Health care bill vote de­layed; McCain ill

Top Trump ad­min­is­tra­tors woo gov­er­nors


PHOENIX — Se­nate Ma­jor­ity Leader Mitch McCon­nell an­nounced Satur­day night that he will post­pone con­sid­er­a­tion of the Se­nate’s health care leg­is­la­tion while Sen. John McCain re­cov­ers from surgery for a blood clot.

The an­nounce­ment came as Pres­i­dent Don­ald Trump’s ad­min­is­tra­tion strug­gled Satur­day to raise sup­port from U.S. gov­er­nors for the re­vised health care bill.

Doc­tors at Phoenix’s Mayo Clinic Hos­pi­tal said McCain un­der­went a “min­i­mally in­va­sive” pro­ce­dure Fri­day to re­move the nearly 2-inch blood clot above his left eye. Doc­tors said in a statement that the surgery went “very well.”

McCain was ad­vised by doc­tors to re­main in Ari­zona this week, his of­fice said.

“While John is re­cov­er­ing, the Se­nate will con­tinue our work on leg­isla­tive items and nom­i­na­tions, and will de­fer con­sid­er­a­tion of the Bet­ter Care Act,” McCon­nell, R-Ky., said in a statement Satur­day. A pro­ce­dural vote orig­i­nally had been ex­pected in the com­ing days.

A close vote al­ready had been pre­dicted for the GOP health care bill, with all Democrats and in­de­pen­dents

com­ing out against it and some Repub­li­cans op­posed or un­de­cided. With the GOP hold­ing a 52-48 ma­jor­ity, the party can af­ford to lose only two mem­bers. Vice Pres­i­dent Mike Pence would break a tie for fi­nal pas­sage.

Two Repub­li­cans, Rand Paul of Ken­tucky and Su­san Collins of Maine, have al­ready said they’ll vote against the mea­sure, leav­ing McCon­nell with no mar­gin of er­ror.

McCon­nell and other GOP lead­ers have been urg­ing sen­a­tors to at least vote in fa­vor of open­ing de­bate, which would al­low sen­a­tors to of­fer amend­ments.


Be­fore McCon­nell’s an­nounce­ment, Health and Hu­man Ser­vices Sec­re­tary Tom Price and Cen­ters for Medi­care and Med­i­caid Ser­vices Ad­min­is­tra­tor Seema Verma made the ad­min­is­tra­tion’s pitch Satur­day morn­ing dur­ing a closed meet­ing of the Na­tional Gov­er­nors As­so­ci­a­tion.

The White House is at­tempt­ing to win over gov­er­nors, es­pe­cially Repub­li­cans who ex­panded Med­i­caid in their states. Some of those gov­er­nors are con­cerned about cuts to Med­i­caid and what they see as shift­ing costs for the pro­gram.

Arkansas Gov. Asa Hutchin­son, a Repub­li­can, said he thinks the bill has been im­proved from an ear­lier ver­sion, with $70 bil­lion added to help sta­bi­lize health in­sur­ance ex­changes and with grants to help peo­ple tran­si­tion from Med­i­caid to pri­vate in­sur­ance. He said he’s “open” to the bill but is wait­ing for the fi­nal ver­sion.

“The bill that we’re look­ing at to­day is prob­a­bly not the bill that’s ac­tu­ally go­ing to be voted on,” Hutchin­son told re­porters af­ter meet­ing with Price and Verma. “Our job is to in­flu­ence the di­rec­tion of that and try to make the im­prove­ments that work for the states.”

Ne­vada Gov. Brian San­doval, one of the bill’s most prom­i­nent Repub­li­can skep­tics, said Satur­day that it’s un­likely the ad­min­is­tra­tion has changed any­one’s mind about the plan to re­place the Pa­tient Pro­tec­tion and Af­ford­able Care Act.

“I am strug­gling to val­i­date the num­bers that are be­ing pre­sented to me by the ad­min­is­tra­tion, ver­sus what I’m hear­ing from in­de­pen­dent [ex­perts], what I’ll likely hear from the [Con­gres­sional Bud­get Of­fice], what I’m hear­ing from back home,” San­doval

said af­ter the meet­ing Satur­day.

San­doval has ex­pressed con­cern about the leg­is­la­tion’s cuts to the Med­i­caid pro­gram for the poor and dis­abled. His po­si­tion is im­por­tant be­cause of the pres­sure he could place on Ne­vada’s Repub­li­can U.S. Sen. Dean Heller, a pos­si­ble swing vote on the mea­sure.

San­doval said “Sen. Heller’s his own man,” but he’s try­ing to give Heller the best in­for­ma­tion about how the leg­is­la­tion would af­fect their state.

“He’s the United States sen­a­tor. At the end of the day, he’s the one who pushes the but­ton,” San­doval said. “I’m go­ing to in­form him about how I feel about the bill.”

Con­necti­cut Gov. Dan­nel Mal­loy, chair­man of the Demo­cratic Gov­er­nors As­so­ci­a­tion, said the mood at the Satur­day break­fast meet­ing was “tense” and that “there are a lot of Repub­li­can gov­er­nors who ap­par­ently have a neck prob­lem, be­cause they were all look­ing down.”

Mal­loy said a few Repub­li­can gov­er­nors did ask ques­tions. Others said they raised their con­cerns with the White House in one-on-one meet­ings.

Pence met sev­eral of the gov­er­nors pri­vately af­ter his pub­lic ad­dress at the Rhode Is­land con­fer­ence Fri­day.

A for­mer In­di­ana gov­er­nor who ex­panded Med­i­caid in his state, Pence ac­knowl­edged in Fri­day’s speech the con­cerns that gov­er­nors of both par­ties have raised about the pro­posed cuts to Med­i­caid. He said the Se­nate mea­sure would re­store Med­i­caid to its orig­i­nal pur­pose of help­ing the poor and dis­abled while giv­ing states the flex­i­bil­ity to ad­min­is­ter the aid prop­erly.

Par­tic­i­pants said Satur­day’s meet­ing in­cluded an ap­peal from Demo­cratic Sen. Tom Carper, who is a for­mer gov­er­nor of Delaware, ask­ing the Trump ad­min­is­tra­tion to put the de­bate on hold and look for a bi­par­ti­san so­lu­tion.

“We don’t need a Demo­cratic vic­tory, we don’t need a Repub­li­can vic­tory here, we don’t need a vic­tory for the pres­i­dent,” Carper told re­porters. “We need a vic­tory for our coun­try and for 50 states, and the voices of the gov­er­nors is crit­i­cal.”


The ef­fort to as­suage gov­er­nors’ con­cerns comes as two of the in­sur­ance in­dus­try’s most pow­er­ful or­ga­ni­za­tions say a pro­vi­sion in the Se­nate bill al­low­ing the sale of bare­bones poli­cies is “un­work­able in any form.”

The lan­guage was crafted by U.S. Sen. Ted Cruz, R-Texas, and lead­ers have in­cluded it in the over­all bill in hopes of win­ning votes from con­ser­va­tives. But mod­er­ates have wor­ried that it will cause peo­ple with se­ri­ous ill­nesses to lose cov­er­age, and some con­ser­va­tives say it doesn’t go far enough.

The crit­i­cism of Cruz’s pro­vi­sion was lodged in a rare joint statement by Amer­ica’s Health Care Plans and the BlueCross BlueShield As­so­ci­a­tion. The two groups re­leased it late Fri­day in the form of a let­ter to McCon­nell.

“It is sim­ply un­work­able in any form,” the let­ter said. The groups said it would “un­der­mine pro­tec­tions for those with pre-ex­ist­ing med­i­cal con­di­tions,” in­crease pre­mi­ums and lead many to lose cov­er­age.

The pro­vi­sion would let in­sur­ers sell low-cost poli­cies with skimpy cov­er­age, as long as they also sell poli­cies that meet a strin­gent list of ser­vices they’re re­quired to pro­vide un­der the Af­ford­able Care Act, like men­tal health coun­sel­ing and pre­scrip­tion drugs.

Cruz said the pro­posal would drive down pre­mi­ums and give peo­ple the op­tion of buy­ing the cov­er­age they feel they need.

Crit­ics say the mea­sure would en­cour­age healthy peo­ple to buy the skimpy, low-cost plans, leav­ing sicker con­sumers to con­front un­af­ford­able costs.

The two groups say pre­mi­ums would “sky­rocket” for peo­ple with pre-ex­ist­ing con­di­tions, es­pe­cially for mid­dle-in­come fam­i­lies who don’t qual­ify for the bill’s tax cred­its. They also say the plan would leave con­sumers with fewer in­sur­ance op­tions, so “mil­lions of more in­di­vid­u­als will be­come unin­sured.”

The bill pro­vides $70 bil­lion for states to use to help con­tain ris­ing costs for peo­ple with se­ri­ous con­di­tions. But the in­sur­ance groups said that amount “is in­suf­fi­cient and ad­di­tional fund­ing will not make the pro­vi­sion work­able for con­sumers or tax­pay­ers.”

McCon­nell and other Repub­li­cans are con­sid­er­ing ways to re­vise the Cruz pro­vi­sion in hopes of win­ning broader sup­port.

The non­par­ti­san Con­gres­sional Bud­get Of­fice is ex­pected to re­lease its anal­y­sis of McCon­nell’s re­vised bill this week, in­clud­ing an as­sess­ment of Cruz’s plan.

The of­fice es­ti­mated that McCon­nell’s ini­tial bill would have caused 22 mil­lion ad­di­tional peo­ple to be unin­sured over the next 10 years.


Govs. Brian San­doval (left), a Ne­vada Repub­li­can, and Ter­ence McAuliffe, a Vir­ginia Demo­crat, at­tend the clos­ing ses­sion Satur­day of the Na­tional Gov­er­nors As­so­ci­a­tion meet­ing in Providence, R.I. The na­tion’s health care sys­tem was front and cen­ter at this sum­mer’s ses­sion.

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