Washington Week

Friday Nights on PBS

The challenges facing Mitch McConnell as he tries to pass the Republican health care bill.

By Robert Costa

When Congress returns to Washington, Senate Majority Leader Mitch McConnell will once again be tasked with passing the GOP’s rewrite of the nation’s health care laws.

It won’t be easy for the 75-year-old Kentucky Republican. As our roundtable discussed at length last week, McConnell faces challenges on both sides of his party. Moderates are uneasy about the proposal’s reduction of Medicaid funding, while conservatives say the bill doesn’t go far enough to gut the Affordable Care Act, the law better known as Obamacare.

The coming days will surely test McConnell and his long-vaunted ability to master the byzantine ways of the Senate and keep his members together. To get a better sense of him and his challenges, here are five stories that I’ve found useful as I’ve gone about my reporting on Capitol Hill.

1. “In McConnell's Own State, Fear and Confusion Over Health Care Bill,” Sheryl Gay Stolberg, The New York Times

This story by Sheryl Gay Stolberg is a powerful reminder that as reporters and lawmakers closely follow the vote count and wonder about how various deals will be cut, the consequences of health care policy run deep, far beyond Washington. In McConnell’s state — “where nearly one in three people now receive coverage through Medicaid” — there is anxiety and confusion about the bill, and about whether the “crushing medical needs” of working people will be addressed. Pay close attention to the voices in this report and to how some people in the state see federal medical funds as vital to the economy of “a region already decimated by unemployment from the coal industry downturn.”

2. “McConnell is known as a deal-closer, but he’s never done policy this big,” Paul Kane, The Washington Post

When my colleague Sean Sullivan and I were reporting on the McConnell-Trump relationship, we talked a lot about how President Trump is increasingly relying on McConnell to usher one of his signature campaign promises to passage. But, as Paul Kane explains, McConnell’s savvy has usually been showcased while he was in the minority. Passing a big-ticket item like a health care bill is a somewhat new experience for him, at least as majority leader. A pro’s pro at playing the role of “deal-closer” on budget talks over hushed phone calls, he now has to rally nervous Republicans around unpopular legislation, all as an outsider president clamors for a win.

3. “Portman and McConnell clash over health bill,” John Bresnahan and Seung Min Kim, Politico

Oh, the drama. After years of carefully keeping GOP senators in line and aligned against President Obama, McConnell is confronting revolts to his left and to his right. His clash with Sen. Rob Portman, Republican of Ohio, is one of the more intriguing episodes of recent weeks. Long known as an establishment favorite, Portman has become one of the bill’s most vocal critics due to its Medicaid provisions and what he sees as insufficient funding for opioid addiction treatment programs, which has become one of his core causes. This juicy article reveals how even senators like Portman are causing McConnell headaches. “The leadership has overreached on this bill,” Portman is said to have “shot back” in a testy, closed-door exchange with McConnell.

4. “Where Will Mitch McConnell Go from Here?” Benjamin Wallace-Wells, The New Yorker

Benjamin Wallace-Wells takes an elevated view of McConnell in this short essay, examining how the majority leader is hindered not only by skittish senators — like Sen. Dean Heller, a moderate Republican from Nevada — but by a political environment in Washington that’s almost foreign, compared to what it was during the Obama presidency. The dynamics from that time seem to have been erased and McConnell is dealing with a president whose allies are wading into his territory with ads against Heller (which have since been pulled) and with an energized Democratic base that has echoes of the tea-party movement from nearly decade ago, in terms of its vocal activism. “Will his particular political genius still win the day?” the writer asks. “Or will he come to seem an emblem of the mania of the very recent past — Kissinger, but for the phlegmy partisan era, now maybe in its evening.”

5. “Strict Obstructionist,” Joshua Green, The Atlantic

This profile from 2011 by Joshua Green is an illuminating stroll through McConnell’s rise in the Republican leadership ranks while President Obama was in his first term. It has colorful observations —McConnell “looks bothered, as though lunch isn’t agreeing with him” — and insights into how McConnell sees the press and the GOP’s roiling base, which has frequently criticized him “for not doing more, not going further, not pulling down the pillars of the temple.” The tensions from back then continue today, making the current push on the health care bill not an isolated moment for McConnell, but the latest in a series of Republican struggles.