A Bipartisan Health Care Bill Will Be Tougher to Pass than a Partisan One

Stuart Rothenberg July 19, 2017 · 7:18 PM EDT

The calls from Democrats and many in the media for a bipartisan health care bill are understandable. But a bipartisan plan is a very heavy lift for Congress – probably even heavier than a partisan one.

Almost everyone likes the sound of a “bipartisan approach.” It comes with connotations of compromise, reasonableness, moderation and sensitivity to all sides. In an era when voters distrust the parties and major institutions, “bipartisanship” automatically has special appeal.

But the two parties have such different values and priorities these days, it’s hard to see how and where they come together. 

On health care, Republicans want to cut spending (so they can apply it to tax reform), eliminate government mandates, cut regulations and encourage the free market to provide ways to help Americans get health insurance and coverage, if they want it.

Democrats, on the other hand, are all about coverage, including an unalterable commitment to expanded Medicaid, even if it means more spending, more mandates and more regulations.

Yes, there are a handful of more moderate/pragmatic Senate Republican and Democrats who can rally around a short-term fix for the Affordable Care Act, and that’s a formula for passing something.

GOP Sens. Susan Collins (Maine) and Bill Cassidy (Louisiana) have their own plan, while Democrats like Joe Manchin (West Virginia), Joe Donnelly (Indiana) and Heidi Heitkamp (North Dakota) surely would be interested in signing onto a bipartisan approach.

But there are other factors that work strongly against a bipartisan plan.

Any bill that gets bipartisan support is almost certain to keep the architecture of Obamacare in place, and that’s a non-starter for many Republicans, who have just spent seven years promising to get rid of it.

The House must agree with any Senate bill, and the chances of House Republicans doing that are, well, small. If anything, the House GOP would like to move the Senate bill to the right, not to the left.

Even more important, the pressure on the House and Senate GOP leadership not to bring to the floor any bill that essentially leaves the ACA intact would be enormous. 

Conservatives – and many Republicans – will argue that they control the House, the Senate and the White House and ask why Democrats are going to dictate the terms of any Obamacare re-write.  

Can you imagine the name-calling and finger-pointing on Hannity, Lou Dobbs, Newsmax and One America News? Conservatives would accuse Republicans of selling out, and of caving into Senate Minority Leader Chuck Schumer and House Minority Leader Nancy Pelosi. Conservative talk radio and TV would skewer McConnell and Ryan if they end up supporting a truly bipartisan compromise.

During his years as House speaker, John Boehner did bring a few bills to the floor that didn’t have a majority in his party but could (and did) pass the House. Would Paul Ryan and Mitch McConnell do that?

Bipartisan approaches are possible on bipartisan issues. But Republicans and Democrats are light years apart on health care, the role of government and taxes – all of which are very much involved in the health care debate.

Anything is possible in Washington, D.C. But it would be naïve to think that a bipartisan health care plan will be easy to construct. Health care, as we learned from the president of the United States, is very complicated.