amenable to compromise. More time also gives opposition groups on both the right and left time to coalesce against the bill.
Actually, that's not hard to do given 62 percent of Americans disapprove of the Republicans' health-care plan, according to a recent Quinnipiac University poll. Just 6 percent “strongly” approve of the legislation.
“If the Senate can't get it done now, I don't see how they're going to get it done later,” said Paul Ginsburg, a health policy expert with the University of Southern California's Schaeffer-Brookings Initiative, “because the bill is just not very popular with the public.”
(Republicans could always postpone their week-long break and try to keep senators in Washington, away from angry constituents. But, Fourth of July parades!)
2. Put off tax reform
But: Republicans are also rushing to pass health care now because they're running up against a legislative deadline. For Senate Republicans to avoid a Democratic filibuster, they have to pass this bill while they're debating the budget. (I've got an explainer on the reconciliation process here.)
By this summer, Republicans had hoped to wrap up health care, because that's when they need to start planning for next year's budget, which is due Oct. 1. They had hoped to use that budget process to pass tax reform — again under a budget rule that lets them duck Democrats' wrath.
October is coming up sooner than we realize, especially when you consider that Congress is taking all of August off. So if Republicans don't pass health-care reform in the next few weeks, they'll likely have to choose: tax reform or health care.
“Until health care is off the budget tracks,” said Sarah Binder, a procedural expert at the Brookings Institution, “a tax reconciliation bill is stuck in the rail yard.”
3. Put this off until next year and do low-profile tweaks with Democrats to Obamacare
Here's another idea: Just set health care aside. Republicans can say they're still negotiating health care, says Alice Rivlin, Brookings Institution's health and economics fellow, but they can quietly push it under the rug.
When things calm down, lawmakers can revisit this and make tweaks to Obamacare that both parties can sell back home.
But: In 2018, most of Congress will be singularly preoccupied with surviving their reelection that November. And just like getting yelled at by constituents, elections make lawmakers less — not more — likely to compromise with the other side.
4. Give up and say they tried
As far as Senate Majority Leader Mitch McConnell (R-Ky.) is concerned, it's not the end of the world if Republicans can't pass health-care legislation, especially if that legislation could leave 22 million fewer people uninsured over the next decade.
Republicans could say they tried their best and hope that their base doesn't get too riled up that Obamacare is still the law of the land.
But: It's not perfect, but giving up on health care may be the best option Republicans have right now.