Fears slow GOP health care effort
Speaker tries to ease concerns over fate of latest bill.
Three WASHINGTON — Republican senators on Thursday threatened to hold up health legislation in the Senate unless they got assurances from House Speaker Paul Ryan that the House would negotiate a more comprehensive replacement to so-called “Obamacare” and not vote to make the Senate bill law.
Ryan responded that “the House is willing” to convene a conference committee with the Senate to craft compromise legislation. But two of the senators, John McCain of Arizona and Lindsey Graham of South Carolina, said that wasn’t enough of an assurance, leaving health legislation in limbo once again at a crucial moment.
The convoluted developments played out as the Senate debated legislation to repeal and replace former President Barack Obama’s Affordable Care Act. With Democrats unanimously opposed, the slender GOP majority was divided among itself over what it could agree to.
After a comprehensive bill failed on the Senate floor, and a straight-up repeal failed too, Majority Leader Mitch McConnell and his top lieutenants turned toward a lowest-common-denominator solution known as “skinny repeal.” It would repeal a few of the most unpopular pieces of the 2010 law, along with a few other measures, with the goal of getting something — anything — out of the seemingly paralyzed Senate.
That would be the ticket to negotiations with the House, which passed its own legislation in May.
But that plan caused consternation among GOP senators after rumors began to surface that the House might just pass the “skinny bill,” call it a day and move on to other issues like tax reform after frittering away the first six months of Donald Trump’s presidency on unsuccessful efforts over health care.
McCain, Graham and Sen. Ron Johnson of Wisconsin held a news conference to announce they would oppose the “skinny bill” unless they got a guarantee from Ryan that the House would not pass it, and instead would agree to a conference committee to negotiate a broader bill.
With at least 50 votes of the 52-member Republican majority needed to advance the measure — along with a tie-breaking vote by Vice President Mike Pence — the three senators, or just two of them, collectively could sink the GOP plan.
The senators were unsparing in their criticism of the “skinny repeal” bill. It would end the ACA mandates that most individuals have health insurance and large employers cover their employees but leave most of the health law in place.
Such a bill would crater the health insurance market and send premiums skyward, the senators said.
“The skinny bill as policy is a disaster,” Graham said. “The skinny bill as a replacement for Obamacare is a fraud.”
He also said that passing it would be “the dumbest thing in history.”
Johnson said the bill would betray Republican pledges to replace the ACA with a better law.
“The skinny bill in the Senate doesn’t come close to meeting our promises,” he said.
But the three senators expressed concern that House Republican leaders could just take the stripped-down bill, pass it and send it to President Donald Trump for his signature.
“Right now, I am voting no,” McCain said. Graham was emphatic. “I need assurances from the speaker of the House and his team that if I vote for the skinny bill, then it will not be the final product,” Graham said. “I’m not going to vote for a pig in a poke.”
Ryan responded not long after with a discursive and far-from-definitive statement that blamed the Senate for being unable to pass anything, but said, “if moving forward requires a conference committee, that is something the House is willing to do.”
“The reality, however, is that repealing and replacing Obamacare still ultimately requires the Senate to produce 51 votes for an actual plan,” he said.
McCain and Graham, however, insisted on a guarantee that the bill would go to conference.
The back-and-forth played out as the Senate prepared for a bizarre Capitol Hill ritual, a “vote-a-rama” on amendments that promised to last into the wee hours of this morning — at the end of which, the path ahead would perhaps be clearer.
Even if Republicans succeed in passing a bill this week — and start negotiations with the House — they will face significant obstacles in accomplishing anything more substantial.