Baltimore Sun

HEALTH CARE:

With vote deferred and CBO review held up, Ky. senator among those fearing opposition

- By Elise Viebeck

The Senate delayed a highly anticipate­d vote to repeal and replace the Affordable Care Act after Sen. John McCain's announced absence due to surgery, an enormous setback as time dwindles for Republican­s to pass their signature legislatio­n.

WASHINGTON — Republican critics of the Senate’s latest version of health care legislatio­n were energized after leaders postponed votes on the measure, yet another sign the bill’s fortunes are in limbo.

A vocal conservati­ve opponent of the measure, Sen. Rand Paul, predicted the delay would strengthen critics’ position by giving them more time to mobilize against the bill.

“The longer the bill is out there, the more conservati­ve Republican­s are going to discover it is not repeal,” Paul, R-Ky., said Sunday in an interview with CBS’ “Face the Nation.”

Paul said he spoke with President Donald Trump on Friday and suggested the president support repealing the Affordable Care Act and deciding the details of a replacemen­t plan later if the latest version of the bill does not pass.

Trump did not comment on health care over the weekend. The lack of response from Trump came after Sen. John Mc- Cain, R-Ariz., announced Saturday he is recovering from a surgery and would be absent from votes, depriving Republican­s of the support they need to advance the legislatio­n. The developmen­t temporaril­y dashed Senate Majority Leader Mitch McConnell’s hopes of wrapping up the health care debate by passing a reworked version of the Better Care Reconcilia­tion Act this week.

Adding to the uncertaint­y, the Congressio­nal Budget Office indicated on Sunday it no longer expected to release its analysis on Monday on the estimated cost and scope of insurance coverage under the latest GOP bill. The report is expected Tuesday or later in the week.

The White House also was largely silent about health care over the weekend. “We wish Senator McCain a speedy recovery,” Helen Ferre, White House director of media affairs, told reporters Sunday when asked about the Senate delay.

The bill experience­d a separate blow on Friday and Saturday at a conference of governors in Provi- dence, R.I., where Trump administra­tion officials failed to gain support from influentia­l Republican­s such as Nevada Gov. Brian Sandoval. Opposition from Sandoval and others will make it easier for undecided Republican senators from those states to vote “no” on the bill.

These setbacks are the latest in the GOP’s struggle to enact a bill to replace the Affordable Care Act and fulfill a campaign promise central to the party’s message over the past seven years. Despite unified control of Congress and Trump in the White House, disagreeme­nts within the GOP still threaten to cripple its effort to overhaul the health-care system.

The difficult political calculus facing Republican­s was clear in a new poll released Sunday showing the public prefers the Affordable Care Act to the Republican health care plan by a roughly 2-to-1 margin. Among Republican­s, 59 percent preferred the GOP plan, compared with 11 percent who preferred the current law.

The same poll, conducted by The Washington Post and ABC News, found 63 percent believe it is more important for the government to provide health coverage to lowincome people compared with cutting taxes (27 per- cent). Among Republican­s, 48 percent favored cutting taxes, compared with 39 percent who favored providing health coverage for low-income people.

The bill’s dramatic cuts to the Medicaid program are a significan­t concern for governors such as Sandoval and moderate senators such as Susan Collins, R-Maine.

Vice President Mike Pence and other administra­tion officials sought to allay these fears on Friday and Saturday by arguing that the health care bill shores up Medicaid’s finances to preserve the program for the future. They also downplayed the possible effects of the cuts.

“President Trump and I believe the Senate health care bill strengthen­s and secures Medicaid for the neediest in our society,” Pence said in a speech to governors on Friday. “And this bill puts this vital American program on a path to long-term sustainabi­lity.”

Collins strongly disagreed in an interview Sunday with CNN.

“You can’t take more than $700 billion out of the Medicaid program and not think that it’s going to have some kind of effect,” she said on “State of the Union.”

“This bill imposes fundamenta­l, sweeping changes in the Medicaid program, and those include very deep cuts that would affect some of the most vulnerable people in our society, including disabled children and poor seniors. It would affect our rural hospitals and our nursing homes, and they would have a very hard time even staying in existence.”

Pence’s speech was criticized by Democrats, health care advocates and even some Republican­s for mischaract­erizing the possible ramificati­ons of the GOP bill.

During the same speech, the vice president went after Ohio Gov. John Kasich, a Republican and critic of the legislatio­n, by suggesting his state’s expansion of Medicaid left nearly 60,000 residents with disabiliti­es “stuck on waiting lists, leaving them without the care they need for months or even years.”

Collins estimated Sunday that there are eight to 10 Republican senators with “serious concerns” about the bill. “At the end of the day, I don’t know whether it will pass,” she said.

 ?? J. SCOTT APPLEWHITE/AP ?? Rand Paul, R-Ky., says “the longer the bill is out there,” the more conservati­ves “are going to discover it is not repeal.”
J. SCOTT APPLEWHITE/AP Rand Paul, R-Ky., says “the longer the bill is out there,” the more conservati­ves “are going to discover it is not repeal.”

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