Ted Cruz may be the only man who can save the GOP health bill

  • Senator Ted Cruz isn't well-liked, but he may hold the key to fixing and passing the AHCA.
  • Cruz is pushing a simpler, and probably more workable Obamacare replacement plan.
  • Only Cruz has the ability to bring wary GOP Senators together.
Sen. Ted Cruz (R-TX) speaks to reporters on Capitol Hill, May 10, 2017 in Washington, DC.
Getty Images
Sen. Ted Cruz (R-TX) speaks to reporters on Capitol Hill, May 10, 2017 in Washington, DC.

Senator Ted Cruz has spent much of his tenure in Washington angering Democrats, Republicans, and the Trump team to boot. It often seems like he may be the most hated man in American politics. But now, he just might be the most needed.

This is all because the GOP Obamacare replacement bill is on life support on arrival in the U.S. Senate. As it stands now, it's a lot like Cruz in that it's almost universally hated by everyone. Of course the bill is a non-starter for Democrats, but many Republicans are terrified by the fact that it basically keeps almost all of Obamacare intact without maintaining even its currently insufficient sources of funding. And then comes the White House, which seems to only be interested in getting a replacement bill passed and then declaring victory no matter what's in the measure.

So who can save this damaged bill that has almost no fervent supporters? Don't look to the Majority Leader Mitch McConnell, who hasn't proven he could do even as good a job as Speaker Paul Ryan did to get the bill squeaked through the House. And don't look to President Donald Trump himself, who didn't play a hands on role in crafting the House bill and won't be doing that now as the Senate wades into its own amendment process.

This sounds like a job for Super Cruz and his super one-shot Obamacare fix!

First, let's look at the plan Cruz is pushing. He wants the Senate to ditch the House bill's plan to repeal and replace Obamacare over three phases. Instead, he's calling for one bill that will repeal the Obamacare mandates, allow for cross-state insurance purchases, bring in medical malpractice reform, and expand the use and size of health savings accounts. Just about every Republican in the Senate has at one time or another called for each of the above changes. And since Cruz's plan also reportedly leans on just getting that 51-49 vote majority in a Senate with 52 Republicans, so far, so good.

Ah, but what about the thorny issue of the folks with pre-existing conditions that almost derailed the House Obamacare replacement bill thanks to those Republicans with cold feet over the fate of their care? No problem, says Cruz who told the Washington Examiner he believes "robust high risk pools" are the answer to covering that segment of the population. That looks like it will be a tougher sell. But as the option of risk pools is getting more scrutiny lately, some good evidence is popping up that they can work when funded properly. A recent defense of risk pools written by the man who ran the pre-Obamacare risk pool system in Maryland was just actually published this week in the Washington Post. Look for Cruz and many other Republicans to lean heavily on that defense and the general logic behind it in the coming weeks.

Of course, this is all about convincing and mobilizing Republicans and only Republicans. Democrats aren't and won't be swayed by any of Cruz's arguments. It'll be hard enough for Cruz to find a way to get polar Senate GOP opposites like libertarian hero Senator Rand Paul of Kentucky and moderate stalwart Senator Susan Collins of Maine to agree to back the same bill.

But Cruz is really the only man in the Senate who can get this done. His own hard core conservative and libertarian bona fides should get him a fair hearing before the bill's biggest GOP skeptics like Senator Paul. Paul can't dismiss Cruz as just another liberal when the Texas Senator stumps hard for the risk pools for reasons of compassion and pragmatism. And if he can really back up his push for risk pools with adequate funding, Cruz could soothe senators like Collins and other nervous Republicans who are terrified of any bad p.r. that would come from any Americans losing coverage. It would be one thing if the usually firebrand Cruz was responding to that lost coverage scenario with a hard-edged screed about government free loaders. But as long as he's pushing a risk pool option not done on the cheap, he's going to be a lot more persuasive.

One of the reasons why the House Obamacare replacement bill was a mess is because it really had no nationally prominent leader backing its key details or making the case for them within and without the Republican Party. Cruz may still not win any popularity contests on Capitol Hill, but he demands respect and attention from Republicans and even some Democrats.

When it comes to the sick patient that is the AHCA, Cruz may be just what the doctor ordered.

Commentary by Jake Novak, CNBC.com senior columnist. Follow him on Twitter @jakejakeny.

For more insight from CNBC contributors, follow @CNBCopinion on Twitter.