Senate Republicans are desperately trying to craft health care legislation that can win 50 votes, and to do that they badly need skeptics like Jerry Moran. But the Kansas senator skipped a high-level GOP caucus this week, and there’s little evidence he’s about to change his mind.
Moran is one of about 10 Republican senators who opposed last month’s effort to overhaul the nation’s health care system. Because the GOP controls 52 seats, it can only afford three defections.
So when senators returned Monday from their 10-day Fourth of July recess, the political heat was on. Republican leaders made it clear they were writing a draft bill, and were listening to all offers to do what it would take to reach consensus. They needed Moran.
Monday, Moran attended a board meeting at the U.S. Military Academy at West Point in New York, though he was back in the Senate in time for two brief votes.
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The next day, he skipped a crucial, private Capitol lunch for Senate Republicans where colleagues discussed the healthcare legislation with Vice President Mike Pence and White House adviser Kellyanne Conway.
Moran’s office said he was in Maryland, touring the National Institutes of Health facility with the chancellor of University of Kansas Douglas Girod.
Senate Republican leaders plan to introduce a draft bill Thursday. But it isn’t clear, even to some of Moran’s fellow senators, what would get him to a yes.
“What I know about his views I’ve probably read in your paper,” Ohio Sen. Rob Portman, another Republican senator who has needed convincing, told McClatchy’s Kansas City Star.
Moran’s office listed five problems he had with last month’s Republican plan, a proposal that went nowhere.
He felt it didn’t provide enough premium and deductible relief. Rural hospitals and nursing homes were more likely to close or financially deteriorate. Medicaid, the joint federal-state insurance program for lower-income consumers, still benefited states that expanded the coverage under Obamacare over states like Kansas that did not, with non-expansion states paying a higher bill.
Kansans are more likely to lose access to health care under the Senate bill. And the bill did not address the systemic issues that drive up the cost of health care.
To gain support, Moran also would need language or “a program in the bill” confirming it will help ensure rural hospitals “be better off not worse” during the bill’s 10 year budgetary window, his office said in a statement.
“Nearly every hospital that has contacted the Senator in recent weeks has said that despite a few positive reforms within the (Senate bill last month) they would be more likely to face closure under the current text of the bill,” the statement said.
Moran’s spokesman, Tom Brandt, said the senator hasn’t shied away from tough conversations on the subject, whether with party leaders or with constituents who peppered Moran with questions at three town halls last week in Kansas.
“He’s had countless and ongoing conversations with a number of his colleagues, including the Senate leadership,” Brandt said.
There’s a longstanding pattern at work here. Moran always has been cautious about major votes, going back to his days in the Kansas state legislature. And he’s withstood heavy pressure from his own party in the past on major legislation, sometimes by making himself scarce.
“It took him a long time to make up his mind. That’s just the way he’s always been,” said Kansas Senate Minority Leader Anthony Hensley, a Topeka Democrat who served with Moran in the Kansas Senate.
Moran has demonstrated that he’s perfectly capable of bucking his party – even a Republican president’s agenda.
In 2003, then-Congressman Moran earned the ire of House Speaker Dennis Hastert as one of the few Republicans who voted against the GOP’s Medicare prescription drug benefit, a major legislative priority for then-President George W. Bush.
“Some members had assured me that they would be with us, but when the crunch time came, they weren’t,” Hastert wrote in his 2004 memoir. “One prairie state member, a fourth-term representative from a solidly Republican district, voted no, then ran and hid. I sent people to find him, they couldn’t.”
“I have never been under such pressure to vote contrary to what I thought was right as I was with this vote,” Moran said at the time. He thought the bill didn’t do enough to lower drug prices. He held firm on no.
Moran also voted against the 2001 No Child Left Behind Act, another Bush-supported initiative that created standardized testing for public schools.
In 2007, Moran helped push an amendment through the House that would have prevented the Treasury Department from forcing Cuba, an importer of Kansas wheat, to pre-pay for shipments of food and medicine. To avoid a veto from Bush, Republican leaders nixed it.
For the most part, however, Moran has been a reliable Republican vote. The American Conservative Union gives him a score of 87.2 out of 100 for his voting record on issues of concern to conservatives. That puts him close to fellow Kansas Sen. Pat Roberts, with 86.5, and Missouri Sen. Roy Blunt, with 86.7.
It’s when he perceives the GOP’s priorities to be in conflict with Kansans that he has broken with his party, said Chapman Rackaway, chairman of the political science department at the University of West Georgia.
“If there’s anything we know about Jerry Moran, it’s that he’s quite old school in that his party will always come secondary or even farther down the line if his constituents tell him to go a different way than the party,” Rackaway said.
For Moran, who was born in a rural Kansas hospital and represented the farming and ranching communities in the state’s 1st district, rural health care has long been a top concern. The Urban Institute, a left-leaning think tank, predicts 120,000 Kansans could lose health care under the current version of the GOP’s health care bill.
So far, his opposition to the June Senate health care bill has drawn little criticism from Republicans back home.
“Frankly I’m pleased to see him standing up for rural Kansas with regard to the Senate bill so I think he’s motivated by that deep sense of wanting to make sure that health care is delivered appropriately and at reasonable cost for rural Kansans,” said Kansas House Majority Leader Don Hineman.
In era when many Republicans are reluctant to face angry voters, Moran has not wavered from his usual practice of hosting town hall meetings in each of Kansas’ 105 counties every Congress. He also made a point of visiting all 127 hospitals in his state.
That’s why the Kansas Hospital Association and other health care groups lobbying against the June version of Republicans’ health care bill had been hopeful Moran might oppose it.
“He has had an open ear,” said Cindy Samuelson, a spokeswoman for the association, which met with Moran the day he announced his decision.
What the association and other health care advocates in the state really want is for the bill to keep open the possibility of expanding Medicaid. Expansion would mean $900 million for Kansas the first year. The state already has forgone about $2 billion in federal money so far from failure to expand.
Moran’s office did not respond to the Star when asked whether he supported adding language to the bill that would allow states like Kansas to expand Medicaid enrollment.
The Kansas City Star’s Bryan Lowry and Andy Marso contributed from Kansas City, Mo.