Republicans see political necessity in health care effort

Sen. Cory Booker, D-N.J., and Sen. Ben Cardin, D-Md., pat Sen. Bernie Sanders, I-Vt., center, on the back as he leaves after speaking at a rally of health care advocates, grassroots activists, and others outside the Capitol in Washington, Tuesday, Sept. 19, 2017. Senate Republicans begin another push to repeal the Affordable Care Act with the Graham-Cassidy proposal. (AP Photo/Andrew Harnik)

WASHINGTON — It’s divisive and difficult, but the Republican drive to erase the Obama health care overhaul has gotten a huge boost from one of Washington’s perennial incentives: political necessity.

In the two months since Senate Republicans lost their initial attempt to scuttle President Barack Obama’s statute, there’s fresh evidence GOP voters are adamant that the party achieve its long-promised goal of dismantling that law. This includes conservative firebrand Roy Moore forcing a GOP primary runoff against Sen. Luther Strange, R-Ala., who’s backed by President Donald Trump, and lots of money, plus credible primary challenges facing Republican Sens. Jeff Flake of Arizona and Nevada’s Dean Heller.

“Republicans campaigned on this so often that we have a responsibility to carry out what you said in the campaign. And that’s as pretty much as much of a reason as the substance of the bill” to support it, Sen. Charles Grassley, R-Iowa, told Iowa reporters in a conference call Wednesday.

“That base is so insistent. You made this promise, stick to it, and you’ll be penalized if you don’t,” said Bill Hoagland, a former top Senate GOP aide and health policy expert.

GOP Sens. Bill Cassidy of Louisiana and South Carolina’s Lindsey Graham have spent weeks concocting and selling the party’s new approach to scrapping Obama’s law. They say their proposal, shifting money and decision-making from Washington to the states, nearly has the votes it would need in a showdown expected next week, a deadline that’s focused the party on making a final run at the issue.

Graham and Cassidy would end Obama’s requirement that most people buy health coverage and larger employers offer it to workers. It would let insurers charge higher premiums to seriously ill customers and cut Medicaid, the health insurance program for the poor, over time. Money from the law’s Medicaid expansion and cost-reductions it provides lower-earning people would be folded into block grants dispersed to states –totaling $1.2 trillion over seven years — with few federal strings attached.

The new package has clear appeal to most Republicans. It would wed the party’s oft-repeated goals of uprooting Obama’s law and shipping more power and plenty of money back home.

“We have ONE LAST CHANCE to repeal and replace the most intrusive, overbearing health care law in the history of our country,” Cassidy emailed supporters Wednesday.

Republicans commanding the Senate by a 52-48 margin must stage the vote before Sept. 30, when special protections expire that have shielded the measure from needing 60 votes to pass. Three GOP defections would sink the measure because of solid Democratic opposition.