Expert: Very Quietly, Below Radar Of Trump Scandals, Rand Paul And Ted Cruz Planning To Go Nuclear On Obamacare Repeal

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But other Senate Republicans aren’t on board, setting up an intra-party showdown over how to gut the health law.

OBAMACARE EXPERT: Dr. Dennis Deruelle (Durr-Rell), Author Of Your Healthcare Playbook: Winning the Game of Modern Medicine.

“Conservative GOP Sens. Ted Cruz and Rand Paul are pushing to test the limits of how much of Obamacare can be repealed under Senate rules, setting up a potential “nuclear” showdown.

The firebrands want to overturn long-standing precedent for what can be done under reconciliation, the fast-track budget process the GOP is using to dismantle the Affordable Care Act. They argue Republicans are allowing stale Senate norms to tie their hands and are forfeiting a chance to completely abolish the law.

The key factor in allowing reconciliation to proceed is whether each provision in the bill has a direct impact on the budget — a question typically put to the Senate parliamentarian, a nonpartisan staffer named Elizabeth MacDonough.

But Cruz, of Texas, and Paul, of Kentucky argue that it is up to whoever is presiding over the Senate at the time, which can be Vice President Mike Pence as president of the Senate. Under their argument, Pence could make the call about whether certain parts of Obamacare can be scrapped or whether new policy, such as allowing insurers to sell across states lines, can be enacted — and he would presumably be more aggressive than MacDonough.

“The original law says the [person in the] chair decides — it doesn’t say anything about the parliamentarian,” Paul said.

But as the Senate drafts its health care bill, Cruz and Paul are finding themselves on a virtual island. Many other Republicans interviewed by POLITICO say they have no interest in testing the Senate’s procedural bounds, arguing that doing so would undermine the institution and quickly lead to the end of the legislative filibuster.

“I don’t think it’s the best approach, and I think there would be resistance to that,” said Sen. Roger Wicker (R-Miss.). “It’s tempting, but it’s also the proverbial slippery slope.”



BIO: Dr. Dennis Deruelle is a physician and National Medical Director of Acute Services for IPC Healthcare/TeamHealth, one of the largest suppliers of healthcare professional staff and integrated care providers in the country. Dr. Deruelle helps hospitals and hospital systems across the country improve their quality, safety and efficiency. He is a national speaker and consultant with expertise in how the Affordable Care Act affects the new value-based world of healthcare.

Dr. Deruelle completed a fellowship in Hospitalist Medicine Leadership at the University of California at San Francisco. Dr. Deruelle was Chief Resident and did his internal medicine training at the University of North Carolina at Chapel Hill after earning his M.D. from Albany Medical College. An accomplished musician, Dr. Deruelle has performed at the National Aids Conference among other venues.


TWITTER: @Drderuelle

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