By Erin Mershon, CQ Roll Call
November 16, 2016 -- Some vulnerable Senate Democrats are already signaling an openness to working with Republicans in their efforts to replace President Barack Obama's signature health care law.
"Do we need to fix some things with the health care bill? Absolutely. And it's going to take Republicans and Democrats working together to make that happen," said Sen. Jon Tester, D-Mont. "There's going to be areas, there's going to be spaces where we can work together and spaces where we can't. Hopefully if the needle isn't pushed too far to the right, we'll be able to get some things done," Tested added.
"What I've been saying to people about repeal is that I want to see what they're going to replace it with," said Sen. Joe Manchin III of West Virginia. "I'm open to working with everybody but I want to see what they're going to replace it with."
"Absolutely. I've been talking about appropriate amendments," said Sen. Heidi Heitkamp of North Dakota. "Until now it's been all or nothing. Let's see if it's something that can get managed here," Heitkamp added.
The Democrats' open minds may help Republicans, who will likely need to bring along at least eight Democrats to help pass their promised "replacement" for the controversial and mammoth health care law. Republicans can repeal and perhaps even replace some of the law through an arcane process known as reconciliation that requires only 51 votes, but any other legislative efforts will need to clear the Senate's 60-vote threshold. Republicans are expected to have 52 seats in the upper chamber next year.
The new statements reflect the suddenly much-improved political odds for repeal. Democrats in both chambers have remained united against many Republican affronts to the health care law over the last six years. Even after the election, many progressives on and off the Hill have vowed to continue fighting to preserve the law.
The openness to replacement, however, from Tester, Manchin, Heitkamp and other vulnerable Democrats, isn't a complete reversal for many of the more moderate lawmakers in the upper chamber. Many in the caucus have in the past offered or supported legislation to "fix" narrow pieces of the law, several of which became law.
The new statements highlight instead just how vulnerable many Democrats are after last week's election. At least 10 of the 25 Democrats who are up for reelection in 2018 come from states that Donald Trump won on Election Day. Another handful are from states that Trump narrowly lost.
Several said their main concern is providing coverage for the millions of Americans who rely on the law.
"I want to hear about replacement before I start talking about repeal," said Angus King, an independent from Maine who caucuses with the Democrats and faces a 2018 reelection race. "Working with them may be too strong a term. I've been proposing fixes for the ACA for three years. I think there are a number of things that can be fixed. But I'm also deeply worried about 20 million people losing insurance. I'm not going to support anything that would lead to that result."
Tester and Sen. Debbie Stabenow, D-Mich., shared King's sentiment that anything that would take away health insurance for the 20 million Americans who got it under the health law would be very hard to support.
Replacement Process
That will be a challenge for Republicans as they draft their replacement bill. Already many GOP leaders have said they do not want anyone to lose their coverage. Trump has said he wants to minimize disruption to those Americans while a replacement is being worked out. Using the reconciliation process might let senators bypass the 60-vote threshold, but it is not a quick and easy process, several lawmakers warned.
"There are things that you can do with regulations pretty quickly to provide some relief, but even to do reconciliation you have to do a budget, so it takes a little bit longer," said Sen. John Barrasso, R-Wyo., who helms the Senate Republican Policy Committee. Republicans must pass a budget resolution before passing reconciliation legislation, which could take months.
"I think that's the discussion we need to have—do we want a show vote or a real vote? Do we want to make law?" said Rep. Pat Tiberi, R-Ohio, the Ways and Means Committee health subcommittee chair. "You can't get rid of a lot of Obamacare without either going through reconciliation or getting eight more Democrats in the Senate to get to the president's desk."
Finding those eight votes still could require work. Outside of a moderate, vulnerable group of Democrats, many in the Democratic caucus aren't ready to give much room to the Republicans who are trying to repeal Obama's landmark domestic achievement.
"We're going to fight like hell against [repeal]," said Sen. Sherrod Brown of Ohio, who is also up for reelection in a red state. "They didn't expect to win this. They just thought their talking point would go on until the 22nd Century, I guess. . . . How do they explain to the 600,000 Ohioans? We're going to start naming the victims."
Still, it's possible Democrats may not be quite the obstructionists that Republicans have been.
"Unlike them, we're not out to simply deny Trump victories at any cost," said Sen. Sheldon Whitehouse, D-R.I., who is also up for reelection in 2018. "Nobody is going to buy the proverbial pig and a poke, and so until they have proposed a solution to that problem it's hard to know how to react to it. But I think a solution that continues to provide coverage, solves the pre-existing condition problem, maintains the end of the donut hole [lowering seniors' drug costs], particularly if it makes progress in the quality and performance area—I mean we want to do what's right here."
