Analysis: GOP confronts no-win situation on health care

WASHINGTON (AP) - Republicans find themselves in a no-win situation as they struggle to pass health care legislation in the Senate: Success could alienate a majority of the population, but failure could anger the crucial group of GOP base voters the party relies on to build election victories.

It's a version of the dilemma now confronting Senate Majority Leader Mitch McConnell as he tries to maneuver between opposing poles in the GOP caucus to fashion an "Obamacare" repeal-and-replace bill that will satisfy everyone. After an earlier failure last month, one senior Republican, Sen. Chuck Grassley of Iowa, said Tuesday on Fox News Channel that he's "very pessimistic" about success.

Republicans are trying to convince the public that they're cleaning up a mess Democrats made in passing the law - a point McConnell, R-Ky., makes daily in Senate floor speeches. But even many in the GOP are skeptical the argument will prove convincing, now that they control the House, the Senate and the White House, largely on the strength of campaigning for seven years against Democrat Barack Obama's law.

Those campaigns were successful, but now Republicans own responsibility for the nation's sprawling and unsatisfying health care system, and that's hard to see as a political boon.

"If you fix it, then nobody's going to be 100 percent happy with what you do. If you don't fix it, then it's your fault," GOP Sen. David Perdue of Georgia told reporters at the Capitol Tuesday. "But the problem is, is that we didn't create it."

For their part, Democrats are practically salivating at the opportunity to use the health care issue against Republicans in the 2018 midterm elections. The GOP bill, which cuts taxes and mandates but also boots 20 million people off the insurance roles, has registered below 20 percent popularity in some polls.

Although Democrats are pessimistic about their chances of retaking control in the Senate next year, due to a challenging map, they are more hopeful about regaining the majority in the House. Democratic strategists and lawmakers themselves say health care is poised to be one of the top issues in campaigns around the country. Even if the Senate fails to act, Republicans will have to defend their support for a GOP bill that already passed the House that increases costs for the elderly and cuts off Medicaid benefits for the poor and disabled.

"I know that when I go back home, this is issue No. 1," said Rep. Cheri Bustos of Illinois, part of a group of House Democrats working with their Senate counterparts to develop a new message for the party. "It is an irresponsible argument to say that the Affordable Care Act is crashing and burning, when there is a Republican in the White House and Republicans are leading the House and leading the Senate."

Yet after countless promises to repeal and replace the Affordable Care Act, Republicans feel that they have a responsibility to their voters to deliver. Grassley warned on Twitter over the weekend that failure to fulfill their key campaign promise could result in losing their majority.

Congressional Republicans are also under intense pressure from President Donald Trump to help him fulfill his campaign promises.

"We're confident that it's going to pass and that we're not going to be in a situation of failure," White House legislative affairs director Marc Short told reporters this week. "But at the same time, the president recognizes that Republicans have campaigned on repeal and replace since 2010. In all candor, in many ways, he was looking forward to the day he was inaugurated having a bill on his desk to repeal it."

Some GOP strategists are concerned that the greatest risk to Republican lawmakers in upcoming election cycles would be for Trump to turn against Congress and start complaining about its failures. The fear is that Trump's core group of supporters - some 25 or 30 percent of voters - would stick with the president and vote out their own GOP lawmakers.

On Tuesday, after pressure from the White House, McConnell announced that the Senate's traditional five-week August recess would begin two weeks late to allow for progress on health care and nominations, which McConnell accused Democrats of stalling. McConnell's announcement came a day after Short suggested the president could call Congress back into session to confirm more nominees, and came after a group of junior senators led by Perdue had called on the majority leader to delay recess.

The last time the Senate delayed its August recess, in 1994 to deal with health care legislation, it was an unsuccessful interlude.

To be sure, some Republicans argue there could be a silver lining to their dilemma if they can actually pass a bill that succeeds in lowering premiums for some consumers and stabilizing marketplaces.

But such optimism can be hard to find.

Said Sen. Jeff Flake, R-Ariz.: "It's a tough situation, put it that way."

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EDITOR'S NOTE: Erica Werner has covered Congress since 2009.