Stephanie Grace: On health care, it’s all about the vote | Stephanie Grace

Senators spend a lot of time in airports, and Bill Cassidy was obviously trying to be efficient when he recorded a walk-and-talk testimonial Monday while switching planes in Atlanta. He also, clearly, had something he wanted to get off his chest.

Cassidy used his time in transit to insist his vote for the widely-panned “skinny” repeal of the Affordable Care Act days earlier had been misconstrued. It was merely a “process” vote to move on to a House/Senate conference committee, “not the end result,” he said.

Well, OK. But that doesn’t explain why Cassidy thought it was a good idea to send the bill into yet another closed-door setting. It doesn’t explain his misplaced faith that the House would somehow, at this late date, craft a thoughtful repeal-and-replace bill and not just adopt the Senate language. It doesn’t explain why Cassidy believed Congress would pivot and adopt the proposal he and Lindsey Graham had offered up well into the debate, which would convert money being spent on the health care law to block grants and send it to states.

And it definitely doesn’t explain why Cassidy thought a process that bypassed governmental norms for purely political reasons, with little regard to how vast changes would affect millions of Americans, or even whether it addressed the problem it purported to solve, could somehow end well.

If Cassidy found himself in an untenable position as the GOP health care drive crumbled, it’s not hard to see how he got there.

A former Charity system physician who ran and won as a critic of the law, he’s been angling to be a player in the revamp ever since Republicans won control of both houses of Congress and the presidency.

Early on, he gave up a seat on the Appropriations Committee and joined Finance, which under normal circumstances would be a key stop for health care legislation. He’s also on Health, Education, Labor and Pensions, or HELP, another committee that would be expected to have a say.

And once the discussion got underway, Cassidy emerged as a surprisingly independent actor who embraced principles that his more conservative colleagues rejected, including the idea that it’s better to have more people covered by health insurance than fewer. He also piggybacked on talk show host Jimmy Kimmel’s plea to preserve coverage for pre-existing conditions and a ban on lifetime limits, even though some Republicans endorsed ideas that would have undermined those protections.

In a mad dash to force through some version of a stunningly unpopular proposal, though, Senate Majority Leader Mitch McConnell skipped the committee process and instead appointed an ad hoc group to write the legislation. But he omitted Cassidy from the panel, even though he and fellow Republican Susan Collins had proposed their own bill that was clearly not Draconian enough for the leadership’s taste.

Most recently, Cassidy has teamed up with Graham on the new proposal, although key senators say the chamber’s ready to move on.

Still, Cassidy might soon actually have a chance to address some of the real problems with the health care law.

While President Donald Trump has tauntingly threatened to let Obamacare “implode” by withholding key payments due to insurers who offer policies on the law’s exchanges, Lamar Alexander, the chairman of the HELP committee, and Democratic ranking member Patty Murray, have scheduled bipartisan hearings next month aimed at shoring them up instead. So Cassidy — along with two fellow Republicans and committee members who voted “no” on skinny repeal, Collins and Lisa Murkowski — may finally get to do something productive on health care.

Hopefully, he’ll see this not as a defeat but as a way to do some good, as he’s been saying he hopes to do all along.

He might even consider what happened to his colleagues who voted the other way on their recent travels. Collins stepped off her plane and into a terminal full of her constituents Friday, hours after the early morning vote, and was met with a rousing ovation. Murkowski was photographed being greeted with hugs.

If Cassidy wants to earn that sort of reception as he dashes through an airport, there’s one lesson he should take from their experience. Talking, explaining and rationalizing aside, it all comes down to the vote.


Follow Stephanie Grace on Twitter, @stephgracela.


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