Obamacare battle faces its last rites
UNITED STATES: The last-gasp Republican drive to tear down former US president Barack Obama’s healthcare law essentially died yesterday, as Maine Senator Susan Collins joined a small but decisive cluster of GOP senators in opposing it.
The moderate senator said the legislation would make ‘‘devastating’' cuts to the Medicaid programme for poor and disabled people, drive up premiums for millions of Americans, and weaken protections that Obama’s law gives people with pre-existing medical conditions. She said the legislation was ‘‘deeply flawed,’' despite 11th-hour changes its sponsors made in search of support.
The only way Republicans could resuscitate their push would be to change opposing senators’ minds, which they have tried unsuccessfully to do for months.
Collins said she made her decision despite a phone call from President Donald Trump, who has been trying to press unhappy GOP senators to back the measure.
‘‘They’re still working it and a lot of conversations are going on,’' No 3 Senate GOP leader John Thune of South Dakota said. But he conceded that a revival would be ‘‘a heavy lift’' and the prospects were ‘‘bleak’'.
The collapse marks a replay of the embarrassing loss Trump and Republican leaders suffered in July, when the Senate rejected three attempts to pass legislation erasing Obama’s 2010 law.
The GOP has made promises to scrap the law a high-profile vow for years, and its failure to deliver despite controlling the White House and Congress - has infuriated conservatives whose votes Republican candidates need.
Republicans had pinned their last hopes on a measure by Senators Bill Cassidy of Louisiana and Lindsey Graham of South Carolina. It would end Obama’s Medicaid expansion and subsidies for consumers, and give the money - US$1.2 trillion through to 2026 - to states to use on health services, with few constraints.
With the GOP’s narrow 52-48 majority and solid Democratic opposition, three GOP ‘‘no’' votes would doom the bill. Republican Senators John McCain of Arizona, Rand Paul of Kentucky and Ted Cruz of Texas have said they oppose the measure, though Cruz’s aides said he was seeking changes that would let him vote yes.
Alaska Senator Lisa Murkowski remains undecided. She voted against the failed bills in July, and says she is analysing the new bill’s impact on her state, where medical costs are high.
The Senate must vote this week for Republicans to have any chance of prevailing with their narrow margin. Next Monday, protections expire against Democratic bill-killing delays that Republicans lack the votes to overcome.
It was unclear if Senate Majority Leader Mitch McConnell, of Kentucky, would hold a roll call. Thune said he believed McConnell could hold a vote if Republicans ‘‘have at least some hope that we would pass it’'.
Collins announced her decision shortly after the non-partisan Congressional Budget Office said ‘‘millions’' of Americans would lose coverage under the bill and projected that it would impose US$1t in Medicaid cuts through to 2026.
Desperate to win over reluctant senators, GOP leaders revised the measure several times, adding money on Monday for Alaska, Arizona, Maine, Kentucky and Texas, in a clear pitch for Republican holdouts. They also gave states the ability - without federal permission - to permit insurers to charge people with serious illnesses higher premiums and to sell low-premium policies with big coverage gaps and high deductibles.
Paul said the bill spent too much and that Republicans were motivated by fear of punishment by conservative voters if they failed.
‘‘It’s like a kidney stone. Pass it, pass it, pass it,’’ he said.
Loud protesters forced the Senate Finance Committee to briefly delay the chamber’s first and only hearing on the charged issue. Police dragged some demonstrators out of the hearing room and trundled out others in wheelchairs as scores chanted, ‘‘No cuts to Medicaid, save our liberty’'.
Trump yesterday took on McCain, who returned to the Senate after a brain cancer diagnosis in July to cast the key vote that wrecked the GOP’s effort. Trump called this ‘‘a tremendous slap in the face of the Republican Party’'.