Everyone is confused about the health-care vote — including Republican senators

After two more senators came out against the Better Care
Reconciliation Act — the Senate Republicans’ revised plan to repeal
and replace Obamacare — on Monday, for a total of four “no” votes,
Congress’s upper chamber has devolved into a state of chaos and
confusion. Sen. John
McCain is in Arizona, having just received a cancer
diagnosis, and without his vote, every form of Obamacare repeal
looks more and more uncertain.

As it stands, the BCRA doesn’t look like it has the votes to
pass, and there isn’t much finagling with the numbers that could
get enough moderates on board without losing senators on the other
side of the ideological spectrum. Leadership has reportedly offered
a Medicaid option that would put $200 billion toward getting
Americans in expansion states onto private insurance, but even that
looks uncertain to sway the party’s most moderate faction.

Every Congressional Budget Office score of the Republican plans
has projected that tens of millions fewer people would be insured
than under the current law. A clean repeal bill is estimated to be
the worst in terms of coverage, leaving 32 million fewer people
insured.

Nonetheless, Majority Whip Sen. John
Cornyn (R-TX) told reporters that there will be a vote on
health care next Tuesday, knowing McCain will likely still be
unable to vote. As for telling what the vote will be on, “that’s a
luxury we don’t have,” Cornyn said.

Senate procedure requires Republicans to first vote to proceed
to a floor debate on the health bill the House sent over in May.
Then Senate Majority Leader Mitch
McConnell (R-KY) is able to substitute it with whatever
bill he would like to be voted on — a process followed by unlimited
amendments.

Earlier this week, McConnell said he would put forward a vote on
a clean Obamacare repeal bill first — the same bill Republicans put
on then-President Barack
Obama‘s desk in 2015. But on Wednesday, President Donald Trump
called for Republican senators to work toward voting on a
replacement plan. Neither option currently has the votes to
pass.

So Republican leadership is pushing to get senators to commit to
voting in favor of debate, without any clear picture of what they
would be debating.

“The statement is we will let you know what comes afterward, and
at that point we hope you would agree to a motion to proceed,” Sen.
Bill Cassidy (R-LA) said of Republican leaders’ current pitch.

But Collins sounded so resolute in her opposition to the BCRA’s
impacts on Medicaid as a whole that even with additional funds, she
continued her calls to start from scratch with a bipartisan
deal.

“I really think at this point, particularly given the divisions
in our conference, that we should go back to normal order [and]
have hearings on the problems of the Affordable Care Act, which
there are many,” Collins said.

Meanwhile, Sen. Rand
Paul (R-KY) has stated that his support is contingent on
getting rid of a fund for insurance companies to stabilize the
prices between comprehensive plans and skimpier options, calling it
“insurance bailout money.” But without that fund, moderates are
unlikely to sign on. Paul said he would support moving toward
debate only if clean repeal were brought up for a vote first.

Collins, along with Sens. Lisa Murkowski (R-AK) and Shelley
Moore Capito (R-WV), said she would not vote to proceed to a clean
repeal vote.

There is no consensus on how to move forward — only a sense of
urgency to get something done. Republican leadership seems adamant
on voting on something, but it’s anybody’s guess on what that
something is.

After the BCRA fell apart on Monday morning, Trump, apparently
frustrated, told reporters his new plan was to “let Obamacare fail,
it will be a lot easier.”

Then he said he was in favor of a clean Obamacare repeal
bill.

On Wednesday, he brought all the Republican senators to the
White House in a renewed call to negotiate a replace plan.

Trump has repeatedly made it clear he doesn’t have much policy
preference on health care whatsoever. During the House debate, Rep.
Mark Meadows (R-NC) said Trump needed only two assurances: that
premiums would go down and that people with preexisting conditions
would be protected. Since, he has been convinced to support bills
that do neither of those things.

“The president made very clear at lunch yesterday that he wants
to see a bill passed. I’m unclear, having heard the president and
read his tweets, exactly which bill he wants to pass, and whether
he is for just repealing or repealing and replacing, whether he is
for the Senate bill,” Collins said. “There has been a bit of a lack
of clarity, but there is no lack of clarity in his determination to
have us pass a bill.”

Late Wednesday night, seemingly at the directive of the
president, Republican senators met to try to rehash a version of
the BCRA that could pass.

But leaving that meeting, Sen. Bob Corker (R-TN) said that at
this point, he would rather just move forward with a clean repeal,
putting aside Trump’s calls altogether.

Corker called the BCRA is something akin to a “bazaar,” a round
of haggling that is unlikely to develop into good policy. His
growing concern has pushed him toward wanting to just vote for
clean repeal, despite having argued against a repeal-and-delay
strategy only six months ago.

Paul has a different idea: a random drawing to decide the order
of voting on the BCRA, or a clean repeal bill.

“I think they’re pretty equal in support. Let’s do a random
selection; let’s have three or four of them. Put them in random
order on the first day, equal billing,” he told reporters. “I think
that’s a compromise.”

In other words, with tens of millions of people’s health care on
the line, just pull something out of a hat.