MANY STAKEHOLDERS OPPOSE PROPOSAL
affect my state, that are peculiar to my state,” Cassidy said on CBS’ “Face the Nation.”
The bill was drafted in secret, mainly by the Senate majority leader, Mitch Mcconnell of Kentucky, who unveiled it Thursday. Mcconnell wants a vote this week, before lawmakers take a break for the July 4 holiday.
Sen. Jerry Moran of Kansas, usually a reliable vote for Senate Republican leaders, said on Fox News, “I just don’t know whether the votes will be there by the end of the week.”
Over the weekend, senators and their aides were poring over the bill, drafting possible amendments, preparing speeches and compiling personal stories from constituents whom they portrayed as either beneficiaries or victims of the Affordable Care Act.
But the bill’s supporters were battling an internal threat: reluctant Republicans. Sen. Ron Johnson of Wisconsin said Sunday that “there’s no way we should be voting” on the legislation this week. “No way.
“I have a hard time believing Wisconsin constituents or even myself will have enough time to properly evaluate this for me to vote for a motion to proceed,” Johnson said on NBC’S “Meet the Press.”
And Sen. Susan Collins, R-maine, said on ABC’S “This Week”: “It’s hard for me to see the bill passing this week, but that’s up to the majority leader. We could well be in all night a couple of nights.”
The U.S. Chamber of Commerce, the National Federation of Independent Business and the National Retail Federation have all said they support the bill. Thomas J. Donohue, president of the Chamber of Commerce, said it would “help stabilize crumbling insurance markets” and eliminate “ill-conceived Washington mandates and taxes.”
But much of the nation’s $3 trillion health care industry opposes the bill. And Mcconnell has done little to woo the health care stakeholders whom President Barack Obama courted assiduously from his first months in office.
The concerns expressed by outside groups also appear to be growing. Top lieutenants in Charles G. and David H. Koch’s political network sharply criticized the legislation over the weekend, saying it was insufficiently conservative and did not do enough to rein in the growth of Medicaid. And a number of Republican governors have joined doctors, hospitals and patient advocacy groups in opposing the bill, in part because of its cuts to Medicaid.
Mcconnell has only a few days to wheel, deal and cajole reluctant senators to get behind legislation that has grown less popular with more exposure. He has considerable firepower to win votes by guaranteeing amendments that would address the concerns of individual Republican senators, and by playing on their loyalty to him and to conservative voters still demanding an end to the Affordable Care Act. At the same time, Democrats say, he has striking liabilities. Trump has endorsed the bill, and Democrats say they will take every opportunity to link the legislation to an unpopular president.
And the Democratic wall of opposition is backed by less partisan voices. Senators are being flooded with appeals like this from the advocacy arm of the American Cancer Society: “Cancer is scary enough. Don’t take away our coverage.”
The American Childhood Cancer Organization, a charitable group formed by parents, is mobilizing a small army of grassroots lobbyists with the message that the bill, with its deep cuts to Medicaid, “will threaten the lives of children battling cancer.”
The U.S. Conference of Catholic Bishops said the Senate bill was “unacceptable as written” and would “wreak havoc on low-income families.” At the same time, the bishops said they liked two sections that seek to “prohibit the use of taxpayer funds to pay for abortion or plans that cover it.”
Five Republican senators have announced that they cannot support the bill as drafted: Dean Heller of Nevada, who says it cuts coverage too deeply, and four conservatives — Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Johnson — who say it does not do enough to lower health costs. Other Republicans, like Collins and Sen. Lisa Murkowski of Alaska, have expressed misgivings, and Sen. Ben Sasse of Nebraska declined to say Sunday how he would vote.
Senate leaders, trying to muster support, are looking for ways to address a conspicuous omission: The bill requires insurers to accept anyone who applies, but repeals the mandate for people to have coverage and does not replace it with anything. So people could wait and buy insurance only when they need it. Insurers say they need large numbers of healthy people to help pay for those who are sick.
Republicans said they might revise their bill to establish a sixmonth waiting period for people who go without insurance and then want to sign up, in the belief that this would encourage consumers to maintain continuous coverage.
The House bill has an incentive, imposing a 30 percent surcharge on premiums for people who have gone without insurance. But the Congressional Budget Office said this provision could backfire. As a result of the surcharge, it said, 2 million fewer people would enroll, and the people most likely to be deterred are those who are healthy.
The Senate’s answer also has potential problems. For someone with cancer, a six-month waiting period could be a death sentence.
The Senate fight is happening amid a striking shift in public opinion. Fifty-one percent of Americans now have favorable views of the Affordable Care Act, according to a monthly tracking poll by the Kaiser Family Foundation. “That’s the first time in our 79 tracking polls over seven years that this share has topped 50 percent,” said Craig Palosky, a spokesman for the foundation.