A tough call for Iowa’s senators
I have sympathy for Iowa Republican Sens. Chuck Grassley and Joni Ernst, who right now are wrestling with the U.S. Senate’s consideration of health care legislation.
The Republican Senate caucus is tied in knots over the issue, and the situation seems to grow more difficult each day.
There are 52 Republicans out of a total of 100 senators, so if three GOP senators vote against whatever plan is brought to the floor, it will fail.
No Democrat is going to help Republicans repeal Obamacare.
The GOP is apparently too split between conservatives and moderates to reach a compromise on the bill. If it moves to the right, it loses moderate votes. If it shifts to the left, it loses conservatives.
Right now, 10 Senate Republicans have said they do not support the bill in its current iteration. Some of the 10 think the bill is too tough, and some think it’s not tough enough.
Eight of those 10 will have to change from “no” to “yes” to get the bill passed, while none of the current supporters change their minds.
Regardless of the apparent deadlock, though, Senate Majority Leader Mitch McConnell was to announce a new version of the bill on Thursday, and to try to take a vote on it next week.
My sympathy for Grassley and Ernst derives from the fact that Iowa is a microcosm of the nation as a whole on the health care issue right now: Our state seems split on whether to erase Obamacare or to preserve its protections for the poor, the disabled and the elderly.
Neither Ernst nor Grassley wants to alienate a big chunk of their constituents by announcing for or against the bill.
So neither has done so.
Both Iowa senators argue that they are withholding judgment on the Senate Republican health care bill until they see it in its final form. When that might be is anyone’s guess.
My personal opinion is that at least some of the bill’s key components won’t kick in until a few years down the road. That’s standard operating procedure when legislators can’t agree on a bill’s provisions. (I’m writing this column on July 11.)
Even after McConnell’s release of the new bill draft, though, it is subject to alteration, and if tweaks are necessary in order to achieve approval by 50 Republican senators, the tweaks will be made.
So there is no assurance that either Grassley or Ernst will be willing to stake a claim for or against the new bill — at least not until it gets to the Senate floor.
What’s more, amendments during debate on the floor (if the proposal gets that far) may be allowed. That would let both Iowa senators withhold public judgment until all amendments are disposed of in debate.
In that case, their Iowa constituents might not know how the senators will vote until roll call on the bill.
I realize that the United States is a democratic republic. Voters elect legislators to create laws for them, and Grassley and Ernst are exercising their legal right to wait until the last minute to indicate their opinions on any bill, including one involving health care, which is responsible for one-seventh of the entire American economy.
Both senators have given a few clues on their opinions. Grassley told the Des Moines Register Friday that he sees no major problems that would prevent him from supporting the bill as now constituted, but he refused to say he would vote for it.
And both senators want to protect insurance coverage for people with pre-existing health problems.
Neither senator has given support to the proposal, floated by President Trump and others, that Congress repeal Obamacare now and replace it later.
Both senators, in the past and during the current discussions, have indicated their support for rural health care providers such as hospitals and doctors.
The Senate Republican bill as it now stands would phase out the expanded Medicaid provisions of Obamacare after a few years.
Hospitals like Greene County Medical Center have benefited greatly from that expansion, and both Grassley and Ernst are from rural Iowa.
My guess is that if that provision remains in the bill, it will be hard for them to support.
But that’s just a guess, since they haven’t said it’s a deal-breaker.
In fact, to my knowledge, neither Grassley nor Ernst has listed any absolute deal-breakers in the bill.
For example, neither has indicated opposition to the bill’s intention to cut $700 billion of Obamacare taxes on the wealthy over the next 10 years in order to reduce the costs and subsidies of providing affordable coverage to millions of previously uninsured low and middle income Americans.
At some point between now and the Senate roll call vote on the bill, if one actually happens, Grassley and Ernst will have to make their views known.
The final bill will require either an “aye” or a “nay.”
It will be one of the most difficult votes either senator will ever be called on to make.
I believe that both will do what they think is in the best interests of Iowans rather than the interests of their party’s leaders or their major funders.
I hope I’m right.
The test will be whether most Iowans agree with them.