Racing the clock on healthcare
Republicans feeling pressure on repeal and replace — not to mention on the rest of Trump’s agenda.
WASHINGTON — President Trump summoned Republican leaders to the White House on Tuesday to discuss his summer legislative agenda, but progress is being stalled by the GOP’s inability to fulfill its promise to repeal and replace Obamacare.
Lacking consensus over how to gut the Affordable Care Act without leaving millions more Americans uninsured — as the House GOP’s bill would do — Senate Republicans face a logjam that could imperil other priorities, such as tax reform and infrastructure.
This week was expected to be pivotal for the overhaul, which lawmakers hope to finish before the July 4 break in order to move to other issues like raising the debt ceiling to avoid defaulting on the nation’s bills.
But senators emerged from closed-door meetings Tuesday no closer to an agreement than they have been after weeks of talks.
“The areas we have consensus on? Let’s see, Obamacare sucks,” said Sen. John Kennedy (R-La.). “We may be working on this for a while.”
That echoed recent comments from Senate Majority Leader Mitch McConnell and others. Some speculate leaders may be tempted to call a Senate vote on the bill even if they know it will fail, simply to move the issue off their plate for now.
Trump emphasized the importance of a healthcare vote in a talk with House Speaker Paul D. Ryan, McConnell and other leaders. “At the core of this agenda is repealing and replacing the disaster known as Obamacare,” said Trump, who dined later Tuesday with House and Senate Republicans. He praised the House bill as a good first step. “Now the Senate, I’m sure, will follow suit and get a bill across the finish line this summer.”
But the GOP is staring down a calendar with little to show for its hold on the House, Senate and White House. Usually the first six months of a presidency — especially with a Congress controlled by the same party — are prime time for legislating before the midterm campaign.
But this year is an exception, thanks in part to Trump’s unusual leadership style and the inquiry into his campaign’s potential ties with Russia in the 2016 election. His shifting positions have Ryan and McConnell struggling to lead the party in a coherent strategy.
The White House acknowledged that the Russia investigation had taken a toll. Questions swirl almost daily with developments on Capitol Hill, and more are expected this week when fired FBI Director James B. Comey testifies before the Senate Intelligence Committee.
“There’s no doubt that keeping members focused on investigations detracts from our legislative agenda and detracts from what we’re trying to deliver,” Marc Short, White House legislative director, said in a call with reporters this week.
The crux of the stalemate is the GOP’s inability to deliver on its healthcare vow. Though Ryan ushered the House GOP’s healthcare bill through in May, Senate Republicans dismissed it, in part because it could leave 23 million more Americans without insurance.
In trying to build their own bill, McConnell has jettisoned the traditional process of committee hearings and expert testimony in favor of closed-door meetings among key senators.
Some, including Sen. Ted Cruz of Texas, praise this strategy. “One of the most encouraging aspects of these discussions is they have not been litigated in the press,” he told reporters Tuesday.
But others say a more open process, including one that doesn’t rely on a procedural maneuver that will allow simple majority passage without any need to build bipartisan consensus with Democratic votes, would have been more productive.
“This is a really big mess, and a very complex system, and so you don’t do that in a couple of weeks,” said Sen. Ron Johnson (R-Wis.), who expects his party will need a stopgap measure to stabilize insurance markets while they work on a broader overhaul.
Senate Republicans face a series of difficult decisions, including how to protect older, sicker and lower-income consumers who would see huge insurance premium hikes under the House bill.
But no issue has proved more challenging than Medicaid, the 52-year-old plan for the poor that is a pillar of Obamacare’s coverage expansion.
While many Republicans have long pledged to cut Medicaid, they are now reluctant to undo the program that provides coverage to more than 70 million low-income Americans.
The House bill would slash more than $800 billion in federal Medicaid spending in the next decade, rolling back the expansion and capping future aid to states.
But those cuts — decried by major physician and patient groups — make some key GOP senators uncomfortable, including lawmakers from states that have expanded Medicaid, such as Nevada and Arizona.
Sen. John Barrasso (RWyo.) said senators were considering taking longer to cut Medicaid than the House bill, delaying reductions until after 2020 — and the next presidential election.
If McConnell cannot bridge the Medicaid divide, he may have to refocus efforts on limited legislation to rescue insurance markets that have been battered by the political turmoil.
A growing number of insurers are leaving Obamacare markets or proposing steep premium increases, partly because of the law’s weaknesses but also because the Trump administration refuses to commit to steps to keep them operating, such as enforcing a penalty on people who don’t get insurance and providing aid to low-income consumers.
That is becoming a growing problem for Republican lawmakers, as polls indicate Americans increasingly hold the GOP responsible for insurance markets’ fate.
House Minority Leader Nancy Pelosi said Tuesday that Trump was “sabotaging” the healthcare law.
“The Affordable Care Act is the law of the land,” Pelosi said on CNN. “The president should be honoring the law of the land and funding it…. If the rates go up, that’s at his doorstep.”
SENATE MAJORITY LEADER Mitch McConnell of Kentucky, left, and President Trump take their seats as GOP congressional leaders meet at the White House to discuss the president’s legislative agenda.