Divide Among GOP In Congress Isn’t Going Anywhere

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Robert Donachie Capitol Hill and Health Care Reporter
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A rift between conservative and moderate Republicans in Congress is emerging, stalling nearly every legislative push of President Donald Trump’s administration.

At first glance, it would appear Republicans find themselves in a unique position to drive their agenda. The GOP has a president in the White House and an empirical majority in Congress — 238 out of 435 seats in the House and 52 out of 100 seats in the Senate.

Speaker of the House Paul Ryan told voters November 15 to prepare for “the dawn of a new unified Republican government,” a statement that withers in credibility with each passing day.

Every time the White House and Republican leadership in Congress attempt to push an agenda, differences in policy preferences between moderates and conservatives both robs Republicans of their political capital and derails any momentum the party builds.

Look no further than Trump and Ryan’s push in March to pass the American Health Care Act (AHCA), which marked the first time the divide between moderates and conservatives stymied legislative progress.

Disagreements between the conservative House Freedom Caucus (HFC) and the “centrist” Tuesday Group proved to be fatal for the AHCA in late March, forcing Trump and Ryan to pull the bill hours before it was slated to go up for a vote on the House floor.

Conservatives wanted to limit the government’s interference in the health care marketplace, while moderates believed that in doing so Republicans would leave millions of Americans without insurance — a situation that would prove disastrous in the 2018 mid-term election cycle. (RELATED: Meet The Group Of Conservatives Holding Up Obamacare Reform)

After a second round of negotiations, Chairman of the HFC Rep. Mark Meadows of North Carolina and Tuesday Group leader Rep. Tom MacArthur of New Jersey put forward an amendment that allowed both conservatives and moderates to support the AHCA.

With the addition of the MacArthur amendment, AHCA lets states opt-out of certain provisions of Obamacare through waivers. The amendment was a great sell in the House because it provided key concessions to both conservatives and moderates. Conservatives wanted states to have greater autonomy in implementing Obamacare, which they got through the waiver system. Moderates gained peace of mind in knowing that Medicaid customers, as well as pre-existing conditions, will still be protected under the law.

The Party did not have long to rejoice over their House victory. Before the AHCA hit the Senate, moderate and conservative senators spoke out against the bill, voicing many of the same concerns GOP representatives had previously articulated. Republican senators immediately signaled their plans to gut the AHCA and rewrite their own version of Obamacare reform.

The central point of contention between Senate moderates and conservatives  is whether or not to continue funding Obamacare’s Medicaid expansion program after 2020. (RELATED: GOP Senators Can’t Agree On Medicaid Reform)

Conservative senators are pushing for steep cuts to Medicaid but face a formidable obstacle from Republican senators in states that participated in Obamacare’s Medicaid expansion program.

Senate conservatives want an immediate roll back of the federal money granted to the Obamacare Medicaid expansion program under the rationale that serious cuts would force states to make prudent decisions regarding how they choose to spend Medicare funds.

Some 20 Republican senators are in states that chose to expand Medicaid under Obamacare, and many are concerned about the number of Medicaid recipients who would lose coverage under the AHCA.

If Republican lawmakers push for any more cuts to Medicaid funding, moderate senators are signaling it could mean the end of the line for the AHCA.

“As soon as you move further that direction, you’re going to lose about six or eight people. So I don’t see how that works,” Republican Sen. Shelley Moore Capito of West Virginia told reporters.

Trump is scheduled to release his first budget proposal Tuesday, which reportedly includes large cuts to major entitlement programs like Medicaid. His budget proposal is expected to follow the House Republican plan, which calls for an $800 billion cut to Medicaid over the next decade. (RELATED: Trump Backs Senate Conservatives In Gutting Medicaid)

Once again, disagreements among members of the president’s own party are likely to muddle his agenda.

While the move would align the president with conservative Republicans in the House and Senate, it positions him against a number of moderate Republican representatives and senators who fear retribution from voters if they support rolling back funding for Obamacare’s Medicaid expansion.

The president also hopes to push tax and regulatory reform through Congress, but he is adamant that can only happen after his administration successfully passes a viable replacement for Obamacare.

Democrats in the Senate are sure to oppose any Republican proposal to repeal and replace Obamacare, as they feel a duty to support former President Barack Obama’s hallmark legislative achievement. A slew of negative coverage surrounding the AHCA and a CBO score that predicts massive losses in insurance coverage have Democrats angling to use Obamacare repeal as a chief campaign issue in the upcoming 2018 mid-term elections.

With Democrats united in opposition, Republican lawmakers will have to reach a consensus to pass the AHCA in the Senate — a task that is proving more difficult by the day.

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