The arithmetic for Senate Republicans is pretty straightforward: they have 52 members in the chamber, and their far-right health care overhaul will need 51 votes to pass.
If one or two GOP senators break ranks and decide they can't support the bill, that won't be enough to change the outcome: Vice President Mike Pence would break the tie and advance the legislation. If three or more Republicans oppose the plan, it dies.
And that, in turn, gives a group of four GOP senators a fair amount of influence.
Four Republican senators have announced that they will not vote for the GOP health care bill unless changes are made, putting passage of the bill at risk just hours after it was unveiled. [...]
The four conservative GOP senators -- Rand Paul of Kentucky, Mike Lee of Utah, Ron Johnson of Wisconsin and Ted Cruz of Texas -- released a joint statement outlining their concerns:
"Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor," the four conservatives said in a written statement. "There are provisions in this draft that represent an improvement to our current healthcare system but it does not appear this draft as written will accomplish the most important promise that we made to Americans: to repeal Obamacare and lower their healthcare costs."
This isn't exactly a hard-hitting threat. On the contrary, it's a lukewarm, almost mealy-mouthed statement. It's one thing for a group of senators to announce their opposition; it's something else when senators say in the first sentence of their statement that they're "open to negotiation and obtaining more information."
Still, it's a warning shot of sorts: Senate Republican leaders are apparently going to have to move the bill even further to the right, at least in some tangible ways, to pick up these four far-right members.
But before health care proponents and critics of the GOP's regressive plan get too excited, I'd recommend caution.
These four -- or at least most of them -- want to vote for a Republican bill. Maybe not this bill in its current iteration, but they're very much inclined to support a package that overhauls the current system in a far-right direction. With this in mind, the conservative quartet is likely to demand some concessions, which the party will accept to make them happy, at which point they're almost certain to return to the fold.
In other words, if you're an advocate of a strong public-health system, and you're counting on Ted Cruz, Ron Johnson, Mike Lee, and Rand Paul to rescue the interests of struggling families, you're almost certainly making a mistake.
The tricky part, however, is on the other end of the GOP's ideological spectrum. Less conservative members such as Maine's Susan Collins and Alaska's Lisa Murkowski have their own concerns about the bill, and every step the bill takes in Ted Cruz's direction is a step that will make Collins and Murkowski more uncomfortable -- and give them an excuse to walk away.
In other words, with seven days until a scheduled floor vote, Mitch McConnell will have to thread a needle if he intends to gut the nation's health care system.