Conservatives Face Establishment Roadblock in Senate Healthcare Reform

Conservatives continue to face establishment opposition to Sen. Ted Cruz’s “consumer choice” amendment that could save the bill’s prospects of passing through the Senate.

Cruz (R-TX) will continue to push for an amendment that would allow health insurers to sell plans that do not comply with Obamacare insurance regulations if they sell plans that do comply with those regulations. Cruz’s amendment would allow insurers to sell more flexible and affordable health insurance plans.

Senate Majority Leader Mitch McConnell (R-KY) will send two versions of the revised Senate healthcare bill, the Better Care Reconciliation Act (BCRA), to the Congressional Budget Office (CBO) to analyze. One version will include Sen. Cruz’s consumer choice amendment, and another will not include the amendment. The CBO reported that under the previous version of the BCRA, 22 million more Americans would not have health insurance, the deficit would reduce by $321 billion, and premiums would lower by 20 percent during the next years.

Senate staffers argued that Cruz has consistently pushed for more flexible and affordable healthcare plans.

One staffer said, “From day one of the Senate discussions, in a working group that Sen. Cruz started with Chairman Alexander, consumer freedom has been one of Cruz’s major points. The idea that this is sprouting at the last minute is inaccurate.”

Conservative leaders, such as Freedom Caucus chair Mark Meadows (R-NC), have endorsed the Cruz plan, citing the amendment’s effort to offer more affordable healthcare plans. Meadows told reporters, “If the Cruz consumer choice amendment gets there, yes I can support it without the MacArthur amendment in there, because I think it gives everybody some options.”

“Right now I’m looking at the Cruz consumer choice amendment as the primary vehicle that makes the most sense to me,” Meadows said, “and I applaud him for stepping out,” Meadows added.

Conservative activist groups such as Club for Growth and FreedomWorks support the Cruz consumer choice amendment. Club for Growth President David McIntosh argued that Republicans should include Cruz’s amendment in the BCRA. McIntosh said, “At a bare minimum, Congress should not stand in the way of allowing Americans who want to opt out of Obamacare to do so. And that’s why it’s so important that the new Senate Obamacare repeal bill include the Lee-Cruz Consumer Freedom Option, which would allow individuals to opt out of Obamacare’s costly regulations.”

FreedomWorks President Adam Brandon echoed McIntosh’s sentiments. Brandon explained:

We continue to believe that the best outcome is language modeled after the 2015 reconciliation bill that repealed much of Obamacare. But if Senate Republicans insist on tweaking Obamacare, we urge them to adopt language being pushed by Sens. Cruz and Lee that will provide consumers with more choice and truly affordable health insurance coverage.

Both conservative activist groups reiterated that although they support the Cruz consumer choice amendment, ideally, they would like to see the 2015 reconciliation bill that repealed more provisions of Obamacare.

Not every Republican senator remains convinced by the Cruz amendment. Sen. Roy Blunt (R-MO) argued that the Senate needs to do more to protect those with pre-existing conditions in the BCRA.

“The draft healthcare legislation preserves access to care for people with pre-existing conditions, strengthens Medicaid and does not change Medicare, gives people more health insurance choices, and allows people to stay on their family health insurance plan until they are 26,” said Sen. Blunt. Blunt serves as a member of Senate leadership.

Sen. Richard Burr, another ally to Senate leadership, said, “The Senate bill keeps current-law protections for individuals with pre-existing conditions, prohibiting the denial of health insurance coverage for this reason.”

Sen. Cruz argues that his amendment would allow for more flexibility when it comes to choosing healthcare plans and that patients with pre-existing conditions can continue to purchase insurance plans with the help of the BCRA’s tax credits and stabilization funds.

“You would likely see some market segmentation. But the exchanges have very significant federal subsidies, whether under the tax credits or under the stabilization funds,” Cruz explained.

The Cruz consumer choice amendment would likely garner support from Sens. Mike Lee (R-UT), Rand Paul (R-KY), and Ron Johnson (R-WI), which could give Republicans the necessary support to pass the BCRA through the Senate. House Freedom Caucus chair Mark Meadows (R-NC) also endorsed the amendment, which serves as a significant endorsement, considering that the bill would also have to pass through the House after it goes through the Senate.

Cruz and his conservative allies will take a stand for the consumer choice amendment. One conservative Senate staffer argues that if the Senate leadership does not include the amendment, conservatives will not vote for the BCRA.

“If they don’t want to include that amendment, they can get to 50 elsewhere,” the Senate aide said.